N368 Test 2 Drugs Affecting the ANS Flashcards
adrenergic agonists
stimulate that sympathetic nervous system
adrenergic antagonists
inhibit the stimulation of the sypatheic nervous system
cholinergics
stimulate the parasympathetic nervous system
anticholingerics
inhibit the parasympathetic nervous system
Drugs that stimulate that SNS result in a _____ response
fight ot flight
term given to the parasympathetic nervous system
break pedal
Drugs that stimulate the SNS are called
adrenergics
adrenergic agonists
sympathomimetics
Neurotransmitters for SNS
Epinephrine
Norepinephrine
Dopamine
Exmaples of synthetic neurotransmitters for the SNS
Isuprel and dobutamine
What type of response do Isuprel and dobutamine produce and when are they used?
Sympathomimetic
intense cardiac agents used in shock
Beta 1 Receptor Site
Heart
Beta 2 Receptor Site
bronchiole walls
Alpha 1 Receptor Site
Urinary bladder and ciliary muscle of the cyes
Alpha 2 Receptor Site
GI tract
Alpha 1Stimulation Response
increases force of contractions, increased BP, dialates pupils, decreases salivation, bladder relaxation with urinary sphincter contractions
Alpha 2 Stimulation Response
vasodialation, decrease GI motility and tone, reduces NE release
Beta 1 Stimulation Response
increase BP, increase myocardial contractility, increase renin release, increases oxygen supply to myocardial tissue, has a cardio protective effect
Beta 2 Stimulation Response
bronchodilation, GI relaxation, uterine relaxation, increased blood sugar, blood flow to skeletal muscle
what is renin
a precursor to vasoconstriction
nonselective adrenergic agents:
stimulate more than one receptor site in equal proportions, leading to more side effects
selective adrenergic agents:
have greater affinity for certian receptors
Alpha 1 Sympathomimetic applications
hypotension, mydriasis (eye exams), nasal congestion
Alpha 2 Sympathomimetic applications
hypertension
Beta 1 Sympathomimetic applications
cardiac arrest, heart failure, and shock
Beta 2 Sympathmomimetic applications
asthma, premature labor
synthetic version of epinephrine
adrenalin
What receptor sites are effected by ephinephrine
Alpha, Beta 1 and Beta 2
Through what routes can epinephrine be given
most commonly given through IV but can also be given through IM, SQ, and Inhalation
What are some situations in which epinephrine would be used
anaphylactic shock, bronchial spasms, cardiac arrest, severe allergic reactions
Side effects of epinephrine
anorexia, N&V, nervousness, agitation, headache, insomnia, syncope, dizziness
What is the synthetic name for norepinephrine
levophed
In what situation might norepinephrine be used?
cardiac shock
What response does norepinephrine have
vasoconstrictor, increases BP and CO
Nursing assesment when giving norepinephrine
monitor BP q 2-5 minutes during infusion
catecholamines
naturally occurring neurotransmitters
What should be monitored when giving both Beta 2 agonist and antagonists
blood pressure and blood sugar
Why is epinephrine not usually given IM?
can cause muscular necrosis
What are the receptor sites for norepinephrine?
Alpha 1 and Beta 1
What is the synthetic version of Dopamine?
inotropin
What are the receptor sites for dopamine
Alpha 1 and Beta 1
What is the most common route for giving inotropin?
IV
Why is inotropin used?
to correct hypotension and increase cardiac contractility
What happens to the kidenys in with low doses of inotropin?
increase in renal blood flow
What happend to the kidney in high doses of inotropin?
blood flow is cut of to the kidneys
What should be assesed when giving inotropin
BP, urinary output, cardiac output
What is givin if the IV site becomes infiltrated when giving inotropin
Regitine SQ
What is the generic name for Dobutrex?
Dobutamine
What is the receptor site for dobutamine
Beta 1
What is dobutamine used for
cardiac shock
Through what route is dobutamine given?
IV
What is the result of a dobutamine infusion?
increased cardiac contractility, stroke volume, and cardiac output
Waht is the generic name for Isuprel?
isoproterenol
What are the receptor sites for Isuprel?
Beta 1 and Beta 2
Waht are the routes through which isuprel is given
IV, SQ (intracardiac), inhalation
What is isoproternol used for
cardiac shock, cardiac arrest, severe bronchospasms
What are the theraputic effects of isuprel
increased heart rate, contractilitu, dialates bronchial tubes
What is an adverse side effect of isuprel
arrhythmias and hypertension
What is the classification of albuterol
selective Beta 2
What is the primary theraputic effect of albuterol
bronchodilation
what is albuterol used to treat
asthma, COPD, bronchitis
what are the side effects of albuterol
tremors, restlessness, nervousness if Beta 1 is stimulated
another name for brethine
terbutaline sulfate
what is the receptor site for brethine
Beta 2
what is brethine used for
bronchodiliation and to stop uterine contractions
what would indicate the use of brethine
broncho spasms
what is the pharm. class of brethine
bronchodilator
What should be monitored when using sympathomimetics?
hypertension, arrhythmias, and tachycardia
What are the side effects of sympathomimetics?
dry mouth, anorexia, nausea, vomiting, and increased glucose levels
Patient teaching regarding sympathomimetics used for nasal congestion
rebound congestion can occur
Other names for adrenergic blockers
antagonists or sympatholytics
what does an adrenergic blocker do
blocks the effects of neurotransmitters
Which receptor sites do adrenergic blockers effect?
Alpha 1, Beta !, and Beta 2
What are adrenergic blockers used for?
vasodilation of smooth vascular muscle
Which autonomic agent is the most widely used?
adrenergic blockers
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
How do adrenergic blockers effect Beta 1 receptor sites
decreased HR, decreased myocardial contractility
How do adrenergic blockers effect Beta 2 receptor sites
bronchial constriction,”, uterine contraction, inhibits glycogenolysis (decreased BS)
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)
Side effects of alpha blockers
cardiac dysrhythmias flushing hypotension impotence or decreased libido depression nasal congestion
What are the side effects of alpha blockers usually based on
the dosage
What are the teo types of Beta Blockers
nonselective and selective
What patients should nonselective beta blockers be used cautiously in
COPD and asthma
Which Beta sites do nonselective blockers effect?
both 1 and 2
Which receptor site do cardioselective beta blockers effect?
Beta
What is the primary system that Beta Blockers are used for
cardiovascular
What do selective beta 1 blockers do
decrease HR
decrease contractility
decrease blood pressure
decrease renin release from kidneys
What does the release of renin do
decreases the work of the heart
Applications of Beta Blockers
hypertension decreased cardiac workload after MI tachycardia stable angina pain heart failure narrow angle glaucoma (Timoptic)
What is Lopressor the trade name for
metoprolol
which receptor site does lopressor effect
beta 1
through which routes is Lopressor given
PO
IV
what is the MOA of Lopressor
blocks stimulation of Beta 1 receptor
What is the theraputice effect of Lopressor
decreased HR and BP, decreases O2 demand by heart tissue
What should be monitored before giving Lopressor
BP and Pulse
What are the side effects of Beta Blockers
bradycardia impotence hypotension nightmares headache N&V dizziness diarrhea hypoglycemia fatigue bronchospasms depression
What are the main causes for non-complinance with beta blockers
fatigue and depression
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
What happens when Beta Blockers are abruptly stopped
increase in myocardial oxygen demand and contractility
Why should you not drink alcohol when taking Beta Blcokers
effects the metabolism of the drug
What do cholinergic drugs do
stimulate the PNS
What is another name for cholinergic drugs
parasympathomimetics
How do cholinergics stimulate the PNS
mimic acetylcholine neurotransmitter
what major responsees do cholinergics produce
stimulate bladder and GI tone, constrict pupils and increaseneuromuscular transmissions
other responses that cholinergics produce
decrease HR and BP, increase salivation, GI and Bronchial constriction and secretions
What is activated by cholinergics
Rest and digest response
how do direct acting cholinergics work
act on receptors to activate a response
indirect cholinergics
inhibit the action of cholinesterase allowing acetylcholine to stay in the system
what does cholinesterase do
destroys acetylcholine
direct acting cholinergic drugs
urecholine, reglan, pilocarpine
urecholine
increase urination
reglan
increase gastric emptying time
pilocarpine
increases drainage of aqueous humor from eye, this decreasing IOP in glaucima
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
Side effects of cholinergics
hypotension bradycardia excessive salivation increased salivation increased gastric acid cramps and diarrhea bronchoconstriction
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)
What do anticholingergics do?
inhibit actions of acetylcholine
What is another name for anticholinergics?
cholinergic blockers
Where are the acetylcholine muscarnic receptor sites
heart, lungs, GI tract, bladder, eyes and endocrine glands
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
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
What is the # anticholinergic given
atropine
what is atropine used for
pre-operatively to decrease salivation
antispasmodic for peptic ulcers
increase heart rate in bradycardia
what are the side effects of atropine
dry mouth blurred vision tachycardia constipation urinary retension headache hypotension
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
What condition are anticholinergics contraindicated with
glaucoma
What is a neurological disorder that anticholinergics are used to treat
Parkinson’s disease
Why are anticholinergics used with Parkinson’s disease
supress tremors and muscular rigity
decrease salivation
what is the drug name of the anicholinergic used to treat Parkinson’s disease
Cogentin
