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Pharmocology > Med Chart 5 > Flashcards

Med Chart 5 Flashcards

1
Q

what classification is Epinephrine and Ephedrine

A

Nonselective Adrenergic Agonist

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2
Q

What is Epinephrine and Ephedrine used for?

A
  • Bronchodilator for bronchospasms, asthma attack.
  • Cardiac Arrest with CPR
  • Used to treat HYPOTENSION
  • Antishock
  • Antianaphylaxis
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3
Q

What is the MOA for Epinephrine and Ephedrine?

A

Activate both Alpha and beta receptors

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4
Q

What are Alpha 1 Adrenergic Agonist?

A

Phenylephrine (Neo-Synephrine)

Pseudophedrine (Sudafed) Nasal Congestion

Tetrahydrozoline (Visine) Ocular Use

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5
Q

What are the drugs below used for?

  • Phenylephrine (Neo-Synephrine)
  • Pseudophedrine (Sudafed) Nasal Congestion
  • Tetrahydrozoline (Visine) Ocular Use
A

Nasal congestion, Hypotension, May be used to produce mydriasis (pupil dilation) during ophthalmic exam

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6
Q

What is the MOA for the drugs below?

  • Phenylephrine (Neo-Synephrine)
  • Pseudophedrine (Sudafed) Nasal Congestion
  • Tetrahydrozoline (Visine) Ocular Use
A

Activate Alpha 1 adrenergic receptors

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7
Q

Nursing concerns for Alpha Adrenergic Agonists:

A
  • Examine IV site frequently
  • Remove Contact Lenses and dark eye protection after ophthalmic use
  • Use in limited 3-5 day intervals for nasal decongestion
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8
Q

What drug is an Alpha 2 Agonist?

A

Clonidine

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9
Q

What is Clonidine used for?

A

to treat hypertension

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10
Q

What is Clonidine’s MOA?

A

Act thru non-automatic (Centrally) mechanisms

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11
Q

What drug is a Beta 1 Agonist?

A

Dopamine (Intropin)

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12
Q

What is Dopamin (Intropin) used for?

A
  • Critical care drug for heart attack (M.I)
  • Heart failure
  • Shock
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13
Q

What is Dopamin (Intropin) Adverse Effect?

A

has powerful effects on heart

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14
Q

What drugs are Beta 2 Agonist?

A

Albuterol(Proventil)

Terbutaline (Brethine)

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15
Q

What is Albuterol (Proventil) used for?

A

Asthma attacks

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16
Q

What is Terbutaline (Brethine) used for?

A

Reduce preterm labor contractions of uterus

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17
Q

Adverse effects for ALL Adrenergic Agonist:

Epinephrine (Adrenaline)
Ephedrine (Efedron)
Phenylephrine (Neo-Synephrine)
Pseudophedrine (Sudafed) 
Tetrahydrozoline (Visine)
Clonidine
Dopamine (Intropin)
Albuterol (Proventil)
Terbutaline (Brethine)
A
  • Headache R/T blood vessel dilation
  • Restlessness & Insomnia R/T CNS
  • Euphoria
  • Palpitations
  • Dysrhythmias
  • Tachycardia
  • Hypertension
  • Pulmonary Edema
  • Cardiac Arrest
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18
Q

Nursing concerns for ALL Adrenergic Agonist:

Epinephrine (Adrenaline)
Ephedrine (Efedron)
Phenylephrine (Neo-Synephrine)
Pseudophedrine (Sudafed) 
Tetrahydrozoline (Visine)
Clonidine
Dopamine (Intropin)
Albuterol (Proventil)
Terbutaline (Brethine)
A
  • Assess for underlying problem and Preexisting condition
  • Establish baseline and vital signs: H.R., R.R., and BP changes
  • Monitor Resp. Status
  • Use Cardiac/ Resuscitation monitor including BP
  • Inform Prescriber of changes in I&O
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19
Q

What drugs are Alpha 1 Antagonist?

A

Prazosin (Minipress)

Phentolamine (Regitine)

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20
Q

What are Prazosin (Minipress) and Phentolamine (Regitine) used for?

A
  • Hypertension
  • BPH (Benign Prostatic Hypertrophy) Will relax urinary obstruction, but you can only cure it through surgery

-Can reduce Hypertension from Pheochromocytoma (tumor over adrenal glands)

-Excessive secretion of catecholamine by adrenal glands .
↓ vasospasms to fingers and toes on Raynaud’s Disease

21
Q

MOA of Prazosin (Minipress) and Phentolamine (Regitine) used for?

A

BLOCK Alpha 1 Adrenergic Receptors Selectively

22
Q

Adverse Effects for Prazosin (Minipress) and Phentolamine (Regitine) used for?

A

-First dose phenomenon: orthostatic hypotension
More for alpha 1 antagonists bc they are so potent
This leads to ↓ blood flow to the brain and syncope (loss of consciousness R/T no blood flow)
-Sexual Dysfunction
-N/V and abdominal cramping
-Incontinence & increased urine frequency
-Depression
-Lethargy
-Vivid Dreams

23
Q

Nursing Concerns for Prazosin (Minipress) and Phentolamine (Regitine)

A
  • Initial therapy should be a low dose and given at bed time to prevent first dose phenomenon
  • Assess for syncope
  • Give w/ food
  • Monitor urine hesitancy
  • Monitor BP
  • Advise about OTC drugs that may cause drug-drug interactions
24
Q

What drugs are Beta Adrenergic Antagonist?

A

Propranolol (Inderal)
Metoprolol (Lopressor/Toprol)
Atenolol (Tenormin)

25
Q

What is Propranolol (Inderal) used for?

A
  • Hypertension
  • Angina
  • Glaucoma
  • Dysrhythmias
  • Protect against MI
26
Q

What is the MOA for Propranolol (Inderal)

A

Block BOTH Beta 1 and beta 2

27
Q

Adverse effects for Propranolol (Inderal)

A

Increase side effects

28
Q

Nursing concerns for Propranolol (Inderal)

A

CAUTION for patients with Asthma and COPD

29
Q

What is Metoprolol (Lopressor/Toprol)

Atenolol (Tenormin) used for?

A
  • Hypertension
  • Angina
  • H.F.
30
Q

MOA for Metoprolol (Lopressor/Toprol)

Atenolol (Tenormin)

A

Block ONLY Beta 1 receptor

31
Q

Adverse Effects of Metoprolol (Lopressor/Toprol)

Atenolol (Tenormin)

A

decrease side effects

32
Q

Nursing Concerns for Metoprolol (Lopressor/Toprol)

Atenolol (Tenormin)

A

SAFE for patients with Asthma and COPD

33
Q

Adverse effects for ALL Beta Adrenergiv Antagonist

A
  • A.E. most likely: elderly and impaired renal function pts
  • Interactions: EtOH and OTC Antacids
  • Depression
34
Q

Nursing Concerns for ALL Beta Adrenergic Antagonist

A

-Thorough medical history: allergies, asthma, & COPD
-Vital Signs: BP
-Labs: Kidneys, Liver, Hematologic, Cardiac Functions
-I&O and daily weight
-Educate pt. about interactions w/ EtOH and Antacids
-Caution for diabetics (hypoglycemia)
Can mess with their liver function even more
-Watch for depression
-Discontinue drug SLOWLY

35
Q

What drug is Directly Acting Cholinergic Agonist

A

Bethanechol (Urecholine)

36
Q

What is Bethanechol (Urecholine) used for?

A
  • Increase tone of urinary bladder
  • Relaxation of sphincter
  • Increase Gastric Motility
  • Restores peristalsis or urinary retention
37
Q

MOA for Bethanechol (Urecholine)

A

Inhibit Acetylcholinesterase to allow more Acetylcholine to reach Cholinergic Receptors

38
Q

What are the nursing concerns for Bethanechol (Urecholine)

A

use precautions for patients with obstructive GI and GU diseases

39
Q

What drug is Indirectly Acting Cholinerigc Agonist

A

Neostigmine (Prostigmine)

40
Q

What is Neostigmine (Prostigmine) used for?

A
  • Myasthenia Gravis (a condition causing abnormal weakness of certain muscle)
  • Alzheimer’s (mental deterioration)
  • Glaucoma (gradually losing eye sight)
  • Helps with swallowing function if taken before eating
  • Protect against bioterrorist attack with nerve gases
  • Make more acetylcholine available
41
Q

MOA for Neostigmine (Prostigmine)

A

Inhibit Acetylcholinesterase to allow more Acetylcholine to reach Cholinergic Receptors

42
Q

Nursing Concerns for Neostigmine (Prostigmine)

A

Use precaution to prevent cholinergic crisis (overdose)

43
Q

Adverse Effects for ALL Cholinergic Agonists

A 
CV: 
-Hypotension
-Syncope
-Bradycardia
-Complete Heart Block
GI: 
-Abdominal Cramps
-↑ Salivation
-↑ Sweating
N/V
-Eye:
-Miosis
-Blurred Vision
Resp:
-↑ Bronchial Secretions
-Acute Bronchospasms
44
Q

Nursing Concerns for ALL Cholinergic Agonists

A
  • Assess: HR, RR, & BP for at least 1 hr following administration
  • Monitor for early sign of overdose
  • Ensure Atropine is available for overdose
  • NO OTC preparation (interactions)
  • Monitor I&O, urinary, and bladder distention
  • Instruct pt be near toilet after taking
  • Safety precautions for blurred vision
45
Q

What drug is Muscarinic Antagonist

A

Atropine

46
Q

What is Atropine used for

A
  • Bradycardia

- Anti-dose for Muscarinic Agonist Overdose

47
Q

MOA for Atropine

A
  • Block Muscarinic Receptors at therapeutic doses
  • May block muscarinic and nicotinic receptors at high doses
  • Induce symptoms of fight or flight
48
Q

Adverse Effects for Atropine?

A 
Drying or oral & nasal mucosa
Constipation
Urinary Retention
↑ HR and arrhythmias
Blurred vision and photophobia
Heat Stroke (R/T ↑ HR)
49
Q

Nursing Concerns for Atropine

A
  • Monitor VS: HR & BP
  • Particularly for paradoxical bradycardia
  • Monitor I&O
  • Assess CNS status for changes
  • Pt teaching:
  • Avoid Outdoor Activities (Heat Stroke)
  • No OTC meds
  • Monitor for anticholinergic crisis:
  • Fever

Pharmocology (28 decks)

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