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PN pharmacology > Drugs affecting the autonomic nervous system > Flashcards

Drugs affecting the autonomic nervous system Flashcards

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NCLEX-PN® flashcards
1
Q

Afferent nerves

A

(peripheral Nerves) conduct signals from sensory receptors (vision pressure pain etc) throughout the body to the Central nervous system.
TELLS THE BRAIN ITS HOT

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2
Q

Efferent Nerves

A

The CNS processes signals from the afferent nerves and sends signals back through the efferent nerves.
TELLS THE BODY TO MOVE AWAY FROM THE HEAT

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3
Q

The junction between one neuron and the next

A

synapse

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4
Q

The 2 major neurotransmitters of the autonomic nervous system

A

norepinephrine and acetycholine

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5
Q

the nerve endings that liberate acetycholine are called?

A

Cholinergic fibers

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6
Q

nerve endings that secrete norepinephrine are called

A

adrenergic fibers

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7
Q

Cholinergic agents (parasympthomimetic agents)

A

medications that cause effects in the body similar to those produced by acetycholine

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8
Q

adrenergic agents (sympathomimetic agents)

A

medications that cause effects similar to those produced by adrenergic neurotransmitter.

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9
Q

anticholingeric agents

A

agents that block or inhibit cholingeric activity

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10
Q

adrenergic blocking agents

A

inhibit the adrenergic system

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11
Q

2 classes of drugs that stimulate the adrenergic nervous system

A

catecholamines and noncatecholamines

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12
Q

the bodys naturally occuring neurotransmitter catecholamines

A

norepinephrine epinephrine, and dopamine

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13
Q

where does norepinephrine come from?

A

nerve terminals

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14
Q

where does epinephrine come from?

A

adreanal medulla

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15
Q

where is dopamine found?

A

selected sites in the brain, kidneys and GI tract.

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16
Q

what is the difference in catecholamines and noncatecholamines?

A

noncatecholamines are more selective for certain types of receptors, they are not quite as fast acting but they last longer.

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17
Q

how is the adrenergic side of the autonomic nervous system subdivided?

A

alpha receptors
beta receptors
dopaminergic receptors

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18
Q

what do alpha 1 receptors cause in general?

A

vasoconstriction

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19
Q

what do alpha 2 receptors do?

A

serve as mediators of negative feedback, preventing the further release of norpeinephrine.

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20
Q

what does stimulation of beta 1 receptors do?

A

increase heart rate

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21
Q

what does stimulation of beta 2 receptors do?

A

causes bronchodilation, uterine relaxation, and vasodilation (peripheral arterial blood vessels)

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22
Q

what improves the symptoms associated with Parkinson’s?

A

stimulation of the dopaminergic receptors in the brain.

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23
Q

what increases urine output as a result of the stimulation of specific receptors in the kidneys that result in better renal profusion?

A

dopamine

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24
Q

what patients are more sensitive to adrenergic agents?

A

those with impaired hepatic function, thyroid disease, hypertension and heart disease.

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25
Q

how do adrenergic agents affect people with diabetes?

A

they may have increased frequency of hyperglycemic episodes.

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26
Q

common cardiovascular adverse effects of adrenergic agents

A

palpatations, tachycardia, skin flushing, dizziness, tremors.
usually mild and tend to resolve with continued therapy
encourage not to discontinue therapy w/o talking with provider
may also cause orthostatic hypotention; teach to rise slowly, and sit or lie down when feeling faint

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27
Q

Serious adverse cardiovascular effects of adrenergic agents

A

dysrhthmias, chest pain, severe hypotension, hypertension, anginal pain: discontinue therapy immediately and notify DR. ; ask pt. if there has been change in regimen of medication, OTC or herbal supplements

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28
Q

Serious GI adverse effects

A

nausea, vomiting: notify provider, inquire about med changes including OTC and herbal supplements

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29
Q

Drug interactions for adrenergic agents

A

MAOI (phenelzine, tranylcyromine) tricyclic antidepressants(amitriptyline, imipramine) atropine and halothane anesthesia may increase both therapeutic and toxic effect.
OTC meds contain adrenergic medications that can have an additive effect.

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30
Q

what do you monitor for in patients taking adrenergic agents with possible drug interaction?

A

tachycardia, serious dysrhythmias, hypotension, hypertension and chest pain.

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31
Q

albuterol (Proventil Ventolin, Proair, Pro Air Respiclick

A

adrenergic agent works on B2 receptor
ACTION: bronchodilator
CLINICAL USE: asthma or emphysema

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32
Q

arformoterol (Brovana)

A

adrenergic agent; works on B2 receptor
ACTION: Bronchodilator
CLINICAL USE: emphysema, chronic bronchitis

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33
Q

dobutamine

A

adrenergic agent, works on B1 receptor,
ACTION: cardiac stimulant
CLINICAL USE inotropic agent

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34
Q

dopamine

A

adrenergic agent; works on alpha, B1&dopaminergic
ACTION: vasopressor
CLINICAL USE: shock, hypotension, inotropic agent

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35
Q

ephedrine (Akovaz)

A

works on Alpha and Beta
ACTION: vasoconstrictor
CLINICAL USE: anesthesia-induced hypotension

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36
Q

epinepharine (Adrenalin)

A

works on alpha and beta
ACTION: allergic reactions, vasoconstrictor, bronchodilator, cardiac stimulant.
CLINICAL USES: anaphylaxis, cardiac arrest, topical vasoconstrictor

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37
Q

formoterol (Perforomis, Oxeze)

A

work on B2
ACTION: bronchodilator
CLINICAL USES: asthma, emphysema, chronic bronchitis

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38
Q

indacaterol

Arcapta Neohaler; Onbrez Breezhaler

A

works on B2 receptor
ACTION: bronchodilator
CLINICAL USES: emphysema, chronic bronchitis

39
Q

isoproterenol (Isuprel)

A

works on beta receptors
ACTION: broncholilator, cardiac stimulant
USES: shock, digitalis toxicity, bronchospasm

40
Q

metaproterenol

A

works on beta 2 receptors
ACTION: bronchodilator
CLINICAL USES: bronchospasm

41
Q

norepinephrine(leveterenol) (Levophed)

A

works on alpha 1 receptors
ACTION: vasoconstrictor
CLINICAL USES: shock, hypotenstion

42
Q

phenylephrine

A

works on alpha 1 receptors
ACTION: vasoconstrictor
CLINICAL USES: shock, hypotenstion, nasal decongestant, opthalmic, vasoconstrictor, mydriatic

43
Q

salmeterol (Serevent Diskus)

A

works on Beta 2 receptors
ACTION: bronchodilator
CLINICAL USES: asthma, emphysema, chronic bronchitis

44
Q

terbutaline

A

works on Beta 2 receptors
ACTION: bronchodilator; uterine relaxant
CLINICAL USES: emphysema, asthma

45
Q

agents that inhibit therapeutic activity of adrenergic agents are?

A

concurrent use of BETA-ADRENERGIC BLOCKING AGENTS (propanalol, nadolol, timolol, pindolol, atenolol, metroprolol) ALPHA-ADRENERGIC BLOCKING AGENTS; (phenoxybenzamine, phentolamine) and RESERPINE with adrenergic agents IS NOT RECOMMENDED.

46
Q

How do alpha and beta adrenergic blocking agents act?

A

by plugging the alpha or beta receptors which prevents other agents usually the naturally occurring catecholamines from stimulating the specific receptors

47
Q

how are beta blockers subdivided?

A

non selective and selective beta antagonists.

48
Q

what do nonselective blocking agents do?

A

the inhibit both beta 1 and beta 2 receptors

49
Q

what are propranolol, nadolol, pindolol, penbutolol, carteolol, sotalol, and timolol?

A

nonselective beta-blocking agents

50
Q

what do selective beta-1 blocking agents do?

A

exhibit action against the heart’s beta 1 receptors (cardioselective) and do not readily affect the beta 2 receptors of the bronchi.

51
Q

what are esmolol, metoprolol, acebutolol, betaxolol, bisoprolol, and atenolol?

A

selective beta 1 antagonists

52
Q

use selective beta 1 blocking agents for what patients?

A

patiens in whom nonselective beta blockers may induce bronchospasm; those with asthma

53
Q

what are prazosin, terazosin, & doxazosin,

A

alpha blockers (sometimes used to treat hypertension)

54
Q

Labetalol and carvedilol exhibit what?

A

selective alpha 1 and non selective beta adrenergic blocking activity.

55
Q

what are Alfuxosin, doxazosin, and tamsulosin used for?

A

ACTION: relax the smooth muscle of the bladder and prostate:

used to treat urinary obstruction caused by benign prostatic hyperplasia.

56
Q

Why are beta-adrenergic blocking agents (beta blocker) primarily used for?

A

used extensively to treat post-myocardial infarction.

may also be used for hypertension, angina pectoris, cardiac dysrhythmias, symptoms of hyperthyroidism, and stage fright.

57
Q

Nonselective beta blockers must be used with extreme caution in patients with ?

A

respiratory conditions such as bronchitis, emphysema, asthma, or allergic rhinitis.

58
Q

what is a beta blockade?

A

produces severe bronchoconstriction, and may aggravate wheezing, especially during allergy season.

59
Q

beta blockers should be used with caution in patients with?

A

diabetes; and those suceptible to hypoglycemia.
they may further induce the hypoglycemic effects of insulin and reduce the release of insulin in response to hyperglycemia.

60
Q

beta adrenergic blocking agents and heart failure?

A

use only with controlled heart failure.

further hypotension bradycardia or heart failure may develop.

61
Q

premedication assessment for alpha and beta adrenergic blocking agents

A

baseline vitals

62
Q

what are selective beta 1 antagonists used to treat?

A

hypertension

63
Q

beta adrenergic blockers cause?

A

can cause severe bronchodilation

use with caution in patients with emphysema and asthma

64
Q

what is terbutaline?

A

an adrenergic agent
effective for bronchodilation
can cause excessive CNS stimulation.

65
Q

adverse effects of terbutaline

A

palpitations, tachycardia, flushed skin, dizziness, and tremors
*tend to resolve with continued therapy

66
Q

Stimulation of Alpha 1 receptors causes?

A

vasoconstriction of all blood vessels throughout the body.

67
Q

alpha receptor stimulation =

A

vasoconstriction

68
Q

alpha adrenergic blocking agents are indicated for diseases associate with?

A

vasoconstriction such as Raynauds disease

69
Q

what do adrenergic drugs cause?

A

vasoconstriction

70
Q

beta adrenergic blocking agents are used to treat?

A

hypertension and dysrhythmias

71
Q

cholinergic drugs are used to treat?

A

ocular diseases such as glaucoma,
respiratory tract diseases
urinary tract diseases

72
Q

beta blockers are used cautiously in which patients?

A

pts. with respiratory conditions.

73
Q

what can beta blockers cause?

A

severe bronchoconstriction

74
Q

why are anticholingerics used in parkinsons disease?

A

because they inhibit the action of acetycholine in the PNS…this stimulates dopaminergic receptors which relieves symptoms.

75
Q

anticholingeric effects cause ?

A

pupil dilation, this increases ocular pressure in patients with glaucoma
can cause an acute attack in patients with acute angle glaucoma

76
Q

What are nerve endings that liberate norepinephrine?

A

adrenergic fibers

77
Q

the autonomic nervous system is subdivided into?

A

alpha adrenergic and beta adrenergic receptors

78
Q

what are nicotine and muscarine?

A

specific agonists of one type of cholinergic receptor

79
Q

metoprolol is a ?

A

beta adrenergic blocking agent.

80
Q

what does metoprolol do?

A

causes vasodilation and decreased heart rate resulting in lowering blood pressure.

81
Q

what should a nurse assess before giving metoprolol?

A

the patients blood pressure

82
Q

what do beta adrenergic blocking agents do?

A

decrease heart rate and dilate vessels to lower blood pressure

83
Q

what are some patient teachings for beta adrenergic blocking agents?

A

teach that they can mask symptoms of hypoglycemia

and that stopping suddenly can exacerbate angina symptoms

84
Q

what is atenolol?

A

beta adrenergic blocking agent

85
Q

serious adverse effects of atenelol?

A

low pulse rate, and dependent edema

you should with hold medication

86
Q

Orthostatic hypotension symptoms?

A

dizzy feeling weak the nurses priority is to check blood pressure in supine and sitting position

87
Q

psychological side effects of anticholingeric medications?

A

confusion, depression, night mares hallucinations

The nurses priority is to provide for safety at the onset of symptoms.

88
Q

serious respiratory side effects of cholinergic agents

A

bronchospasm and wheezing.

if present withhold medication and notify physician

89
Q

common side effects of cholinergic agents are

A

nausea dizziness and bradycardia

90
Q

cholinergic agents produce effects similar to?

A

acetycholine

increase GI motility and secretions that cause nausea vomiting diarrhea, and abdominal cramps. (dose related )

91
Q

what do efferent nerves do?

A

leave the CNS and carry impulses to other body parts that control contractions of smooth and skeletal muscles as well as some glandular secretions.

92
Q

how do anticholinergic agents affect mucous membranes?

A

they cause dryness

93
Q

nursing interventions for anticholinergic agents

A

suggest sucking on ice chips, candy or chewing gum and increasing fluid intake to ease the symptoms of dry mouth/dry mucous membranes

94
Q

common adverse effects of adrenergic agents

A

palpitations, rapid heart rate (tachycardia)

PN pharmacology (2 decks)

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