Chapters 15, 16 Flashcards
Which sympathomimetic cant be administered orally due to rapid metabolism from the GI tract and liver?
epinephrine
What is an expected adverse reaction from epinephrine
tachycardia and palpitations. the sympathetic nervous system is being activated, so while this is ad adverse effect, it is expected and should be communicated to your patient
Which enzymes deactivate norepinephrine
monoamine oxidase (MAO) and COMT
What are important points of education to provide to your patient who has been diagnosed with hypertension, and will be starting an anti-hypertensive?
- check BP before each dose and monitor your trend
- do not suddenly stop med
- rise slowly
What is the neurotransmitter for the parasympathetic nervous system?
ACH
What is the neurotransmitter for the sympathetic nervous system
norepinephrine
This central-acting alpha agonist is selective to alpha 2 and can cause rebound hypertension if stopped abruptly
clonidine
Why do you want to assess your patient’s heart rate before administering albuterol
this is a sympathomimetic, so while this will dilate the bronchioles, it will increase heart rate, too. if the patient is already tachycardic, this can be problematic
Why is it important to know if the beta blocker you are administering is selective or non-selective?
if it is non-selective, that means we are blocking beta systemically, instead of a target organ. if your patient as COPD and you administer a non-selective beta blocker, this could cause respiratory distress
What are the 4 major responses to anticholinergics
- decreased GI motility - constipation
- pupillary dilation -difficulty seeing
- increased pulse rate
- decrease in salivation - dry mouth
If your parasympathetic response was initiated, what would your pupils do?
constrict
If your sympathetic response was initiated, what would your pupils do?
dilate
If you are taking an “olol” what category of drugs are you taking
beta blocker
Which medication would you anticipate administering to your patient with a severely low heart rate
atropine sulfate
what is essential to complete prior to administering atenolol
must check heart rate and BP.
what are the effects of cholinergic overdose
- dry as a bone
- mad as a hatter
- red as a beet
- blind as a bat
if your parasympathetic response was initiated, what would your heart do?
decrease
if your sympathetic response was initiated, what would your heart rate do
increase
how do indirect-acting cholinergic agonists work
by inactivating cholinesterase resulting in an increase in circulating levels of acetylcholine
this drug works by reducing the sympathetic outflow from the central nervous system thereby causing vasodilation with resulting decrease in blood pressure
methyldopa
if beta 1 receptors are activated, what effects can you anticipate observing
- increased heart rate
2. increase force of contraction
what is a unique feature of catecholamines
- they cant cross BBB
- can’t be taken orally
- short duration of action
- can be endogenous or exogenous
what are the two divisions of the peripheral nervous system
somatic and autonomic
what comprises the central nervous system
brain and spinal cord
