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Pharm Exam 3 Materials > Nervous System > Flashcards

Nervous System Flashcards

1
Q

What drugs are considered as Adrenergic Agonists?

A

Epinephrine

Albuterol

Clonidine

Atenolol

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2
Q

What do Adrenergic agonists do?

A

Drugs that stimulate the SNS

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3
Q

What is the primary neurotransmitter that is responsible for most of the adrenergic activities?

A

Norepinephrine

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4
Q

What are the two different classifications of Adrenergic Agonists?

A

Direct = Directly stimulating receptors

Indirect = Stimulates release of norepinephrine

Mixed-Acting = Both direct and indirect

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5
Q

What is Catecholamine?

A

A chemical structure of a substance that can produce a sympathomimetic response.

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6
Q

What do Alpha 1 Receptors do and what do they affect?

A

Causes blood vessels to vasoconstriction = Increased BP

Causes Mydriasis (pupil dilation) in the eyes

Causes Bladder relaxation

Causes prostate to contract.

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7
Q

What do Alpha 2 Receptors do and what do they affect?

A

Affects blood vessels by reducing norepinephrine which causes decreased BP

Causes decreased GI tone and motility by affecting smooth muscle of GI

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8
Q

What do Beta 1 Receptors do and what do they affect?

A

Affects the heart by increasing heart contraction and heart rate.

Affects kidney by increasing renin and angiotensin production which increases blood pressure

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9
Q

What do Beta 2 Receptors do and what do they affect?

A

Decreases GI tone and Motility

Causes bronchodilation

Causes Uterine smooth muscles to relax

Activates glycogenolysis in the liver which then increases Blood sugar.

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10
Q

`What is the MOA of Epinephrine?

A

Acts on Alpha 1, Beta 1, and Beta 2 Receptors

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11
Q

What is Epinephrine used for?

A

Nasal congestion

Allergic reaction

anaphylaxis

asthma

bronchospasm

angioedema

status asthmaticus (asthma attack)

cardiac arrest

Cardiac resuscitation

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12
Q

What is the SE and ASE of Epinephrine?

A

Tachycardia

Hypertension

Tissue necrosis if IV infiltrates

Agitation

Hyperglycemia

V-fib

pulmonary edema

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13
Q

Route of Administration of Epinephrine?

A

IV

SQ

Inhalation

Topical

IM

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14
Q

True or false? Epinephrine is considered as an emergency response medication?

A

True

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15
Q

What are the contraindications for Epinephrine?

A

Dysrhythmia, glaucoma and cardiogenic shock

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16
Q

What should be monitored when patient is on epinephrine?

A

Monitor EKG

Monitor VS

Monitor Urine output for Urinary retention

Monitor glucose levels for elevation

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17
Q

What should taught to a patient about epinephrine?

A

Epi-pen should be available at all times

Use at onset of symptoms

Make sure epi-pen is not expired.

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18
Q

When administrating Epinephrine through IV, what are the nursing considerations?

A

IV for cardiac resuscitation should only be at 1 mg every 3-5 minutes

Monitor IV site for extravasation of drugs. Extravasation can cause tissue necrosis.

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19
Q

What is class is Albuterol considered?

A

Beta-adrenergic agoinist

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20
Q

What is the MOA of albuterol?

A

Stimulates Beta 2 adrenergic receptors in the lungs.

This causes bronchodilation by relaxing bronchial smooth muscles.

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21
Q

What is Albuterol used for?

A

Asthma and prophylaxis fore bronchospasms.

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22
Q

What are the SE/ASE of Albuterol?

A

Tremors

Dizziness

Palpitations/Tachycardia

HTN

Anxiety

Headache

Insomnia

Hyperglycemia

Dysthymia

Angioedema

Stevens-Johnson Syndrome

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23
Q

What should patients on albuterol know?

A

Have albuterol available at all times

Exercise can induce asthma so you may have to take some albuterol prior to exercising.

Tremors, dizziness, palpitations and tachycardia are common side effects of albuterol.

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24
Q

What should the nurse assess the patient on albuterol for?

A

VS

Oxygen saturation

Lung sounds (any airway constrictions? )

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25
Q

True or false? A nurse should assess VS and lungs before and after giving albuterol?

A

True

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26
Q

What drug class is Clonidine?

A

Central-acting alpha agonist.

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27
Q

What is the MOA of Clonidine?

A

Stimulates Alpha 2 receptors in the central nervous system.

Decreases Release of NE from sympathetic nerves

Decreases peripheral adrenergic receptor activation

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28
Q

What is Clonidine used for?

A

Hypertension

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29
Q

What is the Off-Label use of Clonidine?

A

ADHD

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30
Q

What are the SE/ASE of Clonidine?

A

Headache

Nasal Congestion

Drowsiness

Ejaculation dysfunction

Elevated liver enzymes

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31
Q

What are the Nursing Considerations for Clonidine?

A

Monitor VS and BP

Monitor CBP for elevated liver enzymes

32
Q

What do Adrenergic Antagonists/Blockers do?

A

Blocks effects of adrenergic transmitters.

It does this either directly occupying receptor space or inhibits release of neurotransmitters.

33
Q

True or false? Most Adrenergic antagonists block either alpha or beta receptors?

A

True

34
Q

Blocking Alpha 1 receptors produces what kinds of response?

A

Miosis (constriction of the pupils)

Vasodilation (decreases BP, reflex tachycardia may occur)

Suppress ejaculation

Reduce contraction of smooth muscles in bladder neck and prostate gland.

35
Q

Blocking Beta 1 receptors produces what kinds of response?

A

Decreases HR

Reduces force of myocardial contraction

36
Q

Blocking Beta 2 receptors produces what kinds of response?

A

Constricts bronchioles

Contracts uterus

Inhibits glycogenolysis = Decrease Blood Glucose.

37
Q

What class drug is Atenolol?

A

Beta 1 Adrenergic blocker.

38
Q

What is the MOA of Atenolol?

A

Selectively blocks Beta-1 Adrenergic receptor sites.

Decreases sympathetic outflow to the periphery

Suppresses RASS

39
Q

What is Atenolol used for?

A

HTN

Angina

Prophylaxis of AMI

40
Q

What are the SE/ASE of Atenolol?

A

Drowsiness

Dizziness

ED

Hypotension

Bradycardia

Bronchospasm

Dysrhythmia

Bronchospasm

41
Q

What do Cholinergic agonist drugs do?

A

Stimulate the parasympathetic nervous system

Mimics the action of acetylcholine

42
Q

What are the two types of cholinergic receptors?

A

Muscarinic (affects smooth muscle)

NIcotinic ( neuromuscular)

43
Q

What are the two types of Cholinergic agonists?

A

Direct acting = Directly binds to receptors

Indirect acting = Binds to acetylcholinesterase to slow down breakdown of acetylcholine, which means more acetylcholine

44
Q

What class drug is Bethanechol chloride?

A

Parasympathomimetic Cholinergic drug

45
Q

What is the MOA of Bethanechol chloride?

A

Stimulates cholinergic (muscarinic) receptors

46
Q

What is Bethanechol chloride used for?

A

Urinary retention and neurogenic bladder

47
Q

What are the contraindications for Bethanechol chloride?

A

Intestinal or urinary tract obstruction

IBS (irritable Bowel syndrome)

Bradycardia

COPD

Asthma

48
Q

What are the SE/ASE of Bethanechol chloride?

A

Hypersalivation

Sweating

Urinary urgency/frequency

Tachycardia

Weakness

Bronchospasm

Cholinergic crisis

49
Q

What should the nurse assess for in a patient with Bethanechol chloride?

A

VS

Urine output

Heath history (asthma, urinary obstruction)

50
Q

What is the antidote for Bethanechol chloride?

A

Atropine sulfate

51
Q

What needs to be monitored for a patient on Bethanechol chloride?

A

I&O

Lung sounds rales/ronchi

Signs of cholinergic crisis

52
Q

What should be taught to a patient on Bethanechol chloride?

A

Slow position changes due to orthostatic hypotension

Report any breathing difficulty and urinary problems

53
Q

What does SLUD stand for in cholinergic crisis?

A

Salivation

Lacrimation

Urination

Defection

54
Q

What do Cholinergic Antagonists do?

A

Inhibit actions of acetylcholine by blocking acetylcholine receptors

55
Q

What do Cholinergic Antagonists affect?

A

Heart

Respiratory Tract

GI tract

Urinary system

Eyes

Exocrine glands

56
Q

What class drug is Atropine?

A

Anticholinergic

57
Q

What is the MOA of Atropine?

A

Inhibits acetylcholine by occupying receptors

58
Q

What is Atropine used for?

A

Pre-op med to reduce salivation

Increase Heart rate

Dilate pupils

59
Q

What is the SE/ASE of Atropine?

A

Dry mouth

Urinary retention

Tachycardia

Paradoxic bradycardia

Pulmonary Edema

Laryngospasm

ANTICHOLINERGIC TOXICITY

60
Q

What are the contraindications of Atropine?

A

Glaucoma

BPH

MI

Myasthenia Gravis

61
Q

What precautions should a nurse know about with Atropine?

A

Renal or hepatic disorder

COPD

HF

62
Q

What should nurses monitor for?

A

VS

I&O

Bowel sounds/constipation

Mouth care.

63
Q

What should a patient on Atropine do if they have dry mouth? What if they have constipation?

A

For dry mouth, suck on hard, sour candy and suck on ice chips to decrease salivation

For Constipation, encourage more fluid intake and exercise

64
Q

What are the signs of Anticholinergic Toxicity?

A

Dilated Pupils (mydriasis)

Confusion

Dry mouth

Urinary retention

haking

Flushed skin

tachycardia

Absent bowel sounds

Hyperthermia

Grabbing invisible objects

65
Q

What class drug is Benztropine?

A

Antiparkinson, Anticholinergic Agent

66
Q

What is the MOA of Benztropine?

A

Blocks cholinergic (muscarinic) receptors

Decreases acetylcholine to reduce excess cholinergic activity

Blocks dopamine reuptake

67
Q

What is Benztropine used for?

A

Decrease involuntary symptoms of Parkinsonism like tremors and muscle spasms

68
Q

What are the contraindications of Benztropine?

A

Glaucoma

Myasthenia gravis

Tardive dyskinesia (involuntary and abnormal movements of the jaw, lips and tongue)

69
Q

What are the SE/ASE of Benztropine?

A

Urinary retention

Ocular hypertension

Ileus

Hyperthermia

Hallucinations (esp with older patients)

paresthesia

70
Q

What are some things nurses need to know about Benztropine?

A

It has little effect on mobility and muscle weakness

Can only be used in early stages of parkinsonism.

Remember that ileus is life threatening and the intestines no longer moves.

71
Q

What class drug is Tolterodine Tartrate?

A

Antimuscarinic; Anticholinergic Agent.

72
Q

What is the MOA of Tolterodine Tartrate?

A

Blocks cholinergic (muscarinic) receptors selectively in the urinary bladder

73
Q

What is Tolterodine Tartrate used for?

A

Decrease urinary frequency, urgency, incontinence

74
Q

What are the contraindications of Tolterodine Tartrate?

A

Urinary retention

Gastric paresis

Glaucoma

GI obstruction

75
Q

What are the SE/ASE of Tolterodine Tartrate?

A

Angioedema

Chest pain

tachycardia

peripheral edema

dry eyees

blurred vision

confusion

Pharm Exam 3 Materials (5 decks)

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