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Pharmacology > Chp 18 Adrenergic Drugs > Flashcards

Chp 18 Adrenergic Drugs Flashcards

1
Q

Adrenergic agonists

A

Drugs that stimulate and mimic the actions of the sympathetic nervous system (sympathomimetics)

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2
Q

Catecholamines

A

Substances that can produce a sympathomimetic response. They are either endogenous catecholamines (such as epinephrine, norepinephrine, and dopamine) or synthetic catecholamine drugs (such as dobutamine and phenylephrine).

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3
Q

Adrenergic receptors

A

receptor sites (located throughout the body) for the sympathetic neurotransmitters norepinephrine and epinephrine

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4
Q

What three classes are adrenergic receptors divided into?

A

Alpha-adrenergic receptors
Beta-adrenergic receptors
Dopaminergic receptors

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5
Q

Alpha-adrenergic receptors

A

A type of adrenergic receptors that are further broken down into alpha1 and alpha2 adrenergic receptors which are differentiated by their location on nerves

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6
Q

Where are alpha1 receptors located?

A

on postsynaptic effector cells (the tissue, muscle, or organ that the nerve stimulates

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7
Q

Where are alpha2 receptors located?

A

on the presynaptic nerve terminals

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8
Q

What d alpha2 receptors control?

A

the release of neurotransmitters

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9
Q

Beta-adrenergic receptors

A

receptors located on postsynaptic cells that are stimulated by specific autonomic nerve fibers. (also broken down into beta1 and beta2)

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10
Q

Where are beta1 receptors located?

A

primarily in the heart

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11
Q

Where are beta2 receptors located?

A

in the smooth muscle fibers of the bronchioles, arterioles, and visceral organs.

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12
Q

Dopaminergic receptor

A

a type of adrenergic receptor located in various tissues and organs and activated by the binding of the neurotransmitter dopamine, which can be either endogenous or a synthetic drug form. (Respond only to dopamine)

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13
Q

What are the alpha-adrenergic agonist responses?

A
  • Vasoconstriction

- CNS stimulation

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14
Q

What are the Beta-adrenergic agonist responses?

A
  • Bronchial, GI, and uterine smooth muscle relaxation
  • Glycogenolysis
  • Cardiac stimulation
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15
Q

What do dopaminergic receptors do?

A

Causes dilation of the following blood vessels, resulting in increased blood flow: renal, mesenteric, coronary, cerebral

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16
Q

What are the three ways in which catecholamine drugs can induce a response?

A
  1. direct stimulation
  2. indirect stimulation
  3. Mixed-acting (combination of direct and indirect)
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17
Q

How do direct-acting sympathomimetic drugs work?

A

by binding directly to the receptor and causing a physiologic repsonse

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18
Q

How do indirect-acting sympathomimetic drugs work?

A

by causing a release of catecholamine from storage sites in nerve ending and then binding to receptors causing a physiologic response

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19
Q

How do mixed-acting sympathomimetic drugs work?

A

by directly stimulating the receptor by binding to it AND indirectly stimulating the receptor by causing the release of stored neurotransmitters from vesicles in the nerve endings.

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20
Q

What does stimulation of alpha-adrenergic receptors on smooth muscles result in?

A
  • Vasoconstriction of blood vessels
  • Relaxation of GI smooth muscles (decreased motility)
  • Constriction of bladder sphincter
  • Contraction of uterus
  • Male ejaculation
  • Contraction of pupillary muscles of the eye (dilated pupils)
21
Q

What does cardiac stimulation of beta1-adrenergic receptors on the myocardium, atrioventricular (AV) node, and sinoatrial (SA) node result in?

A
  • Increased force of contraction (positive inotropic effect)
  • Increased heart rate (positive chronotropic effect)
  • Increased conduction through AV node (positive dromotropic effect)
22
Q

What does stimulation of beta2-adrenergic receptors on the airways result in?

A

Bronchodilation (relaxation of the bronchi)

23
Q

What are some other effects of beta2-adrenergic stimulation?

A
  • Uterine relaxation
  • Glycogenolysis in the liver
  • Increased renin secretion in the kidneys
  • Relaxation of GI smooth muscles (decreased motility)
24
Q

What are some examples of respiratory conditions that adrenergics are used to treat?

A

asthma and bronchitis (premature labor)

25
Q

What is albuerol used for?

A

acute bronchospasms

26
Q

What is salmeterol used for?

A

prevention of bronchospasms NOT management of acute symptoms

27
Q

What is advair diskus used for?

A

daily maintenance of bronchospasms

28
Q

What nasal condition do adrenergics treat and how?

A

congestion - causes constriction of dilated arterioles and reduction of nasal blood flow, thus decreasing congestion

29
Q

What are some medication examples of adrenergics that treat nasal congestion?

A

ephedrine, naphazoline, oxymetazoline, pheylephrine, and tetrahydozoline

30
Q

What are some ophthalmic conditions that adrenergics treat?

A
  • Temporary relief of conjunctival congestion

- Reduction of intraocular pressure and dilation of pupils: treatment of open-angle glaucoma.

31
Q

What are vasoactive adrenergics used for?

A

to support the heart during cardiac failure or shock

also called cardioselective sympathomimetics

32
Q

What are some common vasoactive sympathomimetic drugs?

A 
dobutamine
dopamine
ephedrine
epinephrine
fenoldopam
phenylephrine
midodrine
norepinephrine
33
Q

What adverse affect may happen when using an intravenous solution containing an adrenergic drug lead to?

A

infiltration of the solution leading to necrosis from excessive vasoconstriction around the intravenous site.

34
Q

What is phentolamine often used for?

A

the treatment of infiltration

35
Q

infiltration

A

the diffusion or accumulation (in a tissue or cells) of foreign substances or in amounts in excess of the normal. The material collected in those tissues or cells is called infiltrate.

36
Q

What are the CNS adverse effects of alpha-adrenergics that can happen?

A

headache, restlessness, excitement, insomnia, euphoria

37
Q

What are the cardiovascular adverse effects of alpha-adrenergics that can happen?

A

palpitations, tachycardia, vasoconstriction, hypertension

38
Q

What are some miscellaneous adverse effects of alpha-adrenergics that can happen?

A

loss of appetite, dry mouth, nausea, vomiting, taste changes

39
Q

What are the CNS adverse effects of beta-adrenergics that can happen?

A

mild tremors, headache, nervousness, dizziness

40
Q

What are the cardiovascular adverse effects of beta-adrenergics that can happen?

A

increased heart rate, palpitations, fluctuations in BP

41
Q

What are some miscellaneous adverse effects of beta-adrenergics that can happen?

A

sweating, nausea, vomiting, muscle cramps

42
Q

What are the drugs that can interact with adrenergics?

A 
Anesthetic drugs
Tricyclic antidepressants
MAOIs
Antihistamines
Thyroid preparation
43
Q

What do adrenergic antagonist do to adrenergics?

A

directly anatgonize each other, resulting in reduced effects

44
Q

What are the nursing implications when intravenously administering adrenergics?

A
  • Check IV site often for infiltration
  • use clear IV solutions
  • Use an infusion pump
  • infuse drug slowly to avoid dangerous cardiovascular effects
  • monitor cardiac rhythm
45
Q

What are the nursing implications when administering adrenergics to a patient with chronic lung disease?

A
  • instruct patient to avoid factors that exacerbate their condition
  • encourage fluid intake (up to 3000 mL/day if permitted
  • educate patients about proper dosing, use of equipment, and equipment care
46
Q

What should a nurse’s immediate assessment priority be when administering a nebulizer treatment with albuterol?

A

Monitor SpO2 with a pulse oximeter

47
Q

What can happen if you administer two adrenergic drugs together?

A

it may precipitate severe cardovascular effects such as tachycardia or hypertension

48
Q

What therapeutic effects should you monitor for when administering adrenergics for cardiovascular purposes?

A
  • decreased edema
  • increased urinary output
  • return to normal vital signs
  • improved skin color
  • increased LOC (loss of consciousness)
49
Q

What therapeutic effects should you monitor for when administering adrenergics for asthma purposes?

A
  • return to normal respiratory rate
  • improved breathing sounds, fewer crackles
  • increased air exchange
  • decreased cough
  • less dyspnea
  • improved blood gases
  • increased activity tolerance

Pharmacology (12 decks)

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