test 1 Flashcards
what makes us the CNS
brain and spinal cord
what makes up the PNS
motor neurons and sensory neurons
what systems deprive from motor nuerons
somatic and autonomic
what divisions are under ANS
sympathetic and parasympathetic
sympathetic recpector
adrenergic receptors
parasympathetic receptor
cholinergic receptor
fight or flight – stressfull or energetic activity
sympthetic
rest and digest – maintenance activity
parasympathetic
controls voluntary movements by activating skeletal muscles
somatic nervous system
controls involuntary responses by influencing organs, glands, and smooth muscle
autonomic nervous system
function of ANS
achieve homeostasis
effects of parasympathetic
constricts pupils
stimulates salvation
slows heart rate & contractility
constricts bronchioles
stimulates digestion
stimulates gallbladder function
controls bladder
stimulates erection/vaginal lubrication
effects of sympathetic
dilates pupils
inhibits salvation
accelerates heart rate
dilates bronchioles
inhibits digestion
stimulates release of glucose
secretes epinephrine and norepinephrine
relaxes bladder
stimulates ejaculation/orgasm
sympathetic nervous system neurotransmitter
norepinephrine
parasympathetic nervous system neurotransmitters
acetylcholine
what meds cause sympathetic nervous system responses
sympathomimetics
adrenergics
anticholinergics
parasympatholytics
what meds cause parasympathetic effects
parasympathomimetics
muscarinics
cholinergics
adrenergic antagonist
sympatholytics
types of cholinergic receptors
nicotinic, muscarinic
bethanechol (urecholine) ther. class, pharm class, and pregnancy class
ther class- non obstructive urinary retention drug
pharm class- muscarinic cholinergic receptor
pregnancy class= C
bethanechol (urecholine) action and uses
direct acting parasympathomimetic that interacts with muscarinic receptors to cause actions of parasympathetic effects. effects are mostly noted in urinary and Gi tract where it stimulates smooth muscle contraction.
uses: urinary retention, myasthenia gravis, alzheimer’s, glaucoma
bethanechol (urecholine) adverse effects, admin concerns and contraindications
adverse effects- profuse salivation, sweating, increased muscle tone, urinary frequency, bradycardia
admin concerns- never admin IM or IV, monitor vitals
contraindications- asthma, epilepsy, parkinsonian, hyperthyroidism, peptic ulcer disease, bradycardia
treatment of OD for bethanechol (urecholine)
atropine sulfate
what are cholinergic blocking drugs
drugs that inhibit parasympathetic nervous system
physostigmine (antilirium) ther. class, pharm class, and pregnancy class
ther class- antidote for anticholinergic toxicity
pharm class- acetylcholinesterase inhibitor
pregnancy class- C
physostigmine (antilirium) action and uses
indirect acting parasympathomimetic that inhibits acetylcholinesterase (ACHe), the enzyme responsible for breakdown of acetylcholine, stimulating muscarinic and nicotinic receptors
uses- treat glaucoma, and anticholinergic activity
physostigmine (antilirium) adverse effects, admin concerns and contraindications
adverse effects-Bradycardia, asystole, restlessness, sweating, seizures, salvation, Urinary frequency, muscle twitch, resp distress
admin concerns- Admin slowly over 5 mins to avoid seizures, monitor vitals; Discontinue med if excessive sweating, diarrhea or frequent Urination occurs
contraindications- Use with caution in patients with asthma, epilepsy, diabetes, cardiovascular disease, bradycardia
atropine (atropen) ther. class, pharm class, and pregnancy class
ther class-Antidote for anticholinesterase poisoning
pharm class-Muscarinic cholinergic receptor blocker
pregnancy class- C
Atropine (AtroPen) action and uses
by occupying muscarinic receptors, atropine blocks parasympathetic actions of ACh and induces symptoms of fight or flight such as increasing HR, bronchodilation, decreased mobility in GI tract, mydriasis
uses- peptic ulcers, Ibs, mydriasis for eye exam, bradycardia
atropine (atropen) adverse effects, admin concerns and contraindications
adverse effects- tachycardia, CNS stimulation, dry mouth, constipation, urinary retention, dry eyes, photophobia
admin concerns- monitor vitals, PO and subq doses are not interchangeable
contraindications- Glaucoma, obstructive GI patients, bladder neck obstruction, BPH, MG, acute hemorrhage, cardiac insufficiency
what receptor does norepinephrine go to and what does it do
adrenergic receptor, causes adrenaline like response
alpha 1 adrenergic receptor
in all sympathetic organs except heart;
constricts blood vessels and dilates pupil
primarly used for nasal congestion, hypotension, and dilation of pupil
alpha 2 adrenergic receptor
at presynaptic adrenergic nerve terminals;
inhibits release of norepinephrine
used for hypertension
beta 1 adrenergic receptor
in heart and kidneys;
increases heart rate and force of contraction and releases renin
used in cases of cardiac arrest, heart failure and shock
beta 2 adrenergic receptor
in all sympathetic target organs except heart;
inhibits smooth muscle
used in asthma and premature labor contractions
beta 3 adrenergic receptor
adipose tissue- lipolysis
urinary bladder- relaxation of the detrusor
phenylephrine (neo-synephrine) therapeutic class , pharm, and pregnancy cat.
ther- nasal decongestant; mydriatic drug; antihypotensive
pharm- adrenergic drug
pregnancy class C
phenylephrine (neo-synephrine) action and uses
a selective alpha adrenergic agonist that is available in different formations, causing sympathetic stimulation
uses- Nasal- reduce nasal congestion
Topical (in eye)- dilate pupil
Parenteral- reverse acute hypotension caused by spinal ane
phenylephrine (neo-synephrine) adverse effects, admin concerns and contraindications
adverse effects- side effects are uncommon in nasal and topically; High doses can cause bradycardia, possible death with IV use
admin concerns- Parenteral can cause tissue damage with extravasation
Drops may damage soft contacts
contraindications- Don’t use if patient has pancreatitis, heart disease, hepatitis, or narrow angle glaucoma
prazosin (minipress) therapeutic class , pharm, and pregnancy cat.
ther class- antihypertensive
pharm class- adrenergic blocking drug
pregnancy category- not established
prazosin (minipress) action and uses
Selective alpha 1 adrenergic that competes with norepinephrine at its receptors on vascular smooth muscle in arterioles and veins. Causes rapid decrease in peripheral resistance that reduces BP.
uses- treat hypertension
prazosin (minipress) adverse effects, admin concerns and contraindications
adverse effects- Orthostatic hypotension due to alpha 1 inhibition in vascular smooth muscle; dizziness, drowsiness
admin concerns- give low dose first to avoid severe hypotension
contraindications- safety in pregnancy and lactation not established
what are bronchioles
muscular tube like structures whose diameter (lumen) varies on contraction or relaxation of smooth muscle which is controlled by ANS
respiration
bringing o2 in body and co2 out
beta 2 adrenergic receptors
activated by sympathetic, causes smooth muscle to relax and diameter increases
how does parasympathetic branch control airways
causes bronchiolar smooth muscle to contract, narrowing airway
why is pulmonary inhalation drugs efficient
it goes straight into resp system
oral drugs
frequent side effects because it goes everywhere in body
how is nebulizer used
patient breathe normally, difficult to measure dose received
metered dose inhaler
propellent delivers measured drug of dose
dry powder inhaler
patient inhales powdered drug from inhalation
bronchospasm
spasm of bronchi; causes wheeze
status asthmaticus
prolonged asthma attack; med emergency
quick relief asthma drugs
beta 2 adrenergic agonist, anticholinergic, systemic corticosteroids
long acting asthma meds
inhaled corticosteroids, mast cell stabilizers leukotriene modifier, long acting beta 2 adrenergic agonist, methylxanthines, immunomodulators
short acting beta 2 adrenergic agonist (SABAs)
bronchodilation, preferred drug for relief of acute symptoms
anticholinergic for asthma
causes bronchodilation, alternate to those who cant take SABAs
systemic corticosteroids for asthma
anti-inflammatory, used for short periods to reduce frequency of acute exacerbations
inhaled corticosteroids for asthma
anti inflammatory, preferred drugs for long term asthma management
mast cell stabilizers for asthma
anti inflammatory, control of mild, persistent asthma or exercise induced asthma
leukotriene modifier for asthma
anti-inflam, control mild, persistent asthma, or adjunctive therapy with inhaled corticosteroid
long acting adrenergic agonist (LABAs)
bronchodilation, used in combination with inhaled corticosteroids for preventing moderate to severe asthma
methylxanthines
for bronchodilation, used in combination with inhaled corticosteroids for preventing moderate to severe asthma. long term
common side effects - nauasea, vomiting, CNS stimulation
given IV or orally
immunomodulators for asthma
monoclonal antibody, for patients who have allergies and severe persistent asthma
albuterol (proair HFA, proventil HFA, ventolin HFA) ther class, pharm class, preg category
ther- bronchodilator
pharm- beta 2 adrenergic agonist
preg class C
albuterol (proair HFA, proventil HFA, ventolin HFA) action and uses
A SABA (short acting beta agonist) that used to relieve bronchospasm of asthma. Rapid onset. Selectively binds to beta 2
for quick acting asthma relief
albuterol (proair HFA, proventil HFA, ventolin HFA) adverse effects, admin concerns and contraindications
adverse effect- Uncommon, palpitations, headaches, throat irritation, tachycardia, tremor, allergic reaction, chest pain, dry mouth
admin concerns- may cause hypokalemia at large dose, concurrent use with beta blockers will inhibit. avoid caffeine
contraindications- People who are hypersensitive to drug. Caution in CAD, HTN
ipratropium (atrovent) ther class, pharm class, preg class
ther class- bronchodilator
pharm class- anticholinergic
preg class- B
ipratropium (atrovent) action and uses
Blocks cholinergic receptors, causing bronchodilation. delivered by inhalation or intranasally. If nasal, inhibits secretions but don’t decongest
for COPD, bronchitis, emphysema. Relief of acute bronchospasm
ipratropium (atrovent) adverse effects, admin concerns and contraindications
adverse- Irritation of upper resp tract, bitter taste- inhalation
Epistaxis, drying of nasal mucosa- intranasal
admin concerns- Dry’s things- be ware if patient has urinary retention, constipation, troubles seeing or salivating
contraindicated if have peanut allergy
how many days should someone use corticosteriod
no longer than 10
beclomethasone (QVAR) ther class, pharm class, preg category
ther class- anti inflammatory drug for asthma and allergic rhinitis
pharm class- inhaled corticosteroid
preg category- C
beclomethasone (QVAR) action and uses
Corticosteroid available through aerosol inhalation for asthma and a nasal spray for allergic rhinitis. reduce inflammation, for prevention
beclomethasone (QVAR) adverse effects, admin concerns and contraindications
adverse effects- Corticosteroid toxicity, hoarseness, dry mouth, long term can cause oral thrush
not for acute attacks. be careful with children as it could stunt growth
contraindications- prior hypersensitivity.
montelukast (singulair) ther class, pharm class, and preg class
ther class- Anti inflammatory drug for asthma prophylaxis
pharm class- leukotriene modifier
preg class- B
Montelukast (singulair) action and uses
Prevents airway edema and inflammation by blocking leukotriene receptors in the airway. Given PO and acts rapidly
Used for prophylaxis of persistent, chronic asthma, exercise induced bronchospasm, and allergic rhinitis
Montelukast (singulair) adverse effects, admin concerns and contraindications
adverse effects- Headache, nausea, diarrhea, possible neuropsychic effects such as suicidal ideation, hallucinations, aggressiveness, depression
if preventing exercise induced, take drug 2 hours prior. don’t use for quick acting
may increase ALT values
don’t use if have hepatic issues
beta blockers
type of adrenergic blocking drug
prevents catecholamines from binding to beta receptors. used for hypertension, MI, heart failure
ex- metoprolol, acebutolol
what does upper resp tract do
warm, humidifies and cleans incoming air
inflammation rhinitis
inflammation of nasal mucosa
caused by exposure to antigen: histamine is released
allergic rhinitis : how does it work
Plasma cells release IgE antibodies, binds to mast cell and histamine is released, attaching to H1 receptors causing allergies
preventers for allergic rhinitis
antihistamine, intranasal corticosteroid, mast cell stabilizer
relievers for allergic rhinitis
oral and intranasal decongestant
what is histamine
chemical mediator of inflammatory response
diphenhydramine (benadryl) ther class, pharm class and pregnancy category
ther class- drug to treat allergies
pharm class- H1 receptor antagonist; antihistamine
preg category C
diphenhydramine (benadryl) similar drug
fexofenadine (allegra)
diphenhydramine (benadryl) action and uses
First gen H1 receptor antagonist whose primary use is to treat minor symptoms of allergy and the common cold such as runny nose, sneezing, tearing. This drug often combines with analgesic, decongestant, or expectorant
diphenhydramine (benadryl) adverse effects, admin concerns, and contraindictions
adverse effects- drowsiness (safety), paradoxical CNS stimulation, anticholinergic effects (dryness)
admin concerns- increased risk of anaphylaxis when given iv
contraindications- Hypersensitivity to the drug, BPH, narrow angle glaucoma, GI obstruction. Use cautiously with asthma or hyperthyroidism
what do intranasal corticosteroids do
reduce tissue edema, cause mild vasoconstriction
vasodilation vs vasoconstriction of airways
vasodilation- nasal mucosa thicker, airway smaller
vasoconstriction- nasal mucosa thinner, airway diameter larger
fluticasone (flonase) ther class, pharm class, preg category
ther class- Drug for allergic rhinitis, asthma, and skin inflammation
pharm class- corticosteroid
preg category C
fluticasone (flonase) action and uses
Decrease local inflammation in nasal passage, reducing stuffiness- nasal
Oral reduce bronchial inflammation
Topical- reduce inflammation of skin
fluticasone (flonase) adverse effects, admin concerns, contraindications
adverse effects- Nasal irritation and epistaxis, inhalation can cause headache and nasopharyngitis. swallowing can cause issues
admin concerns- follow directions. caution with licorice
contraindications- prior hypersensitivity
oxymetazoline (afrin) ther class, pharm class, pregnancy category
ther class- nasal decongestant
pharm class- sympathomimetic
preg category C
oxymetazoline (afrin) action and uses
Activates alpha adrenergic receptors in the sympathetic NS, causes arterioles in the nasal passage to constrict, drying the mucous membranes, also can be used as eye drops to provide relief from red, dry eyed
oxymetazoline (afrin) adverse effects, admin concerns, contraindications
adverse effects- rebound congestion. stinging of mucosa
admin concerns- wash hands after administering to avoid anisocoria
contraindications- Patients with thyroid disorders, hypertension, diabetes, or heart disease
antitussives
inhibit coughs
expectorants
inhibit mucus production
mucolytics
loosen thick bronchial secretions
-> thin them
mucolytics
loosen thick bronchial secretions
-> thin them
drug similar to dextromethorphan
benzonatate (tessalon)
expectorant drug
guaifenesin (mucinex)
examples of mucolytics
acetylcysteine (mucomyst, cetylev), dornase alfa (pulmozyme)
dextromethorphan (Delsym) ther class, pharm class, pregnancy category
ther- cough suppressant
pharm class- centrally acting antitussive
pregnancy category C
dextromethorphan (Delsym) action and uses
Nonopioid drug that is a component in many OTC severe cold and flu preparations. Rapid onset action. Acts through medulla. Many formations
dextromethorphan (Delsym) adverse effects, admin concerns, contraindications
adverse effect-Uncommon. Dizziness, drowsiness, GI upset, CNS toxicity such as resp depression, stupor, seizure, coma
admin concerns- don’t drink grapefruit
contraindications- In treatment of chronic cough due to excessive bronchial secretions, such as asthma, smoking, emphysema. Don’t use under children age 6
