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Pharm > PNS Medications > Flashcards

PNS Medications Flashcards

1
Q

what is the pharmacological effect of CLONDINE?

A

vasodilation of blood vessels, decreases BP & HR

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2
Q

what receptors work with CLONDINE?

A

Alpha-2 adrenergic agonist

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3
Q

Therapeutic use of CLONDINE?

A

hypertension crisis
severe pain
ADHD
anxiety disorders
management of opioid withdrawls

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4
Q

adverse effects of CLONDINE?

A

NEURO= drowsiness, fatigue, headache

CARDIO= hypotension, sinus & AV arrhythmias

GI= dry mouth, constipation, N/V

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5
Q

what is the pharmacologic effects of Propranolol

A

decreases HR & decreases Cardiac output

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6
Q

what receptors work with Propranolol

A

Beta 1 & 2 adrenergic ANTAGONIST

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7
Q

therapeutic use of Propranolol

A

high blood pressure, angina & myocardial infarction

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8
Q

Adverse effects of Propanolol

A

CV: bradycardia, AV heart block, heart failure, rebound cardiac excitation

Pulmonary: bronchoconstriction

CNS: CNS depression, insomnia, nightmares & hallucinations

hypoglycemia

drug interactions= calcium channel blockers * insulin

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9
Q

precautions/ warnings for propanolol

A

diabetes can mask hypogylcemia & tachycardia
cardiac, respiratory (asthma) & psychiatric disorders

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10
Q

metroprolol pharmacologic effects:

(Lopressor, Toprol XL)

A

Decreases HR & decreases CO but does not block bronchial beta 2 receptors

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11
Q

what receptors work with metroprolol?

A

Beta 1 Adrenergic antagonist

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12
Q

Therapeutic uses of metroprolol

A

Hypertension

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13
Q

adverse effects of Metroprolol

A

Bradycardia, AV heart block, Heart failure, Rebound cardiac excitation

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14
Q

precautions, warning & contradictions of Metroprolol

A

Safer with asthma & Diabetic patients

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15
Q

prazosin (minipress)

A

alpha 1 adrenergic antagonists

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16
Q

therapeutic uses for prazosin

A

Dilation of arterioles & veins, relaxation of smooth muscles & prostatic capsule

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17
Q

adverse effects for prazosin

A

Orthostatic hypotension, reflex tachycardia, Inhibition of ejaculation

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18
Q

receptors for
Albuterol

A

beta 2 adrenergic agonist

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19
Q

therapeutic use of Albuterol

A

asthma & delay of preterm labor

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20
Q

adverse effects of albuterol

A

tremor & tracycardia

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21
Q

iv dobutamine receptors

A

beta 1 adrenergic agonists

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22
Q

iv dobutamine therapeutic use

A

heart failure

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23
Q

IV dobutamine adverse effects

A

tachycardia, monitor BP & ECG

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24
Q

IV dopamine receptors

A

beta 1 in high doses
Alpha 1 adrenergic agonists

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25
Q

IV dopamine therapeutic uses

A

shock
heart failure
acute renal failure

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26
Q

IV dopamine adverse effects

A

tachycardia, dysrhythmias & anginal pain

drug interactions: MOA inhibitors

**increase fluid intake to prevent renal failure & measure urine output to measure therapeutic outcome

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27
Q

IV isoproternol receptors used

A

Beta 1 & 2 adrenergic agonist

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28
Q

therapeutic use of IV isoproternol

A

cardiovascular= AV block, increased CO, shock

Asthma= bronchodilation & bronchospasms

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29
Q

Adverse effects of IV isoproternol

A

tachydysrhythmias
angina pectoralis
hyperglycemia

drug interaction= MOA inhibitors

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30
Q

IV epinephrine receptors

A

alpha 1 & 2, beta 1 & 2 adrenergic agonists

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31
Q

IV epinephrine therapeutic uses

A

cardiac arrest & anaphylactic shock

allergic reactions

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32
Q

adverse effects of epinephrine

A

alpha 1= (hypertension crisis)

beta 1= (dysrhythmias & angina pectoris)

beta 2= hyperglycemia

drug interactions:

MOA inhibitors, tricyclic antidepressants, general anesthetics, alpha & beta blocking agents

33
Q

IV norepinephrine (levophed)

A

alpha 1 & 2 and beta 1 adrenergic agonist

34
Q

IV norepinephrine therapeutic uses

A

Hypotensive states

cardiac arrest

35
Q

IV norepinephrine adverse effects

A

Hypertensive crisis

Dysrhythmias

Angina pectoris

Necrosis following extravasation

36
Q

beta adrenergic antagonist receptors

A

nonselective= blocks beta 1 and beta 2 receptors
- propranlol

cardio-selective
= blocks beta 1 receptos
- metoprolol

37
Q

therapeutic response to beta blockage

A

decrease hr
decrease force of contraction
reduced velocity of impulse

38
Q

what are beta blockers (beta adrenergic antagonist) used for?

A

Angina pectoris (decrease cardiac work)

Hypertension & Cardiac dysrhythmias (reduce PVR)

Myocardial infarction (reduces pain and infarct size)

Heart failure

Hyperthyroidism

Migraine

Stage fright

Pheochromocytoma (large amt. of catecholamines)

Glaucoma

39
Q

adverse effects in beta blockers

A

beta 1

Bradycardia

Reduced cardiac output (use with caution in heart failure)

Precipitation of heart failure

AV heart block

Rebound cardiac excitation (do not stop abruptly!)

Adverse effects of beta2 blockade:

Bronchoconstriction (contraindicated with Asthma)

inhibition of glycogenolysis (may cause hypoglycemia)

40
Q

Alpha Adrenergic antagonists

A

non-selective:
produces alpha 1&2 blockers
Drug= phentolamine

Selective:
produces alpha 1 blockers
drug= prazosin

41
Q

therapeutic uses of alpha adrenergic antagonists

A

Essential hypertension

Benign prostatic hyperplasia (BPH)

decrease contraction of smooth muscle in bladder

Raynaud’s disease

peripheral vascular disorder with vasospasms in the toes and fingers

Overdose of alpha1 agonist

42
Q

side effects of alpha adrenergic antagonists

A

Orthostatic hypotension

Reflex tachycardia

Nasal congestion

Inhibition of ejaculation- sexual dysfunction causes compliance issues

Sodium retention and increased blood volume- may see Lasix in conjunction with this type of med

The most significant adverse effect associated with alpha2 blockade is potentiation of reflex tachycardia

43
Q

adrenergic agonists receptors

A

alpha 1 & 2, beta 1 & 2, dopamine

44
Q

alpha 1 therapeutic use

A
  • Hemostasis (vasoconstriction)/Epinephrine
  • Nasal decongestion/Pseudoephedrine
  • Adjunct to local anesthesia (delays anesthesia absorption)/ epinephrine
  • Elevation of blood pressure (vasoconstriction)
  • Mydriasis (dilatation of pupil)
45
Q

adverse effects of alpha 1

A

hypertension
necrosis
bradycardia

46
Q

therapeutic use of alpha 2

A

activates NE

47
Q

therapeutic effects/ drug uses
of beta 1

A

cardiac arrest
heart failure
increased CO
shock
AV heart block

48
Q

adverse effects of beta 2

A

hyperglycemia in diabetics
&
tremor

49
Q

beta 2 therapeutic uses

A

asthma/ inhalation

delay of preterm labor

50
Q

adverse effects in beta 1

A

altered heart rate
angina pectoralis

51
Q

therapeutic effects of dopamine

A

Activation of peripheral dopamine receptors causes dilation of the vasculature of the kidneys

Dopamine is only drug to activate dopamine receptors

52
Q

nicotinic (n)

A

Stimulation of parasympathetic and sympathetic postganglionic nerves

Release of epinephrine from the adrenal medulla

53
Q

nicotinic (m)

A

Neuromuscular junction

Skeletal muscle contraction

54
Q

nicotinic (m) antagonist

A

nmb

55
Q

muscarinic

A

Eye
Contraction of the ciliary muscle focuses the lens for near vision

Contraction of the iris sphincter muscle causes miosis (pupil constriction)

Heart
Decreased rate

Lung
Constriction of bronchi

Promotion of secretions

Bladder-
Contraction of the detrusor increases bladder pressure

Relaxation of trigon and sphincter allows urine to leave the bladder

Coordinated contraction of detrusor and relaxation of trigon and sphincter causes voiding of the bladder

GI tract-
Salvation, increased gastric secretions, increased intestinal tone motility, defecation

  • Sweat glands-
  • Generalized sweating
  • Sex organs
  • Erection (male)
  • Blood vessels-
  • Vasodilation
56
Q

muscarinic antagonist

A

atropine

57
Q

atropine Uses

A

muscarinic antagonist

o Increases heart rate
o Decreases secretions
o Relaxes bronchi
o Decreases bladder tone
o Decreases GI tone and
motility
o Dilates the pupil
o CNS excitation

58
Q

atropine adverse effects

A

o Dry mouth (xerostomia)
o Blurred vision
o Photophobia
o Increased intraocular
pressure
o Urinary retention
o Constipation
o Tachycardia
o Anhidrosis
o Asthma

59
Q

pt education on atropine

A

Contraindicated in patients with glaucoma, intestinal atony, tract obstruction, tachycardia

Use cautiously in patients with asthma

60
Q

oxybutyin

A

anticholinergic

increases bladder capacity

61
Q

oxybutyin adverse effects

A

o General- Increased thirst and urinary retention
o Skin- Decrease sweating, hot flashes
o Neuro- Dizziness, Drowsiness, Hallucinations, blurred vision
o Cardio- Tachycardia
o GI- Constipation, dry mouth, nausea
o GU- Decrease muscle spasms in the bladder and GU tract
o Severe- Anaphylaxis, angioedema

*Drug contraindications:
o Do not take with antihistamines,antidepressants, antipsychotics

62
Q

pancuronium

A

nicotinic cholinergic antagonist

neuromuscular blocking agent

blocks ACH @ receptor site

pk 35-60 min

63
Q

pancuronium & vancuronium therapeutic use

A

Induced paralysis

Skeletal Muscle relaxation (flaccid paralysis)

64
Q

pancuronium and vancuronium AE

A

Respiratory arrest or respiratory depression; pts need mechanical ventilation

hypotension and bradycardia

does not diminish consciousness or perception of pain; pts need sedative with medication

Drug interactions:

General anesthetics: enhances action

Antibiotics: intensifies response

Cholinesterase inhibitors: decrease effects

65
Q

pt education for pancuronium and vancuronium

A

precautions w/ Myasthenia gravis or other neuromuscular disorder

Electrolyte disturbances: low K enhances paralysis or high K reduces effects

Toxicity: respiratory support

66
Q

succinylcholine

A

Intubation for Mechanical Ventilation

67
Q

succinylcholine adverse effects

A

malignant hyperthermia
hyperkalemia
post operative pain

  • Monitor for s/s of malignant hyperthermia
    o Muscle rigidity or muscle spasms
    o Rapid, shallow breathing
    o Problems with low oxygen and high carbon dioxide
    o Rapid heart rate (tachycardia)
    o Abnormal heart rhythm (dysrhythmias)
    o Dangerously high body temperature (fever
68
Q

alpha 1 adrenergic agonists therapeutic use

A

mydryasis (pupil dilation)
increases BP

69
Q

alpha 1 adrenergic agonist side effects

A

hypertension
bradycardia
necrosis

70
Q

alpha 2 adrenergic agonist therapeutic use

A

inhibits NE

71
Q

beta 1 adrenergic agonist therapeutic use

A

cardiac arrest
heart failure
increase cardiac ouput

72
Q

beta 1 adrenergic agonist adverse effects

A

chest pain
dysrhythmia

73
Q

beta 2 adrenergic agonist therapeutic effects

A

asthma

74
Q

beta 2 adgrenergic agonsit adverse effects

A

hyperglycemia
tremors

75
Q

alpha adrenergic antagonists therapeutic use

A

alpha 1 overdose
hypertension

76
Q

alpha adrenergic antagonist adverse effects

A

ejaculation inhibition(alpha 1)
reflex tachycardia (alpha 2)

77
Q

beta adrenergic antagonist therapeutic use

A

decrease HR
hypertension, MI, heart failure

78
Q

beta adrenergic antagonist adverse effects

A

beta 2: bronchoconstriction
(not for asmatics) and can cause hyperglycemia

Pharm (11 decks)

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