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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
IV dopamine therapeutic uses
shock heart failure acute renal failure
26
IV dopamine adverse effects
tachycardia, dysrhythmias & anginal pain drug interactions: MOA inhibitors **increase fluid intake to prevent renal failure & measure urine output to measure therapeutic outcome
27
IV isoproternol receptors used
Beta 1 & 2 adrenergic agonist
28
therapeutic use of IV isoproternol
cardiovascular= AV block, increased CO, shock Asthma= bronchodilation & bronchospasms
29
Adverse effects of IV isoproternol
tachydysrhythmias angina pectoralis hyperglycemia drug interaction= MOA inhibitors
30
IV epinephrine receptors
alpha 1 & 2, beta 1 & 2 adrenergic agonists
31
IV epinephrine therapeutic uses
cardiac arrest & anaphylactic shock allergic reactions
32
adverse effects of epinephrine
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
IV norepinephrine (levophed)
alpha 1 & 2 and beta 1 adrenergic agonist
34
IV norepinephrine therapeutic uses
Hypotensive states cardiac arrest
35
IV norepinephrine adverse effects
Hypertensive crisis Dysrhythmias Angina pectoris Necrosis following extravasation
36
beta adrenergic antagonist receptors
nonselective= blocks beta 1 and beta 2 receptors - propranlol cardio-selective = blocks beta 1 receptos - metoprolol
37
therapeutic response to beta blockage
decrease hr decrease force of contraction reduced velocity of impulse
38
what are beta blockers (beta adrenergic antagonist) used for?
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
adverse effects in beta blockers
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
Alpha Adrenergic antagonists
non-selective: produces alpha 1&2 blockers Drug= phentolamine Selective: produces alpha 1 blockers drug= prazosin
41
therapeutic uses of alpha adrenergic antagonists
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
side effects of alpha adrenergic antagonists
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
adrenergic agonists receptors
alpha 1 & 2, beta 1 & 2, dopamine
44
alpha 1 therapeutic use
* Hemostasis (vasoconstriction)/Epinephrine * Nasal decongestion/Pseudoephedrine * Adjunct to local anesthesia (delays anesthesia absorption)/ epinephrine * Elevation of blood pressure (vasoconstriction) * Mydriasis (dilatation of pupil)
45
adverse effects of alpha 1
hypertension necrosis bradycardia
46
therapeutic use of alpha 2
activates NE
47
therapeutic effects/ drug uses of beta 1
cardiac arrest heart failure increased CO shock AV heart block
48
adverse effects of beta 2
hyperglycemia in diabetics & tremor
49
beta 2 therapeutic uses
asthma/ inhalation delay of preterm labor
50
adverse effects in beta 1
altered heart rate angina pectoralis
51
therapeutic effects of dopamine
Activation of peripheral dopamine receptors causes dilation of the vasculature of the kidneys Dopamine is only drug to activate dopamine receptors
52
nicotinic (n)
Stimulation of parasympathetic and sympathetic postganglionic nerves Release of epinephrine from the adrenal medulla
53
nicotinic (m)
Neuromuscular junction Skeletal muscle contraction
54
nicotinic (m) antagonist
nmb
55
muscarinic
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
muscarinic antagonist
atropine
57
atropine Uses
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
atropine adverse effects
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
pt education on atropine
Contraindicated in patients with glaucoma, intestinal atony, tract obstruction, tachycardia Use cautiously in patients with asthma
60
oxybutyin
anticholinergic increases bladder capacity
61
oxybutyin adverse effects
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
pancuronium
nicotinic cholinergic antagonist neuromuscular blocking agent blocks ACH @ receptor site pk 35-60 min
63
pancuronium & vancuronium therapeutic use
Induced paralysis Skeletal Muscle relaxation (flaccid paralysis)
64
pancuronium and vancuronium AE
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
pt education for pancuronium and vancuronium
precautions w/ Myasthenia gravis or other neuromuscular disorder Electrolyte disturbances: low K enhances paralysis or high K reduces effects Toxicity: respiratory support
66
succinylcholine
Intubation for Mechanical Ventilation
67
succinylcholine adverse effects
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
alpha 1 adrenergic agonists therapeutic use
mydryasis (pupil dilation) increases BP
69
alpha 1 adrenergic agonist side effects
hypertension bradycardia necrosis
70
alpha 2 adrenergic agonist therapeutic use
inhibits NE
71
beta 1 adrenergic agonist therapeutic use
cardiac arrest heart failure increase cardiac ouput
72
beta 1 adrenergic agonist adverse effects
chest pain dysrhythmia
73
beta 2 adrenergic agonist therapeutic effects
asthma
74
beta 2 adgrenergic agonsit adverse effects
hyperglycemia tremors
75
alpha adrenergic antagonists therapeutic use
alpha 1 overdose hypertension
76
alpha adrenergic antagonist adverse effects
ejaculation inhibition(alpha 1) reflex tachycardia (alpha 2)
77
beta adrenergic antagonist therapeutic use
decrease HR hypertension, MI, heart failure
78
beta adrenergic antagonist adverse effects
beta 2: bronchoconstriction (not for asmatics) and can cause hyperglycemia

Pharm (11 decks)

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