nervous system drugs Flashcards
alpha 1 receptors
- vasoconstriction
- mydriasis
- ejaculation
- constriction of sphincter GI/GU
alpha 2 receptor
centrally acting
- decreases SNS outflowfrom CNS
beta 1 receptor
increase HR
increase heart contraction
increase AV node conduction
renin release
decreases insulin
beta 2 receptor
bronchodilation
- uterine muscle relaxation
- skeletel muscle tremors
- glycogenolysis
dopamine effects at low, medium, and high doses
low:
- vasodilation
medium:
- increase HR and contractility output
high:
- affect on A1 receptors-> vasoconstrict-> HTN
SNS effects
palpitations
tachycardia
nervousness
sweating
HA
HTN
mydriasis (pupil dilation)
increased BG
bronchodilation
catecholamines = main SNS neurotransmitters
norepi ** MAIN one
epi
dopamine
what are catecholamines metabolized by
Monoamine oxidase (MAO)
COMT
drugs that act like SNS
sympathomimetic
sympathetic agonist
adrenergic agonist
alpha-adrenergic agonist
beta adrenergic blocker
bronchodilators (beta 2 agonist)
albuterol- DOC acute asthma
epinephrine- DOC anaphylax
salmetrol- long acting
nasal decongestants
pseudoephedrine (Alpha 1)
phenylephrine (alpha 1)
ephedrine (Alpha 1&2, Beta 2)
what has a high rebound effect
nasal decongestants
- wean off one nare at a time
short name for vasoactive sympathomimetics
vasopressors or “pressors”
nursing considerations for pressors
monitor cardiac function
watch K+ level
SE of pressors
palpitations
HA
difficulty urinating
pale/cold skin
dyspnea
labile BP
NV
dobutamine MOA
- affects Beta 1
- increases CO/overall strengthens contractions
- positive inotrope
uses for dobutamine
CHF, shock
what is special about dobutamine administration
uses its own IV line
dobutamine SE
HTN
PVC
life-threatening tachycardia
hypokalemia
what is dopamine
synthetic form of neurotransmitter made in body
what receptors do dopaminergic drugs affect
Beta 1 (moderate dose), Alpha 1 (higher doses)
what is dopamine the DOC for
hypotension and shock
other uses for dopamine
HF and acute renal failure
dopamine SE
wide QRS, palpitations, N/V/D
what is the prototype adrenergic
epinephrine
epinephrine affects what receptors (high/low doses)
alpha receptors (high)
beta 1&2 (low)
epi is DOC for what
anaphylactic shock
other uses for epi
bronchospasm
acute asthma attack
cardiac arrest
epi is not first choice for….
hypovolemic shock
epi is given in high doeses with …?
cardiac arrest
local anesthetics
what is epi never given in combo with/where
in combo with local anesthetics involving fingers and toes bc it can completely occlude blood flow
epinephrine SE
dizziness, anxiety, HTN, dysrhythmias, tachycardia
how to store epi
at room temp in a dark place
epi effects may fade in …
10-20 minutes
isoproterenol affects what receptors
beta 1&2
uses for isoproterenol
heart block and bradycardia
SE of isoproterenol
HA
angina
arrhythmias
tachycardia
isoproterenol is notorious for what
keeping people awake, so it is not given before bed
midodrine affects what receptor
Alpha 1
what does midodrine treat
symptomatic orthostatic hypotension
dysautonomia
what to monitor for midodrine
BP sitting, standing, and lying
when not to give midodrine
4 hours before bed
where is midrodrine activated
the liver **prodrug
norepinephrine affects what receptors
Alpha 1&2, Beta 1
norepi is DOC for…
sepsis/septic shock
norepinephrine is also used for…
hypotension and shock
antidote for extravasation of norepi
phentolamine
2 main centrally acting A2 agonists
clonidine and methyldopa
clonidine is administered how
PO or patch
clonidine is used for…
HTN
severe pain
menopause
nicotine withdrawal
SE of clonidine
xerostomia
rebound HTN
embryotoxic
methyldopa administered how
PO or IV
what is methyldopa used for
HTN in pregnancy
what are the three categories of adrenergic antagonists
alpha blockers, beta blockers, and dual alpha blockers
SE of methyldopa
hepatotoxicity
3 main alpha blockers
doxazosin
phentolamine
tamsulosin
non cardio selective beta blockers
propanolol
sotalol
cardio selective beta blockers
metoprolol
esmolol
dual alpha blockers
carvedilol
labetalol
