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Nursing N368 Pharmacology I > N368 Test 2 Drugs Affecting the ANS > Flashcards

N368 Test 2 Drugs Affecting the ANS Flashcards

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1
Q

adrenergic agonists

A

stimulate that sympathetic nervous system

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2
Q

adrenergic antagonists

A

inhibit the stimulation of the sypatheic nervous system

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3
Q

cholinergics

A

stimulate the parasympathetic nervous system

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4
Q

anticholingerics

A

inhibit the parasympathetic nervous system

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5
Q

Drugs that stimulate that SNS result in a _____ response

A

fight ot flight

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6
Q

term given to the parasympathetic nervous system

A

break pedal

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7
Q

Drugs that stimulate the SNS are called

A

adrenergics
adrenergic agonists
sympathomimetics

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8
Q

Neurotransmitters for SNS

A

Epinephrine
Norepinephrine
Dopamine

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9
Q

Exmaples of synthetic neurotransmitters for the SNS

A

Isuprel and dobutamine

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10
Q

What type of response do Isuprel and dobutamine produce and when are they used?

A

Sympathomimetic

intense cardiac agents used in shock

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11
Q

Beta 1 Receptor Site

A

Heart

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12
Q

Beta 2 Receptor Site

A

bronchiole walls

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13
Q

Alpha 1 Receptor Site

A

Urinary bladder and ciliary muscle of the cyes

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14
Q

Alpha 2 Receptor Site

A

GI tract

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15
Q

Alpha 1Stimulation Response

A

increases force of contractions, increased BP, dialates pupils, decreases salivation, bladder relaxation with urinary sphincter contractions

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16
Q

Alpha 2 Stimulation Response

A

vasodialation, decrease GI motility and tone, reduces NE release

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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

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18
Q

Beta 2 Stimulation Response

A

bronchodilation, GI relaxation, uterine relaxation, increased blood sugar, blood flow to skeletal muscle

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19
Q

what is renin

A

a precursor to vasoconstriction

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20
Q

nonselective adrenergic agents:

A

stimulate more than one receptor site in equal proportions, leading to more side effects

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21
Q

selective adrenergic agents:

A

have greater affinity for certian receptors

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22
Q

Alpha 1 Sympathomimetic applications

A

hypotension, mydriasis (eye exams), nasal congestion

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23
Q

Alpha 2 Sympathomimetic applications

A

hypertension

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24
Q

Beta 1 Sympathomimetic applications

A

cardiac arrest, heart failure, and shock

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25
Q

Beta 2 Sympathmomimetic applications

A

asthma, premature labor

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26
Q

synthetic version of epinephrine

A

adrenalin

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27
Q

What receptor sites are effected by ephinephrine

A

Alpha, Beta 1 and Beta 2

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28
Q

Through what routes can epinephrine be given

A

most commonly given through IV but can also be given through IM, SQ, and Inhalation

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29
Q

What are some situations in which epinephrine would be used

A

anaphylactic shock, bronchial spasms, cardiac arrest, severe allergic reactions

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30
Q

Side effects of epinephrine

A

anorexia, N&V, nervousness, agitation, headache, insomnia, syncope, dizziness

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31
Q

What is the synthetic name for norepinephrine

A

levophed

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32
Q

In what situation might norepinephrine be used?

A

cardiac shock

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33
Q

What response does norepinephrine have

A

vasoconstrictor, increases BP and CO

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34
Q

Nursing assesment when giving norepinephrine

A

monitor BP q 2-5 minutes during infusion

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35
Q

catecholamines

A

naturally occurring neurotransmitters

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36
Q

What should be monitored when giving both Beta 2 agonist and antagonists

A

blood pressure and blood sugar

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37
Q

Why is epinephrine not usually given IM?

A

can cause muscular necrosis

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38
Q

What are the receptor sites for norepinephrine?

A

Alpha 1 and Beta 1

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39
Q

What is the synthetic version of Dopamine?

A

inotropin

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40
Q

What are the receptor sites for dopamine

A

Alpha 1 and Beta 1

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41
Q

What is the most common route for giving inotropin?

A

IV

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42
Q

Why is inotropin used?

A

to correct hypotension and increase cardiac contractility

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43
Q

What happens to the kidenys in with low doses of inotropin?

A

increase in renal blood flow

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44
Q

What happend to the kidney in high doses of inotropin?

A

blood flow is cut of to the kidneys

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45
Q

What should be assesed when giving inotropin

A

BP, urinary output, cardiac output

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46
Q

What is givin if the IV site becomes infiltrated when giving inotropin

A

Regitine SQ

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47
Q

What is the generic name for Dobutrex?

A

Dobutamine

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48
Q

What is the receptor site for dobutamine

A

Beta 1

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49
Q

What is dobutamine used for

A

cardiac shock

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50
Q

Through what route is dobutamine given?

A

IV

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51
Q

What is the result of a dobutamine infusion?

A

increased cardiac contractility, stroke volume, and cardiac output

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52
Q

Waht is the generic name for Isuprel?

A

isoproterenol

53
Q

What are the receptor sites for Isuprel?

A

Beta 1 and Beta 2

54
Q

Waht are the routes through which isuprel is given

A

IV, SQ (intracardiac), inhalation

55
Q

What is isoproternol used for

A

cardiac shock, cardiac arrest, severe bronchospasms

56
Q

What are the theraputic effects of isuprel

A

increased heart rate, contractilitu, dialates bronchial tubes

57
Q

What is an adverse side effect of isuprel

A

arrhythmias and hypertension

58
Q

What is the classification of albuterol

A

selective Beta 2

59
Q

What is the primary theraputic effect of albuterol

A

bronchodilation

60
Q

what is albuterol used to treat

A

asthma, COPD, bronchitis

61
Q

what are the side effects of albuterol

A

tremors, restlessness, nervousness if Beta 1 is stimulated

62
Q

another name for brethine

A

terbutaline sulfate

63
Q

what is the receptor site for brethine

A

Beta 2

64
Q

what is brethine used for

A

bronchodiliation and to stop uterine contractions

65
Q

what would indicate the use of brethine

A

broncho spasms

66
Q

what is the pharm. class of brethine

A

bronchodilator

67
Q

What should be monitored when using sympathomimetics?

A

hypertension, arrhythmias, and tachycardia

68
Q

What are the side effects of sympathomimetics?

A

dry mouth, anorexia, nausea, vomiting, and increased glucose levels

69
Q

Patient teaching regarding sympathomimetics used for nasal congestion

A

rebound congestion can occur

70
Q

Other names for adrenergic blockers

A

antagonists or sympatholytics

71
Q

what does an adrenergic blocker do

A

blocks the effects of neurotransmitters

72
Q

Which receptor sites do adrenergic blockers effect?

A

Alpha 1, Beta !, and Beta 2

73
Q

What are adrenergic blockers used for?

A

vasodilation of smooth vascular muscle

74
Q

Which autonomic agent is the most widely used?

A

adrenergic blockers

75
Q

How do adrenergic blockers effect Alpha 1 receptor sites:

A

vasodilation, decreased blood pressure, pupil constriction, ejaculation supression, relaxes prostate gland muscle, bladder neck and urethra

76
Q

How do adrenergic blockers effect Beta 1 receptor sites

A

decreased HR, decreased myocardial contractility

77
Q

How do adrenergic blockers effect Beta 2 receptor sites

A

bronchial constriction,”, uterine contraction, inhibits glycogenolysis (decreased BS)

78
Q

What is the main use of Alpha 1 blockers

A 
its effect on vascular smooth muscle
relaxes smooth muscle in arteries
lowered BP
relaxes bladder neck, prostate, and urethra
PVD (vasodialation)
79
Q

Side effects of alpha blockers

A 
cardiac dysrhythmias
flushing
hypotension
impotence or decreased libido
depression
nasal congestion
80
Q

What are the side effects of alpha blockers usually based on

A

the dosage

81
Q

What are the teo types of Beta Blockers

A

nonselective and selective

82
Q

What patients should nonselective beta blockers be used cautiously in

A

COPD and asthma

83
Q

Which Beta sites do nonselective blockers effect?

A

both 1 and 2

84
Q

Which receptor site do cardioselective beta blockers effect?

A

Beta

85
Q

What is the primary system that Beta Blockers are used for

A

cardiovascular

86
Q

What do selective beta 1 blockers do

A

decrease HR
decrease contractility
decrease blood pressure
decrease renin release from kidneys

87
Q

What does the release of renin do

A

decreases the work of the heart

88
Q

Applications of Beta Blockers

A 
hypertension
decreased cardiac workload after MI
tachycardia
stable angina pain
heart failure
narrow angle glaucoma (Timoptic)
89
Q

What is Lopressor the trade name for

A

metoprolol

90
Q

which receptor site does lopressor effect

A

beta 1

91
Q

through which routes is Lopressor given

A

PO

IV

92
Q

what is the MOA of Lopressor

A

blocks stimulation of Beta 1 receptor

93
Q

What is the theraputice effect of Lopressor

A

decreased HR and BP, decreases O2 demand by heart tissue

94
Q

What should be monitored before giving Lopressor

A

BP and Pulse

95
Q

What are the side effects of Beta Blockers

A 
bradycardia impotence
hypotension nightmares
headache N&V
dizziness diarrhea
hypoglycemia fatigue
bronchospasms depression
96
Q

What are the main causes for non-complinance with beta blockers

A

fatigue and depression

97
Q

What should be be taught to pts when using Beta Blockers

A 
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
Q

What happens when Beta Blockers are abruptly stopped

A

increase in myocardial oxygen demand and contractility

99
Q

Why should you not drink alcohol when taking Beta Blcokers

A

effects the metabolism of the drug

100
Q

What do cholinergic drugs do

A

stimulate the PNS

101
Q

What is another name for cholinergic drugs

A

parasympathomimetics

102
Q

How do cholinergics stimulate the PNS

A

mimic acetylcholine neurotransmitter

103
Q

what major responsees do cholinergics produce

A

stimulate bladder and GI tone, constrict pupils and increaseneuromuscular transmissions

104
Q

other responses that cholinergics produce

A

decrease HR and BP, increase salivation, GI and Bronchial constriction and secretions

105
Q

What is activated by cholinergics

A

Rest and digest response

106
Q

how do direct acting cholinergics work

A

act on receptors to activate a response

107
Q

indirect cholinergics

A

inhibit the action of cholinesterase allowing acetylcholine to stay in the system

108
Q

what does cholinesterase do

A

destroys acetylcholine

109
Q

direct acting cholinergic drugs

A

urecholine, reglan, pilocarpine

110
Q

urecholine

A

increase urination

111
Q

reglan

A

increase gastric emptying time

112
Q

pilocarpine

A

increases drainage of aqueous humor from eye, this decreasing IOP in glaucima

113
Q

What are cholinesterase inhibitors used for

A 
inhibit action of cholinesterase
cause muscle skeletal stimulation
increase muscle contraction
used in neuromuscular diseases like myasthenia gravis
treatment of Alz
114
Q

Side effects of cholinergics

A 
hypotension
bradycardia
excessive salivation
increased salivation
increased gastric acid 
cramps and diarrhea
bronchoconstriction
115
Q

Nursing interventions used with cholinergics

A 
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
Q

What do anticholingergics do?

A

inhibit actions of acetylcholine

117
Q

What is another name for anticholinergics?

A

cholinergic blockers

118
Q

Where are the acetylcholine muscarnic receptor sites

A

heart, lungs, GI tract, bladder, eyes and endocrine glands

119
Q

What are the theraputic applications for anticholingerics

A 
decrease gastric secretions in PUD
slows GI motility in IBS
mydriasis for eye exams
accelerate heart rhythm 
asthma
prevent motion sickness
120
Q

What actions do anticholingergics have on the body

A 
decreased salivation
pupil dilation
decreased GI motility
increased pulse rate
relax bronchi
decrease bladder constriction
decrease tremors and rigidity
decrease bronchial secretions
121
Q

What is the # anticholinergic given

A

atropine

122
Q

what is atropine used for

A

pre-operatively to decrease salivation
antispasmodic for peptic ulcers
increase heart rate in bradycardia

123
Q

what are the side effects of atropine

A 
dry mouth
blurred vision
tachycardia
constipation
urinary retension
headache 
hypotension
124
Q

what nursing interventions are used with anticholingergics

A

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
Q

What condition are anticholinergics contraindicated with

A

glaucoma

126
Q

What is a neurological disorder that anticholinergics are used to treat

A

Parkinson’s disease

127
Q

Why are anticholinergics used with Parkinson’s disease

A

supress tremors and muscular rigity

decrease salivation

128
Q

what is the drug name of the anicholinergic used to treat Parkinson’s disease

A

Cogentin

Nursing N368 Pharmacology I (16 decks)

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