Peripheral Nervous System Drugs Flashcards
Sympathomimetic/Adrenergic Agonist drugs function:
Stimulates the SNS
1) Directly activate adrenergic receptors
OR
2) Indirectly activate adrenergic receptors by βing release of NE from nerve terminals
1) HTN (alpha2)
2) asthma (beta2)
2) Pre-term labor (beta2)
3) cardiac arrest (beta1)
4) nasal congestion (alpha1)
Sympathomimetic/Adrenergic Agonist drugs act on which receptors?
πlpha and πeta receptors
Ignore alpha2
Sympathomimetic/Adrenergic Agonist Prototype:
Epinephrine (Catecholamine)
Epinephrine MOA:
Activates:
1) Alpha1 receptors (vasoconstriction)
2) Alpha2 receptors ( β release of NE)
3) Beta1 receptors (β HR, contractility, & AV conduction velocity)
4) Beta2 receptors (bronchodilation)
Epinephrine is primarily used for what type of situations? Other therapeutic uses?
PRIMARILY USED FOR EMERGENCIES!
Life-saving Drugs
1) Cardiac arrest (beta1)
2) Anaphylaxis (β BP, alpha1)
3) Hemostasis (alpha1)
4) Bronchodilation (beta2)
5) Vasoconstriction (alpha1)
Epinephrine ADRs:
1) Hypertensive crisis (vasoconstriction)
2) Dysrhythmias
3) Angina
4) Necrosis from extravasation
5) Hyperglycemia (exacerbated in DM pts)
Epinephrine Nursing Considerations & Contraindications:
NCs:
1) Monitor ptβs cardiac status
- can use Beta-blocker (Metoprolol) to reduce cardiac ADRs
2) Monitor BP
- can use
3) Monitor blood glucose levels in DM pts
Contraindicated for use in pts with:
1) cardiac issues (dysrhythmias)
2) HTN
Anti-Adrenergic/Adrenergic Antagonist drugs function:
Blocks the SNS
Directly or Indirectly β release of NE from nerve terminals
Antiadrenergic/Adrenergic Antagonist drugs act on which receptors?
πlpha and πeta receptors
Antiadrenergic/Adrenergic Antagonist drugs used for (Disorders, Location, Receptor, and Effect):
Used for HTN, PV disorders, and CHF
1) Heart (π1) β> βHR, β contractility (force), β conduction
2) Lungs (π2) β> bronchoconstriction
3) Blood vessels (π1) β> Vasodilation (β BP)
MOST WIDELY PRESCRIBED CLASS OF ANS Drugs
Alpha1 Receptor Antiadrenergic/Adrenergic Antagonist Prototype:
Prazosin (Minipress)
Prazosin (Minipress) MOA:
Blocks the SNS
Selective blockade of alpha1 receptors
1) Vasodilation of arterioles & veins (β BP)
2) Contraction of detrusor muscle & Relaxation of bladder sphincters & prostatic capsule (β urinary outflow)
Prazosin (Minipress) Therapeutic Uses:
1) Essential HTN (vasodilation, β BP)
- NOT as a monotherapy
2) BPH (β urinary outflow)
Prazosin (Minipress) Therapeutic ADRs:
1) 1st dose: orthostatic hypotension
2) dizziness, lightheadedness
3) weakness
4) headache
5) Reflex tachycardia
6) Nasal congestion
Prazosin (Minipress) Nursing Considerations:
1) Monitor BP & HR before and after administration
2) Instruct pt to stand or sit up slowly, or take 1st dose before bed to minimize effects of postural hypotension
(1st dose should also be small)
Beta Receptor Antiadrenergic/Adrenergic Antagonist Prototype:
Propranolol (Inderal LA)
Propranolol (Inderal LA) MOA:
Blocks the SNS
Non-selective blockade of beta1 and beta2 receptors
1) β HR, Contractility, & electrical conduction resulting in decreased Cardiac output (beta1)
2) Suppress renin secretion (beta1)
3) Bronchoconstriction of lungs (beta2)
4) Vasoconstriction of blood vessels (beta2)
5) β glycogenolysis (beta2)
(AKA Beta-blocker)
Propranolol (Inderal LA) Therapeutic Uses:
1) HTN
2) Angina
3) Dysrhythmias
4) MI
βlol in your heartβ
Propranolol (Inderal LA) ADRs:
1) Bradycardia
2) AV heart block
3) HF
4) Rebound cardiac excitation
5) Bronchoconstriction
6) Inhibition of glycogenolysis
-More likely in pts w/ DM to become hypoglycemic if med abruptly stopped
⧫ CNS Effects
Propranolol (Inderal LA) Nursing Considerations:
1) Monitor BP & HR before & after administration
- orthostatic BP (supine & standing)
2) Monitor heart with ECG
3) Pts w/ DM: Monitor blood glucose levels more frequently; S/S of hypoglycemia may or may not present
Caution/Contraindicated for pts with:
1) HF
2) Asthma
3) Diabetes
4) Depression
5) Congruent use w/ CCB
Cholinergic/Parasympathomimetic/Muscarinic Agonist drugs function:
Stimulates the PsNS
1) Directly stimulates cholinergic receptors
OR
2) Indirectly stimulates cholinergic receptors by inhibiting acetylcholinesterase (β ACh)
- treat urinary retention
-treat glaucoma
Cholinergic/Parasympathomimetic/Muscarinic Agonist drugs act on which receptors?
Muscarinic and Nicotinic receptors
Cholinergic/Parasympathomimetic/Muscarinic Agonist Prototype:
Bethanechol (Urecholine)
Bethanechol (Urecholine) MOA:
Stimulates PsNS
Directly bind & activate muscarinic receptors
1) Stimulates smooth muscle contraction in GI and Urinary system
