N368 Test 2 Drugs Affecting the ANS Flashcards
1
Q
adrenergic agonists
A
stimulate that sympathetic nervous system
2
Q
adrenergic antagonists
A
inhibit the stimulation of the sypatheic nervous system
3
Q
cholinergics
A
stimulate the parasympathetic nervous system
4
Q
anticholingerics
A
inhibit the parasympathetic nervous system
5
Q
Drugs that stimulate that SNS result in a _____ response
A
fight ot flight
6
Q
term given to the parasympathetic nervous system
A
break pedal
7
Q
Drugs that stimulate the SNS are called
A
adrenergics
adrenergic agonists
sympathomimetics
8
Q
Neurotransmitters for SNS
A
Epinephrine
Norepinephrine
Dopamine
9
Q
Exmaples of synthetic neurotransmitters for the SNS
A
Isuprel and dobutamine
10
Q
What type of response do Isuprel and dobutamine produce and when are they used?
A
Sympathomimetic
intense cardiac agents used in shock
11
Q
Beta 1 Receptor Site
A
Heart
12
Q
Beta 2 Receptor Site
A
bronchiole walls
13
Q
Alpha 1 Receptor Site
A
Urinary bladder and ciliary muscle of the cyes
14
Q
Alpha 2 Receptor Site
A
GI tract
15
Q
Alpha 1Stimulation Response
A
increases force of contractions, increased BP, dialates pupils, decreases salivation, bladder relaxation with urinary sphincter contractions
16
Q
Alpha 2 Stimulation Response
A
vasodialation, decrease GI motility and tone, reduces NE release
17
Q
Beta 1 Stimulation Response
A
increase BP, increase myocardial contractility, increase renin release, increases oxygen supply to myocardial tissue, has a cardio protective effect
18
Q
Beta 2 Stimulation Response
A
bronchodilation, GI relaxation, uterine relaxation, increased blood sugar, blood flow to skeletal muscle
19
Q
what is renin
A
a precursor to vasoconstriction
20
Q
nonselective adrenergic agents:
A
stimulate more than one receptor site in equal proportions, leading to more side effects
21
Q
selective adrenergic agents:
A
have greater affinity for certian receptors
22
Q
Alpha 1 Sympathomimetic applications
A
hypotension, mydriasis (eye exams), nasal congestion
23
Q
Alpha 2 Sympathomimetic applications
A
hypertension
24
Q
Beta 1 Sympathomimetic applications
A
cardiac arrest, heart failure, and shock
25
Beta 2 Sympathmomimetic applications
asthma, premature labor
26
synthetic version of epinephrine
adrenalin
27
What receptor sites are effected by ephinephrine
Alpha, Beta 1 and Beta 2
28
Through what routes can epinephrine be given
most commonly given through IV but can also be given through IM, SQ, and Inhalation
29
What are some situations in which epinephrine would be used
anaphylactic shock, bronchial spasms, cardiac arrest, severe allergic reactions
30
Side effects of epinephrine
anorexia, N&V, nervousness, agitation, headache, insomnia, syncope, dizziness
31
What is the synthetic name for norepinephrine
levophed
32
In what situation might norepinephrine be used?
cardiac shock
33
What response does norepinephrine have
vasoconstrictor, increases BP and CO
34
Nursing assesment when giving norepinephrine
monitor BP q 2-5 minutes during infusion
35
catecholamines
naturally occurring neurotransmitters
36
What should be monitored when giving both Beta 2 agonist and antagonists
blood pressure and blood sugar
37
Why is epinephrine not usually given IM?
can cause muscular necrosis
38
What are the receptor sites for norepinephrine?
Alpha 1 and Beta 1
39
What is the synthetic version of Dopamine?
inotropin
40
What are the receptor sites for dopamine
Alpha 1 and Beta 1
41
What is the most common route for giving inotropin?
IV
42
Why is inotropin used?
to correct hypotension and increase cardiac contractility
43
What happens to the kidenys in with low doses of inotropin?
increase in renal blood flow
44
What happend to the kidney in high doses of inotropin?
blood flow is cut of to the kidneys
45
What should be assesed when giving inotropin
BP, urinary output, cardiac output
46
What is givin if the IV site becomes infiltrated when giving inotropin
Regitine SQ
47
What is the generic name for Dobutrex?
Dobutamine
48
What is the receptor site for dobutamine
Beta 1
49
What is dobutamine used for
cardiac shock
50
Through what route is dobutamine given?
IV
51
What is the result of a dobutamine infusion?
increased cardiac contractility, stroke volume, and cardiac output
52
Waht is the generic name for Isuprel?
isoproterenol
53
What are the receptor sites for Isuprel?
Beta 1 and Beta 2
54
Waht are the routes through which isuprel is given
IV, SQ (intracardiac), inhalation
55
What is isoproternol used for
cardiac shock, cardiac arrest, severe bronchospasms
56
What are the theraputic effects of isuprel
increased heart rate, contractilitu, dialates bronchial tubes
57
What is an adverse side effect of isuprel
arrhythmias and hypertension
58
What is the classification of albuterol
selective Beta 2
59
What is the primary theraputic effect of albuterol
bronchodilation
60
what is albuterol used to treat
asthma, COPD, bronchitis
61
what are the side effects of albuterol
tremors, restlessness, nervousness if Beta 1 is stimulated
62
another name for brethine
terbutaline sulfate
63
what is the receptor site for brethine
Beta 2
64
what is brethine used for
bronchodiliation and to stop uterine contractions
65
what would indicate the use of brethine
broncho spasms
66
what is the pharm. class of brethine
bronchodilator
67
What should be monitored when using sympathomimetics?
hypertension, arrhythmias, and tachycardia
68
What are the side effects of sympathomimetics?
dry mouth, anorexia, nausea, vomiting, and increased glucose levels
69
Patient teaching regarding sympathomimetics used for nasal congestion
rebound congestion can occur
70
Other names for adrenergic blockers
antagonists or sympatholytics
71
what does an adrenergic blocker do
blocks the effects of neurotransmitters
72
Which receptor sites do adrenergic blockers effect?
Alpha 1, Beta !, and Beta 2
73
What are adrenergic blockers used for?
vasodilation of smooth vascular muscle
74
Which autonomic agent is the most widely used?
adrenergic blockers
75
How do adrenergic blockers effect Alpha 1 receptor sites:
vasodilation, decreased blood pressure, pupil constriction, ejaculation supression, relaxes prostate gland muscle, bladder neck and urethra
76
How do adrenergic blockers effect Beta 1 receptor sites
decreased HR, decreased myocardial contractility
77
How do adrenergic blockers effect Beta 2 receptor sites
bronchial constriction,", uterine contraction, inhibits glycogenolysis (decreased BS)
78
What is the main use of Alpha 1 blockers
```
its effect on vascular smooth muscle
relaxes smooth muscle in arteries
lowered BP
relaxes bladder neck, prostate, and urethra
PVD (vasodialation)
```
79
Side effects of alpha blockers
```
cardiac dysrhythmias
flushing
hypotension
impotence or decreased libido
depression
nasal congestion
```
80
What are the side effects of alpha blockers usually based on
the dosage
81
What are the teo types of Beta Blockers
nonselective and selective
82
What patients should nonselective beta blockers be used cautiously in
COPD and asthma
83
Which Beta sites do nonselective blockers effect?
both 1 and 2
84
Which receptor site do cardioselective beta blockers effect?
Beta
85
What is the primary system that Beta Blockers are used for
cardiovascular
86
What do selective beta 1 blockers do
decrease HR
decrease contractility
decrease blood pressure
decrease renin release from kidneys
87
What does the release of renin do
decreases the work of the heart
88
Applications of Beta Blockers
```
hypertension
decreased cardiac workload after MI
tachycardia
stable angina pain
heart failure
narrow angle glaucoma (Timoptic)
```
89
What is Lopressor the trade name for
metoprolol
90
which receptor site does lopressor effect
beta 1
91
through which routes is Lopressor given
PO
| IV
92
what is the MOA of Lopressor
blocks stimulation of Beta 1 receptor
93
What is the theraputice effect of Lopressor
decreased HR and BP, decreases O2 demand by heart tissue
94
What should be monitored before giving Lopressor
BP and Pulse
95
What are the side effects of Beta Blockers
```
bradycardia impotence
hypotension nightmares
headache N&V
dizziness diarrhea
hypoglycemia fatigue
bronchospasms depression
```
96
What are the main causes for non-complinance with beta blockers
fatigue and depression
97
What should be be taught to pts when using Beta Blockers
```
Cannot stop abruptly
rise slowly when standing
can increase hypoglycemia
take pulse and BP before using
dont drink alcohol
do not take OTC meds without checking with HCP
```
98
What happens when Beta Blockers are abruptly stopped
increase in myocardial oxygen demand and contractility
99
Why should you not drink alcohol when taking Beta Blcokers
effects the metabolism of the drug
100
What do cholinergic drugs do
stimulate the PNS
101
What is another name for cholinergic drugs
parasympathomimetics
102
How do cholinergics stimulate the PNS
mimic acetylcholine neurotransmitter
103
what major responsees do cholinergics produce
stimulate bladder and GI tone, constrict pupils and increaseneuromuscular transmissions
104
other responses that cholinergics produce
decrease HR and BP, increase salivation, GI and Bronchial constriction and secretions
105
What is activated by cholinergics
Rest and digest response
106
how do direct acting cholinergics work
act on receptors to activate a response
107
indirect cholinergics
inhibit the action of cholinesterase allowing acetylcholine to stay in the system
108
what does cholinesterase do
destroys acetylcholine
109
direct acting cholinergic drugs
urecholine, reglan, pilocarpine
110
urecholine
increase urination
111
reglan
increase gastric emptying time
112
pilocarpine
increases drainage of aqueous humor from eye, this decreasing IOP in glaucima
113
What are cholinesterase inhibitors used for
```
inhibit action of cholinesterase
cause muscle skeletal stimulation
increase muscle contraction
used in neuromuscular diseases like myasthenia gravis
treatment of Alz
```
114
Side effects of cholinergics
```
hypotension
bradycardia
excessive salivation
increased salivation
increased gastric acid
cramps and diarrhea
bronchoconstriction
```
115
Nursing interventions used with cholinergics
```
monitir for bradycardia or hypotension
monitor UOP
monitor for gastric pain
auscultate breath sounds
increased bronchial secretions
note excessive diaphoresis
atropine for cholinergic crisis ( muscle weakness and increased salivation)
```
116
What do anticholingergics do?
inhibit actions of acetylcholine
117
What is another name for anticholinergics?
cholinergic blockers
118
Where are the acetylcholine muscarnic receptor sites
heart, lungs, GI tract, bladder, eyes and endocrine glands
119
What are the theraputic applications for anticholingerics
```
decrease gastric secretions in PUD
slows GI motility in IBS
mydriasis for eye exams
accelerate heart rhythm
asthma
prevent motion sickness
```
120
What actions do anticholingergics have on the body
```
decreased salivation
pupil dilation
decreased GI motility
increased pulse rate
relax bronchi
decrease bladder constriction
decrease tremors and rigidity
decrease bronchial secretions
```
121
What is the # anticholinergic given
atropine
122
what is atropine used for
pre-operatively to decrease salivation
antispasmodic for peptic ulcers
increase heart rate in bradycardia
123
what are the side effects of atropine
```
dry mouth
blurred vision
tachycardia
constipation
urinary retension
headache
hypotension
```
124
what nursing interventions are used with anticholingergics
increase fluid intake to prevent constipation
monitor urine output due to urinary retension
monitor bowel sounds
provide frquent mouth care
provide safe environment due to blurred vision, risk for hypotension and tachycardia
provide hard candy, ice chips or gum if allowed
provide foods high in fiber
125
What condition are anticholinergics contraindicated with
glaucoma
126
What is a neurological disorder that anticholinergics are used to treat
Parkinson's disease
127
Why are anticholinergics used with Parkinson's disease
supress tremors and muscular rigity
| decrease salivation
128
what is the drug name of the anicholinergic used to treat Parkinson's disease
Cogentin
