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Pharm Exam 2 > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Another word for force of contraction

A

Inotropy

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2
Q

Another word for speed of conduction

A

Dromotropy

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3
Q

Another word for heart rate

A

Chronotropy

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4
Q

What are catecholamines

A

Norepinephrine
Dopamine
Epinephrine

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5
Q

What is an antagonist

A

Inhibits the physiological action

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6
Q

What is an agonist

A

Imitates a physiological response

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7
Q

What happen to the pupils in sympathetic and parasympathetic systems?

A

Sympathetic: dilates pupils

Parasympathetic: constricts pupils

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8
Q

What happens to the salivary glands in sympathetic and parasympathetic systems?

A

Sympathetic: inhibits salivary gland secretions

Parasympathetic: simulates salivary gland secretions

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9
Q

What happens to the bronchi in sympathetic and parasympathetic systems?

A

Sympathetic: relaxes bronchi in the lungs (dilates)

Parasympathetic: constricts bronchi in lungs

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10
Q

What happens to the heart in sympathetic and parasympathetic systems?

A

Sympathetic: accelerates heart

Parasympathetic: slows heart down

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11
Q

What happens to the stomach and intestines in sympathetic and parasympathetic systems?

A

Sympathetic: inhibits activity of stomach and intestines

Parasympathetic: simulates activity of stomach and intestines

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12
Q

What happens to the pancreas in sympathetic and parasympathetic systems?

A

Sympathetic: inhibits activity of pancreas

Parasympathetic: stimulates activity of pancreas

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13
Q

What happens to the gallbladder in sympathetic and parasympathetic systems?

A

Sympathetic: inhibits gallbladder; stimulates glucose release from liver

Parasympathetic: stimulates gallbladder

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14
Q

What happens to the bladder in sympathetic and parasympathetic systems?

A

Sympathetic: inhibits emptying of bladder

Parasympathetic: promotes emptying the bladder

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15
Q

When stimulated what does alpha 1 receptors do?

A

Vasoconstriction

Mydriasis

Constriction of bladder sphincter and urinary retention

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16
Q

When stimulated what does beta 1 receptors do?

A

Increases heart rate

Increases contractibility

Increases AV conduction

Increases blood pressure

Increases renin production

+ (chronotropy, inotropy, dromotrophy)

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17
Q

When stimulated what does beta 2 receptors do?

A

Bronchodilation

Vasodilation

Increases insulin

Decreases GI

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18
Q

What happens when you block alpha 1 receptors

A

Vasodilation, decreased BP, miosis, improved urine outflow

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19
Q

What happens when you block beta 1

A

Negative chronotrophy

Negative dromotrophy

Negative inotrophy

Decreased blood pressure

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20
Q

What happens when you block beta 2

A

Bronchoconstriction

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21
Q

What are cardio selective sympathomimetics used for?

A

Heart failure, increase BP, shock, anaphylaxis (epi) and CPR

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22
Q

What is Dobutamine?

A

Sympathetic stimulate

+ inotrope

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23
Q

Indication, receptors, and drug effect of dobutamine

A

Indication: heart failure (pump failure)

Receptors stimulated: B1

Drug effect: increased cardiac output

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24
Q

Indication for dopamine

A

Shock

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25
Q

Receptors stimulated with dopamine

A

Dopamine

Beta 1

Alpha 1

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26
Q

Drug effect of dopamine in low, moderate, and high doses

A

Low dose: dilate renal, mesentery, coronary and cerebral vessels

Moderate: + intropy

High doses: vasoconstriction

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27
Q

Side effect of dopamine

A

Tachycardia

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28
Q

Indications, receptors stimulated, and drug effect of epinephrine

A

Indications: anaphylaxis, CPR, shock

Receptors stimulated: all (alpha 1, beta 1, beta 2)

Drug effect: for cardiac arrest: increased blood pressure and heart rate. For asthma attack: increased RR and increased oxygen level

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29
Q

Indications, receptors stimulated, and drug effect for norepinephrine

A

Indications: shock

Receptors: alpha 1 and beta 1

Drug effect: vasoconstriction, + intrope, + dromotrope, + chronotrope

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30
Q

Indications, receptors, and drug effect of phenylephrine

A

Indications: hypotension

Receptors: alpha 1

Drug effect: vasoconstriction

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31
Q

Adverse effects of the cardio selective sympathomimetics

A

Hypertension, tachycardia, dysrhythmia, chest pain, dizziness, tremors

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32
Q

Interactions for the cardio selective sympathomimetics

A

MAOIs ( Monoamine oxidase inhibitors)

Thyroid medications

33
Q

Administration safety and nursing considerations for the cardio selective sympathomimetics

A

Monitor HR, BP, SpO2

Monitor IV, IV pump, extravasation

Preferred through a central line

34
Q

Therapeutic effects for cardio selective sympathomimetics

A

Increased CO

Increased HR

Increased BP

Increased SpO2

Increased urinary output

Increased level of consciousness

Colour/ temp WNL

35
Q

What are the alpha blockers?

A

Phentolamine

Prazosin

Tamsulosin

36
Q

Indications for prazosin

A

Hypertension

37
Q

Drug effects for prazosin

A

Decreased BP, vasodilation

38
Q

Therapeutic effects for prazosin

A

HTN: lowers BP

Dysrhythmias: lowers HR, regular rhythm.

Angina: lowers chest pain

BPH: improved emptying bladder

39
Q

Considerations for prazosin

A

High risk for fall

First dose phenomenon

Take first dose at night

Do not abruptly stop

40
Q

Indication for tamsulosin

A

BPH ( benign prostatic hyperplasia)

41
Q

Drug effects of tamsulosin

A

Improve urinary outflow

42
Q

Consideration for tamsulosin

A

No sildenafil (viagra)

43
Q

What are the beta blockers?

A

Metoprolol

Labetalol

Esmolol

Carvedilol

Propranolol

44
Q

What are the hold parameters for beta blockers

A

HR< 60

SBP< 100

45
Q

What is the indication for the selective cardio B1 (metoprolol)

A

Hypertension

Dysrhythmias

Angina

MI (myocardial infarction)

46
Q

What is the receptor blocked for metoprolol and what is this drugs effect

A

Receptor blocked: B1

Drug effect: decrease BP, decrease workload of the heart, decrease conduction

47
Q

What is the indication for the non selective propranolol

A

HTN, dysrhythmias, angina, MI, migraines.

48
Q

Receptors blocked for propranolol

A

B1

B2

49
Q

Therapeutic effect for propranolol

A

Negative chronotrope

Negative dromotrope

Negative intotrope

Bronchoconstriction

50
Q

Adverse effects of beta blockers

A

At risk for fall, monitor for SOB, dizziness, hypotension, bradycardia, conduction issues (AVB), depression.

51
Q

Main adverse effect for alpha blockers

A

First dose hypotension

52
Q

Beta blockers interactions

A

CV drugs, diuretics, alcohol

53
Q

Teachings for beta blockers.

A

Don’t stop taking abruptly

Teach about orthostatic hypotension

Report weight gain (heart failure) over 2 pounds in 24 hours, 5 pounds in a week

54
Q

What happens to the CV and GI system when parasympathetic system is stimulated?

A

CV: decreased HR, vasodilation

GI: increased motility and secretions

55
Q

What happens to the GU system and the eyes when parasympathetic system receptors are stimulated?

A

GU: increase urinary frequency

Eye: miosis (constrict)

56
Q

What happens to the glands and respiratory system when parasympathetic system is stimulated?

A

Glands: increased secretions

Respiratory: bronchoconstriction, increased secretions

57
Q

What happens to the CV when parasympathetic receptors are blocked

A

Small doses: HR decreases

Large doses: HR increases

58
Q

What happens to the CNS when parasympathetic receptors are blocked?

A

Small doses: decrease in muscle rigidity and tremor.

High doses: hallucinations and drowsiness

59
Q

What happens to the eyes, GI, and GU when parasympathetic receptors are blocked?

A

Eyes: mydriasis (dilation)

GI: decrease motility

GU: decrease frequency

60
Q

What happens to the glands and respiratory system when parasympathetic receptors are blocked?

A

Glands: decreased secretions

Respiratory system: bronchodilation, decreased secretions

61
Q

What is the cholinergic drug?

A

Bethanechol

62
Q

What is the indications for bethanechol

A

Post procedural atony of the bladder

63
Q

What is the drug effect and evaluation for bethanechol

A

Drug effect: increases tone and motility of the bladder and G.I. tract.

Evaluation: patient is able to urinate.

64
Q

What are the Alzheimer’s drugs?

A

Donezepil, Galantamine, Rivastigmine

65
Q

What are the indications, drug effects, and considerations of Alzheimer’s drugs

A

Indications: Alzheimers

Drug effect: inhibit cholinesterase

Considerations: improvement of symptoms

66
Q

Adverse effects of Alzheimer’s drugs?

A

G.I. symptoms and bronchoconstriction

67
Q

What is the cholinergic crisis?

A

Circulatory collapse

Hypotension

Bloody diarrhea

Shock

Cardiac arrest

68
Q

Early signs of the cholinergic crisis?

A

Abdominal cramps

Excessive salivation

Flushing

Syncope (LOC)

Transient AVB

Orthostatic hypotension

69
Q

How do you treat the cholinergic crisis?

A

Early: Atropine (0.5 or 1)

Late: Epinephrine

70
Q

What is atropine

A

Anticholinergic used to increase HR

71
Q

What are the indications for atropine?

A

Symptomatic bradycardia (low BP, cool, clammy, decreased level of consciousness)

72
Q

Considerations atropine

A

Pupillary dilation

73
Q

Therapeutic effect for atropine

A

Increased heart rate

Improves breathing

Lowers secretions

74
Q

Drug effect and indications for glycopyrrolate

A

Drug effect: reduce secretions

Indications: peri op

75
Q

Indications and considerations for scopolamine

A

Indications: motion sickness, post op N/V

Considerations: dry mouth, drowsiness

76
Q

Adverse effects for anticholinergics

A

Dysrhythmias, constipation, urinary retention, decreased sweating

77
Q

Drugs that stimulate beta 1

A

Dobutamine, dopamine, epi, norepinephrine

78
Q

Drugs that stimulate beta 2

A

Epi

79
Q

Drugs that stimulate alpha 1

A

Dopamine, epi, norepinephrine, phenylephrine

Pharm Exam 2 (7 decks)

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