Mod 7 PNS Flashcards
Alpha 1 & Beta 1
Vaso CONSTRICTS
Alpha 2 & Beta 2
Vaso DILATES & Bronchial DILATES
Describe the effects of BETA 2 STIMULATORS
-Bronchial dilation
-Vasodilation
-⇩ GI activity
-Relaxes uterine muscle
Drugs: Albuterol & Salmeterol
Explain the effects of CHOLINERGIC medications
Drugs: -stigmine
- Act upon acetylcholine (Ach) neurotransmitter
- Upon activation:
-NicotinicN (neuronal): promotes ganglionic transmission and release of epinephrine
-NicotinicM (muscle): promotes contraction of skeletal muscles
-Muscarinic: targets parasympathetic organs, pupils narrow, ⇩ HR, bronchial constriction, relaxes bladder sphincters, ⇧ GI tract activity, generalized sweating, vasodilation
Muscarinic AGONIST (parasympathomimetic): increases rest & digest (PNS) and mimics effects of Ach
Identify the effects of DOPAMINE RECEPTOR activation medication
Effects:
-Dopamine receptors causes dilation of renal vasculature
Used in shock to improve renal perfusion
-Dopamine also enhances Beta 1 receptors in the heart
⇧ BP, urine output, and renal perfusion
Dosage Strength:
- Low dose (dopamine receptors only): vasoDILATES to renal blood vessels to ⇧ renal perfusion
- Medium dose (Beta 1 & dopamine receptors): vasoCONSTRICTS
- High dose (Alpha 1, Beta 1, & Dopamine receptors: vasoCONSTRICTION, pupil dilation, bladder sphincter contraction, ejaculation
Identify signs of and drugs used for ANAPHYLACTIC SHOCK
Drug: Epinephrine
Signs:
Wheezing, confusion/anxiety, ⇧ HR, lightheadedness, glottis edema, hypotension, difficulty breathing, skin rash,
Drugs: Epinephrine (1st line)
-Activates Alpha 1, Beta 1 and Beta 2 receptors to reverse anaphylactic manifestations
Alpha 1: vasoCONSTRICTION to suppress glottis edema
Beta 1: ⇧ CO to raise BP
Beta 2: bronchial dilation to reduce bronchoconstriction
Explain the consequences of using too much intranasal albuterol and associated patient teaching needed.
Consequences:
-If albuterol is administered in large doses, it can lose its Beta 2 selectivity, causing: tachycardia, angina, & tremors
Patient Teaching:
-Do not exceed prescribed dose for albuterol
-Avoid caffeine
-Observe for palpitations or chest pain
Identify the most serious side effect of alpha1-adrenergic receptor blockers.
**alpha 1-adrenergic receptor blockers inhibit smooth muscle contraction
ORTHOSTATIC HYPOTENSION: causing dizziness, light-headedness, and syncope
List the contraindications for administering beta blockers.
-Bradycardia
-AV block or Heart block
-Diabetes
-Asthma or COPD
-History of anaphylaxis
Describe the nursing interventions for the side effects of clonidine.
Clonidine (Alpha 2 Agonists)
Antihypertensive
Vasodilates
2nd line drug: always used in combination with another antihypertensive med
Side Effects:
Drowsiness
Xerostomia (dry mouth)
Rebound hypertension
Interventions:
Avoid driving or hazardous activities
Chewing gum, sucking on candy, sipping on fluids
Tapering clonidine slowly over 2-4 days
Monitor BP
Identify the drug classes that decrease systemic vascular resistance (vasoconstriction).
ACE Inhibitors
ARBs
Alpha 1 -Adrenergic Blockers (Prazosin)
CNS Alpha 2 Agonist
Direct vasodilators
Describe the effects of beta-2 adrenergic stimulators.
Opens up lung passages and blood vessels
Mimics the natural effects of epinephrine and norepinephrine (sympathomimetics)
Identify the drug of choice for bradycardia treatment.
ATROPINE (anticholinergic):
1st line drug for cardiac arrest
Blocks PNS (slow and digest) to ⇧ HR
What are the toxic effects of cholinesterase inhibitors (helps acetylcholine)?
SLUDGE:
Salivation
Lacrimation
Urination
Diaphoresis / Diarrhea
GI cramping
Emesis (vomiting)
Killer Bs:
Bradycardia
Bronchospasm
Bronchorrhea (watery mucus)
What is the therapeutic use of norepinephrine?
Therapeutic use:
Emergency IV drug for SEVERE HYPOTENSION
VasoCONSTRICTOR
⇧ HR to prevent cardiovascular death/collapse
