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316 Pharmacology > Exam 1: Drug classifications for ANS > Flashcards

Exam 1: Drug classifications for ANS Flashcards

1
Q

Drug classification for ANS

A
  • Adrenergic agonists
  • Adrenergic antagonists
  • Cholinergic agonists
  • Anticholinergics
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2
Q

Adrenergic agonists

A

mimic the effects of the Sympathetic nervous system

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3
Q

Adrenergic antagonists

A

inhibit or block the effects of the sympathetic nervous system

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4
Q

Cholinergic agonists

A

mimic the effects of the parasympathetic nervous system

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5
Q

Anticholinergics

A

block the effects of the parasympathetic nervous system

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6
Q

Drug classification of epinephrine

A

adrenergic agonists; sympathomimetics

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7
Q

Indication of epinephrine (adrenalin)

A 
anaphylactic reactions
cardiopulmonary resuscitation 
bradycardia 
bronchospasm 
acute asthma 
hypotension 
shock
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8
Q

Mechanism of action for epinephrine

A

Alpha 1
Beta 1
Beta 2

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9
Q

Primary effect on the body for epinephrine

A

Alpha 1 - increases blood pressure (vasoconstrictive pressor effect)
Beta 1 - cardiac stimulation
Beta 2 - promotes bronchodilator; vasodilation of skeletal muscle vasculature

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10
Q

Routes of administration for epinephrine

A 
IV push, continuous IV infusion 
Intramuscular, Subcutaneous
INH
Intracardiac 
topical, instillation 
DO NOT GIVE PO
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11
Q

Side effects of Epinephrine

A
  • palpitations, tachycardia, angina, hypertensive crisis, pallor, anxiety, cardiac dysrhythmias
  • cerebral hemorrhage, anxiety, tremors
  • hyperglycemia (increases glycogenolysis)
  • pulmonary edema, dyspnea
  • tissue necrosis (extravasation)
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12
Q

ISMP High alert medication

A

A drug which has heightened risk of causing significant patient harm when used in error

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13
Q

epinephrine use caution when

A

Cerebrovascular disease, diabetes, hyperthyroidism, prostate enlargement or urinary retention, glaucoma

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14
Q

Drug interactions to consider when using epinephrine

A
  • Beta blockers, alpha blockers
  • Tricyclic antidepressants (TCAs) because they inhibit neuronal uptake of NE and 5HT
  • MAO inhibitors- because they block uptake of catecholamines and potentiate effects of epinephrine leading to hypertensive crisis
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15
Q

Drug Classification of dopamine (intropin)

A

Adrenergic agonist, sympathomimetics

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16
Q

Indication for dopamine

A
  • improve hemodynamic status in patients with shock & heart failure
  • acute renal failure
  • profound hypotension
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17
Q

trade name for epinephrine

A

Adrenalin, sus-phrine

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18
Q

Trade name for dopamine

A

Intropin

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19
Q

routes of administration for dopamine

A

IV (continuous infusion, administered as mcg/kg/min)

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20
Q

Method of action for dopamine

A

alpha 1
beta 1
Dopaminergic receptor

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21
Q

Low doses of dopamine (2-5 mcg/kg/min) stimulates

A

Dopaminergic receptos

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22
Q

what happens to the body when given low doses of dopamine

A
  • dilation of renal and mesenteric vasculature
  • increase renal perfusion
  • increase urinary output
  • decrease risk of acute renal failure
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23
Q

Moderate doses (5-15 mcg/kg/min) stimulates

A

dopaminergic and beta 1

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24
Q

what happens to the body when given moderate doses of dopamine

A

increase heart rate
increase contractility
increase cardiac output

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25
Q

high doses of dopamine (>20mcg/kg/min) stimulates

A

Dopaminergic
Beta 1
Alpha 1

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26
Q

What happens to the body when given high doses of dopamine

A

Peripheral vasoconstriction

Increase BP

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27
Q

Side effects of dopamine

A 
Tachycardia 
Anginal pain
Palpitations 
hypertension  
cardiac dysrhythmias 
N/V
Tissue necrosis
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28
Q

drug interactions to consider with dopamine

A

TCAs & MAO inhibitors: intensify effects of dopamine

Alpha and beta blocking agents: Antagonize effects of dopamine

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29
Q

What should be corrected when administering dopamine

A

correct hypovolemic state before drug is administered

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30
Q

administer dopamine via…

A

Infusion pump only

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31
Q

What drug classification is albuterol

A

adrenergic agonist, sympathomimetics

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32
Q

Trade name for albuterol

A

Proventil

Ventolin

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33
Q

Indication for albuterol

A

Bronchospasm
Asthma
Bronchitis
COPD

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34
Q

Routs of administration for albuterol

A

Inhalation

PO, tablet, syrup

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35
Q

Mechanism of action for albuterol

A

Selective stimulation of BETA 2 receptors

BRONCHODILATION

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36
Q

side effects of albuterol

A 
tachycardia 
palpitations 
cardiac dysrhythmias 
Increase BP 
paradoxical bronchospasm (respiratory distress)
tremor 
restlessness 
Insomnia 
Headache 
Nausea/vomiting 
Fatalities reported with excessive use
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37
Q

albuterol : systemic and severe run are more common when

A

Drug is administered PO rather than INH

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38
Q

Albuterol: beta 2 stimulation is

A

relative

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39
Q

Albuterol possible beta 1 stimulation may occur and cause

A

cardiac disease
hypertension
diabete mellitus
glaucoma

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40
Q

Drug interaction consideration for albuterol

A

Caffeine
MAOIs and TCAs may increase vasoconstriction actions and cause HTN
Effects of beta blocking drugs will be blunted
Decrease digoxin levels
additive effects with other sympathomimetic drugs

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41
Q

Drug classification for phenylephrine

A

Adrenergic agonists, sympathomimetics

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42
Q

Trade name for phenylephrine

A

Neo-synephrine

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43
Q

indication for phenylephrine

A

used topically as a nasal decongestant
systemic decongestant
hypotension/shock

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44
Q

Routes of administration for phenylephrine

A

Intranasal/topically (OTC)
PO (OTC)
IV, in critical care settings to treat severe hypotension and shock

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45
Q

Mechanism of action for phenylephrine

A

selective alpha 1 adrenergic agonists
sympathomimetic
decongestant
-Binds with alpha adrenergic receptor on nasal blood vessels leading to local arterial nasal congestion through the shrinkage or swollen membranes
-topical administration produces rapid and intense response

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46
Q

side effects of phenylephrine

A
  • Rebound congestions with prolonged topical use
  • CNS stimulation if topical agent taken in excess
  • alpha agonist that causes blood vessel constriction, causing BP to increase by systemic vascular resistance
  • increase peripheral vascular resistance (HR), leading to increase cardiac output
  • used when coming out of anesthesia
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47
Q

Adrenergic blockers that are A through N are

A

B1 selective

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48
Q

Adrenergic blockers that are O through Z

A

B1 and B2 non selective

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49
Q

Drug classification for propranolol

A

adrenergic blockers

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50
Q

Trade name for propranolol

A

Inderal

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51
Q

propranolol is a …..

A
  • non selective beta blocker
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52
Q

Indications for propranolol

A

Hypertension
Angina
MI (Prevention of repeat infarction
Dysrhythmias

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53
Q

Route of administration for propranolol

A

IV

PO

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54
Q

Mechanism of action for propranolol

A
  • Blocks beta 1 and Beta 2 receptor
  • Decrease sympathetic outflow to periphery and suppresses RAAS
  • decrease BP, HR, force of contraction, CO, and glycogenolysis
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55
Q

Side effects for propranolol

A

Bradycardia, heart block, hypotension, heart failure
drowsiness, vertigo
mask symptoms of hypoglycemia

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56
Q

use propranolol with caution with patients who are

A

Diabetic
severe allergies
heart failure
depressed

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57
Q

Black box warning for propranolol

A

beta blocker therapy should not be withdrawn abruptly

-Can lead to rebound tachycardia/hypertension

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58
Q

Propranolol blocks…

A

Both beta 1 and beta 2

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59
Q

Drug classification for phentolamine

A

Adrenergic antagonists,

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60
Q

Phentolamine blocks

A

alpha 1

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61
Q

trade name for phentolamine

A

regitine

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62
Q

indications for phentolamine

A
  • treatment of pheochromocytoma
  • prevention of tissue necrosis following extravasation of drugs
  • hypertensive tyramine crisis with MAO inhibitor
63
Q

Drug classifications that effects the sympathetic nervous system

A

Adrenergic agonists and antagonists

63
Q

Drug classifications that effects the sympathetic nervous system

A

Adrenergic agonists and antagonists

64
Q

Drug classifications that effects the sympathetic nervous system

A

Adrenergic agonists and antagonists

65
Q

Drug classifications that effects the parasympathetic nervous system

A

Cholinergic agonists and anticholinergics

66
Q

drug classification for bethanechol

A

cholinergic agonist

67
Q

Trade name for bethanechol

A

Duvoid, Urecholine

68
Q

Bethanechol is a

A

Cholenergic agent, parasympathomimetic agent, muscarinic agonist

69
Q

Indication for bethanechol

A

Treatments of non obstructive urinary retention

70
Q

Route of administration for bethanechol

A

PO only (SQ preparation has been withdrawn; circulatory collapse if given IV)

71
Q

Mechanism of action for Bethanechol

A
  • acts directly on muscarinic receptors (especially heart), exocrine glands, smooth muscle (Bladder, GI system), and eyes
  • Includes contraction of the detrusor muscle and relaxation of the external sphincter (leading to micturition)
72
Q

Side effects fo bethanechol

A
  • Bradycardia; Vasodilation, and decrease in BP
  • Exocrine glands: increased sweating, salivation, bronchial secretions, and gastric acid secretion
  • Smooth muscles of the lung and GI tract: contraction of the bronchi, increased tone and mobility of GI smooth muscle
  • Pupil constriction (miosis) and contraction of the ciliary muscle, leading to blurred vision
73
Q

MNEMONIC FOR EFFECTS OF CHOLINERGIC AGENTS

A

Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating

Diarrhea
Urination
Micturition
Bronchoconstriction

74
Q

What do cholinergic agents do

A

Mimic the primary parasympathetic neurotransmitter ACETYLCHOLINE

75
Q

What do anticholinergic agents do?

A

Inhibit the action of primary parasympathetic neurotransmitter ACETYLCHOLINE

76
Q

Method of action phentolamine

A

blocks alpha 1 adrenergic
Produces brief antagonist of circulating epinephrine and NE, helping to control hypertension brought on by high levels of circulating catecholamine

77
Q

Alpha 1

A

Vasoconstriction
Increase BP
increase blood return to heart
increase circulation

78
Q

Alpha 2

A

Inhibits release of NE
Decrease vasoconstriction
Decrease BP

79
Q

Beta 1

A

Targets the heart

increase heart rate and contraction

80
Q

Beta 2

A

Targets the lungs

Relaxation of smooth muscle in bronchi, uterus, peripheral blood vessels

81
Q

subtype of nicotinic receptor

A

Neuronal

Non-Neuronal

82
Q

Neuronal nicotinic

A

CNS stimulation

Adrenal medulla stimulation

83
Q

Non-neuronal nicotinic

A

stimulates contraction of skeletal muscles

84
Q

Muscarinic

A
  • Inhibits cardiac muscle (decrease in HR, contractility, and AV conduction)
  • Stimulates smooth muscle to contract (pupils, intestine, bronchioles_)
  • Exocrine glands (respiratory secretion, salivation, lacrimation, sweat
85
Q

What happens when anticholinergics target muscarinic receptors?

A

Inhibiting muscarinic receptors can lead to vasodilation, inhibit secretion, and inhibit exocrine glands

86
Q

Drug class for atropine

A

Anticholinergic

87
Q

Indications for atropine

A
  • Over active bladder
  • Pupillary dilation
  • Overdose by any Muscarinic agonist
  • Antidote for organophosphate poisoning
  • Treatment for heart block, sinus bradycardia or bradycardia caused by anesthetic agents
  • Pre-operative medication to prevent excessive respiratory secretions and saliva
88
Q

Route of administration for atropine

A

PO
IM
IV
Instillation

89
Q

Mechanism of action for atropine

A 
Muscarinic receptors (cardiac/smooth muscle, exocrine glands)
-Blocking all muscarinic effects
90
Q

Effects on the body atropine

A
  • increase HR
  • Decrease GI motility, secretory activity, and GU muscle tone
  • Ophthalmic mydriasis
91
Q

Side effects for atropine

A
  • Tachycardia/palpitation
  • nasal congestion, dry mouth, thickening of bronchial secretions
  • hot, dry, flushed skin; hyperthermia
  • blurred vision, photophobia’ elevated IOP
  • Nausea, abdominal distention, constipation
  • Urinary retention
  • Crosses BBB! Agitation, restlessness, hallucinations, paranoid behavior
92
Q

Mneumonics Atropine side effects

A 
A norexia 
B lurry vision
C onstipation/confusion 
D ry mouth
S edation/stasis of urine
93
Q

Drug classification: Tolterodine

A

Anticholinergics

94
Q

Trade name for tolterodine

A

Detrol

95
Q

Can Epinephrine be given PO?

A

NO!

96
Q

Drugs that are given IV can cause?

A

Tissue Necrosis

97
Q

What do you have to be considerate of when giving beta blockers

A

Whether the patient has diabetes

98
Q

Hypotension can cause

A

Dizziness
Nausea
Fatigue

99
Q

High alert medication

A

Epinephrine

Dopamine

100
Q

what can effect a patient that is taking albuterol

A
  • Caffeine because it may increase risk for adverse effects
  • Ephedra increases CNS stimulation
  • St. Johns wort decreases effects of albuterol
101
Q

nursing consideration for phenylephrine

A

Holiday every 5 days to avoid rebound congestion

102
Q

Phenylephrine can offset symptoms of ?

A

Anethesia

103
Q

Tolterodine indication

A

Overactive bladder

104
Q

What does tolterodine do?

A

Decrease urination frequency, urgency, and incontinence

105
Q

Tolterodine route

A

PO

106
Q

MoA tolterodine

A

Blocks muscarinic receptors in the wall of the bladder causing relaxation of urinary bladder tone

107
Q

Tolterodine side effects

A 
Dry mouth 
Dizziness 
Urinary retention (UTI!!)
HTN, Chest pain 
Abdominal pain 
Aggravation of dementia 
Blurred Vision
108
Q

What may increase the bioavailability of tolterodine?

A

Food@

109
Q

What food may increase the serum level of tolterodine

A

Grapefruit juice

110
Q

Clonidine MoA

A

Alpha 2

111
Q

Clonidine treats

A

Hypertension
Cancer pain
ADHD

112
Q

Levodopa/Caridopa

A

Treat Parkinson’s

  • Levodopa is converted to dopamine
  • Caridopa helps prevent levodopa break down
113
Q

Isoproterenol MoA

A

Beta 1 and Beta 2

114
Q

Isoproterenol helps treat

A

Bradycardia
Asthma/Bronchospasm
Heartblock

115
Q

Norepinephrine Moa

A

Alpha 1

Beta 1

116
Q

Norepinephrine helps treat

A

Septic Shock

Hypotension

117
Q

Hypertension may cause

A

Headache
Nausea
Fatigue

118
Q

Carvedilol and Labetalol MoA

A

Beta 1
Beta 2
Alpha 1

119
Q

Carvedilol and Labetalol can treat

A

Hypertension
Tachycardia
Broncodilation

120
Q

Atenolol MoA

A

Beta 1

121
Q

Atenolol can treat

A

Tachycardia

122
Q

Alpha 1

A

Vasoconstriction
Increase BP
Increase Circulation

123
Q

Alpha 2

A

Inhibits release of NE
Vasodilation
Decrease BP
Decrease Circulation

124
Q

Beta 1

A

Increase Heart rate

Increase contractility

125
Q

Beta 2

A

Vasodilation bronchial, Uterus, Peripheral blood vessel

126
Q

Types of nicotinic receptors

A

Neuronal

Non-Neuronal

127
Q

Neuronal

A

CNS and adrenal medulla stimulation

128
Q

Non neuronal

A

Stimulates contraction of skeletal muscle

129
Q

Muscarinic receptors

A 
Inhibits Cardiac muscle (Decrease HR, Contractility, av conduction)
Stimulates smooth muscle to contract (pupils, intestine, bronchioles)
Exocrine glands (Respiratory secretions, salivation, lacrimation, sweat)
130
Q

Inhibiting muscarinic can lead to

A

Vasodilation
Pupils dilate, intestine and bronchioles dilate
Increased HR, Contractility, AV conduction
Inhibits saliva, lacrimation, sweat

131
Q

Prazosin + doxazosin MoA

A

inhibit alpha 1 —> vasodilation, decrease HR, decrease Contractility

132
Q

Proazosin and doxazosin help treat

A

hypertension

133
Q

pyridostigmine MoA

A

Inhibits cholinesterase which prolongs ACH, increasing stimulation

134
Q

Pyridostigmine causes

A

Increase muscle tone/improved muscle function
Prevention of woman nerve gas toxicity
Bradycardia
Bronchial/uterine constriction

135
Q

Route of pyridostigmine

A

PO, IV, IM

136
Q

Donepezil MoA

A

inhibits acetycholinsterase and stimulates by making more ACH

137
Q

pyridostigmine acts on

A

Both nicotinic and muscarinic

138
Q

Donepezil helps treat

A

Dementia, but does not cure it

139
Q

route fo donepezile

A

PO

140
Q

Ipatropium MoA

A

Reduces bronchial secretion by acting as a antagonist to Ach

141
Q

Ipatropium indication

A

Secondary to albuterol, used for asthma, bronchospasm, COPD

142
Q

Tolterodine MoA

A

Blocks muscarinic receptors on bladder

143
Q

Tolterodine treats

A

Overactive bladder and decreases urine frequency, urgency, and incontinence

144
Q

Route for tolterodine

A

PO

145
Q

Side effects for anticholinergic

A

Cant see, pee, spit, shit

146
Q

Scopolamine moA

A

Inhibits muscarinic activity

Balances ACH & NE

147
Q

Scopolamine indication

A

Motion sickness, Excessive oral secretion, motion sickness, drooling

148
Q

Scopolamine route

A

PO, Transdermal

149
Q

The Parasympathetic nervous system stimulates cranial nerve X, which is responsible for

A

slowing the heart rate, constricting the airway, and stimulating digestion.

150
Q

Is propanolol lipophilic or lipophobic

A

lipophilic!! Highly lipid soluble

151
Q

Is carvedilol lipophilic or lipophobic

A

Lipophilic! it is highly lipid soluble

152
Q

Pheochromocytoma

A

Over secretion of epinephrine and norepinephrine

153
Q

Side effects phentolamine

A

Reflex tachycardia

Orthostatic hypotension

316 Pharmacology (19 decks)

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