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Pharmacology N2100 > *Unit 4 - Pharmacology Affecting Peripheral Nerve Regulation (ANS) > Flashcards

*Unit 4 - Pharmacology Affecting Peripheral Nerve Regulation (ANS) Flashcards

1
Q

maintains homeostasis without any conscious thoughts or actions

A

autonomic nervous system

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2
Q

contracts cardiac muscle

A

autonomic nervous system

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3
Q

contracts smooth muscle

A

autonomic nervous system

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4
Q

secretions of glands

A

autonomic nervous system

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5
Q

the actions of _____________ assists the body to respond to emergencies and repair and replenish body tissues

A

autonomic nervous system

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6
Q

T/F: Many drugs affect autonomic functions

A

T

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7
Q

Subdivisions of the ANS (autonomic nervous system)

A

SNS (sympathetic nervous system) (fight or flight)

PNS (parasympathetic nervous system) (Rest & Digest or Breed & Feed)

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8
Q

adrenergic blocker - antiadrenergic

A

sympathetic

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9
Q

neurotransmitter of SNS

A

norepinephrine

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10
Q

recepors of SNS

A

alpha 1, alpha 2, beta 1, beta 2

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11
Q

cholinergic blocker - anticholinergic

A

parasympathetic

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12
Q

neurotransmitter of PNS

A

acetylcholine

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13
Q

receptors of PNS

A

nicotinic & muscarinic

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14
Q

SNS response of eye

A

dilates pupild

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15
Q

PNS response of eye

A

constricts pupils

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16
Q

SNS response of lungs

A

dilates bronchioles

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17
Q

PNS response of lungs

A

constricts bronchioles and increases secretions

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18
Q

SNS response of heart

A

increases heart rate

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19
Q

PNS response of heart

A

decreases heart rate

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20
Q

SNS response of blood vessels

A

constricts blood vessels

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21
Q

PNS response of blood vessels

A

dilated blood vessels

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22
Q

SNS response of gastrointestinal

A

relaxes smooth muscles of GI tract

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23
Q

PNS response of gastrointestinal

A

increases peristalsis

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24
Q

SNS response of bladder

A

relaxes bladder muscle

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25
Q

PNS response of bladder

A

constricts bladder

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26
Q

SNS response of uterus

A

relaxes uterine muscle

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27
Q

PNS response of salivary gland

A

increases salivation

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28
Q

T/F: sympathetic and parasympathetic nervous systems have opposite responses on body tissues and organs

A

T different tissues affected by different systems

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29
Q

Neurotrasmitters:

- tyrosine–dopamine–norepinephrine–epinephrine

A

norepinephrine

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30
Q

secreted by nerve fibers call adrenergic fibers

A

norepinephrine

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31
Q

synthesized from acetylcoenzyme A and Choline

A

Acetylcholine

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32
Q

secreted by nerve fibers called cholinergic fibers

A

Acetylcholine

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33
Q

How neurotransmitters work

A
  • act on receptors in tissues and organs to cause a sympathetic or parasympathetic response
  • either system may cause excitatory or inhibiting effects in an organ
  • these effects are specific to SNS or PNS
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34
Q

T/F: just because you have stimulation of one system, you block the other system

A

F

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35
Q

T/F: most organs/tissues are predominantly controlled by either the SNS or PNS

A

T

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36
Q

cells of the lungs are predominantly covered with ______ receptors

A

beta 2

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37
Q

the heart is mostly covered with ______ receptors

A

beta 1

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38
Q

stimulated by stress: both physical and emotional

A

SNS

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39
Q

Which nervous system?

increased BP and cardiac output

A

SNS

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40
Q

Which nervous system?

Increased blood flow to the brain, heart, and skeletal muscles with decreased blood flow to the viscera, skin, and other body systems not needed in the fight or flight response

A

SNS

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41
Q

Which nervous system?

increased O2 used and production of CO2

A

SNS

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42
Q

Which nervous system?

increased breakdown of glycogen to produce energy

A

SNS

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43
Q

Which nervous system?

increased blood sugar

A

SNS

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44
Q

Which nervous system?

increased ability to think

A

SNS

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45
Q

Which nervous system?

increased muscle strength

A

SNS

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46
Q

Which nervous system?

increased rate of blood coagulation

A

SNS

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47
Q

Which nervous system?

increased rate and depth of respirations

A

SNS

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48
Q

Which nervous system?

pupils dilate - aids distant and dark vision

A

SNS

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49
Q

adrenergic neurotransmitters

A

norepinephrine, epinephrine dopamine

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50
Q

amount of norepinephrine and epinephrine present at the synapse effects amount of response

A

adrenergic neurotransmitters

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51
Q

has an intense short reaction

A

adrenergic neurotransmitters

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52
Q

reabsorbed or metabolized by monoamine oxidase (MAO) or catechol-O-methyltransferase (COMT)

A

adrenergic neurotransmitters

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53
Q

2 enzymes that breakdown adrenergic neurotransmitters

A

MAO (monoamine oxidase)

COMT (catechol-O-methyltransferase)

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54
Q

T/F: norepinephrine and epinephrine also act as hormones

A

T

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55
Q

Norepinephrine and epinephrine:

secreted into the blood stream by the ______

A

adrenal medulla

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56
Q

Norepinephrine and epinephrine:

amount present in blood at any time depends on the _____ being experienced and function of the _______

A

stress, adrenal medulla

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57
Q

Norepinephrine and epinephrine:

metabolized in the liver by __ and __

A

MAO or COMT

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58
Q

Adrenergic receptors:

blood vessels

A

Alpha 1 & Alpha 2

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59
Q

Adrenergic receptors:

heart

A

Beta 1

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60
Q

Adrenergic receptors:

coronary vessels

A

Beta 1

61
Q

Adrenergic receptors:

lungs

A

Beta 2

62
Q

Adrenergic receptors:

inhibits release of norepinephrine

A

Alpha 2

63
Q

Adrenergic receptors:

bronchiole dilation

A

Beta 2

64
Q

3 ways neurotransmitters are inactivated…which ones are the *main ways adrenergic neurotransmitters are inactivated?

A
    • re-uptake
    • enzymes MAO and COMT breakdown neurotransmitters
  • diffusion of the neurotransmitter away from the receptor site
65
Q

neurotransmitter is floating around between one cell and another

A

re-uptake

66
Q

prolong action of norepinephrine by:

A
  • inhibiting re-uptake of norepinephrine

- inhibiting the enzyme breakdown of norepinephrine

67
Q

3 ways of stimulation of adrenergic receptors

A
  • direct acting
  • indirect acting
  • mixed acting
68
Q

we are giving a med in the same shape (acts and functions) as the neurotransmitter itself

A

direct acting

69
Q

we are allowing the body’s natural amount of neurotransmitter to stay there..trying to increase the “norepinephrine” that’s already there and available to the receptors

A

indirect acting

70
Q

combination of both direct and indirect acting

A

mixed acting

71
Q

only stimulate one kind of receptor

A

selective

72
Q

affects all the different adrenergic receptors (use for something like shock)

A

nonselective

73
Q

T/F: there are NEVER any contraindications if you can save someone’s life using epinephrine

A

TRUE!

74
Q

Nursing Considerations for Epinephrine:

T/F if you’re using this as an IV, you HAVE to have the patient on a cardiac monitor

A

T

75
Q

Nursing Considerations for Epinephrine:

T/F: you always have to be working on treating the underlying cause for the reason you’re having to use epinephrine

A

T

76
Q

Is Albuterol Selective or Nonselective?

A

Selective

77
Q

We are blocking the effects of the adrenergic system when we give these kinds of medications

A

adrenergic antagonists

78
Q

rare adverse affect that creates a significant drop on BP

  • when a patient takes this med for the 1st time, it has an extraordinary reaction. It decrease their BP significantly because those receptors have not had this kind of stimulation before = significant BP decrease, bradycardia, dizziness, significant HR increase
A

1st dose effect (ex. of drug = Prazosin)

79
Q

All meds that end in “olol” it is a _____

A

beta-blocker

How I love the Beta-blockers, falol-lol-lol-lol-lol-lol

80
Q

T/F: If adrenergic agonists tend to cause bronchodilation, then an adrenergic antagonist would potentially cause bronchiol-constriction

A

T

81
Q

T’F: propranolol should be weened slowly (slowly get off medication, not just suddenly stop taking it)

A

T

82
Q

Which nervous system?

Dilation of blood vessels in the skin

A

PNS

83
Q

Which nervous system?

decreased HR - bradycardia

A

PNS

84
Q

Which nervous system?

increased secretion of digestive enzymes

A

PNS

85
Q

Which nervous system?

increased motility of the GI system

A

PNS

86
Q

Which nervous system?

Constriction of smooth muscles of the bronchi

A

PNS

87
Q

Which nervous system?

Increased Secretions (lungs, stomach, intestines, skin)

A

PNS

88
Q

Which nervous system?

pupil constriction and accommodation of near vision

A

PNS

89
Q

Which nervous system?

contraction of smooth muscle in the urinary bladder

A

PNS

90
Q

Which nervous system?

contraction of skeletal msucles

A

PNS

91
Q

Which nervous system?

No effect on blood coagulation, blood sugar, mental activity or muscle strength

A

PNS

92
Q

Ex. of Cholinergic Neurotransmitter

A

Acetylcholine

93
Q

excitatory effects at nerve synapses and nerve-muscle junctions

A

Acetylcholine (Cholinergic Neurotransmitter)

94
Q

inhibitory effects at some peripheral sites

A

Acetylcholine (Cholinergic Neurotransmitter)

95
Q

after action is split into acetate and choline by the enzyme acetylcholinesterase

A

Acetylcholine (Cholinergic Neurotransmitter)

96
Q

Cholinergic receptors

A

nicotinic and muscarinic

97
Q

Nicotinic:

  • located in the _____________
  • stimulation produces ________
A
  • located in the motor nerves and skeletal muscles

- stimulation produces muscle contraction

98
Q

Muscarinic:

  • location in most ______
  • stimulation can produce either an ______ or _______
A
  • location in most internal organs

- stimulation can produce either an excitatory or inhibiting response

99
Q

blocking the rest/digest system

A

parasympatheolytic (anticholinergic)

100
Q

urinary retention due to detrusor muscle relaxation and increased tone of the internal sphincter

A

parasympatheolytic (anticholinergic)

101
Q

dilates pupils and paralyzes the ciliary muscle causing decreased accommodation

A

parasympatheolytic (anticholinergic)

102
Q

decrease salivation, perspiration, bronchila secretions

A

parasympatheolytic (anticholinergic)

103
Q

dilates the bronchi

A

parasympatheolytic (anticholinergic)

104
Q

decreased tremors

A

parasympatheolytic (anticholinergic)

105
Q

decreased muscle rigidity

A

parasympatheolytic (anticholinergic)

106
Q

drowsiness, disorientation, and hallucinations can be experienced with large doses

A

parasympatheolytic (anticholinergic)

107
Q

Cholinergic Agonists:

bethanechol (urecholine)

A

direct

108
Q

Cholinergic Agonsits:

Pyridostiigmine (Mestinon)

A

Indirect

109
Q

helping or stimulation cholinergic/rest&digest system

A

agonist

110
Q

How do you treat cholinergic crisis?

A

with Atropine, may need mechanical ventilation

111
Q

can cause respiratory muscle paralysis

A

cholinergic crisis

112
Q

excessive parasympathetic stimulation

A

cholinergic crisis

113
Q

muscarinic antagonist

A

atropine

comes from “the deadly night shade plant”

114
Q

nicotine antagonists (3)

A
  • mecamylamin
  • succinylcholine
  • turbocurarine
115
Q

What drug:

  • decrease allergic reaction
  • treat anaphylaxis, branchospasm, cardiac arrest
A

epinephrine

116
Q

What drug:

- treat bronchospasm, asthma, bronchitis, COPD

A

Albuterol

117
Q

What drug:

- treats nasal decongestion, treats hypotension

A

phenylephrine

118
Q

What drug:

- controls HTN, treats BPH, Refractory CHF

A

Prazosin

119
Q

What drug:

- controls HTN, cardiac dysrhythmias, angina, MI

A

Propranolol

120
Q

What drug:

  • decrease urinary retention by prompting bladder contraction
  • increase peristalsis and gastrointestinal secretions
A

bethanechol

121
Q

What drug:

  • treat myasthenia gravis
  • decrease skeletal muscle weakness and fatigue, used in the military to prevent potential nerve gas effects
A

pyridostigmine

122
Q

What drug:

  • used preoperatively to dry secretions, increase heart rate, and to dilate pupils
  • used to treat hypermotility of the GI tract (slows peristalsis)
A

Atropine sulphate

123
Q

The nurse monitors a client on a newly prescribed antihypertensive drug. The nurse recognizes the symptom of hypotension to be indicative of which reaction?

A. an idiosyncratic drug reaction
B. a side effect of the drug
C. an allergic response to the drug
D. a therapeutic drug effect

A

B. a side effect of the drug

124
Q

Can you drive after taking an anticholinergic?

A

NO! You would think it would cause similar symptoms of flight of fight, but it crosses the BBB which makes an affect on sleepiness

125
Q 
Q: The main neurotransmitter of the parasympathetic nervous system is:
A. dopamine.
B. norepinephrine.
C. serotonin.
D. acetylcholine.
A

D. acetylcholine.

126
Q 
Q: A client reports using an herb that is known to block muscarinic receptors. The nurse would expect which of the following effects:
A. Urinary incontinence
B. Watery eyes
C. Hypotension
D. Constipation
A

D. Constipation

127
Q 
Q: The nurse would expect to use which medication for a patient diagnosed as being in cholinergic crisis?
A. Atropine
B. Pyridostigmine
C. Bethanechol
D. Epinephrine
A

A. Atropine

128
Q

Q: Which type of medication would be inappropriate for a patient with hypertension?
A. Propranolol, a nonselective beta antagonist
B. Bethanechol, a direct cholinergic agonist
C. Prazosin, a selective alpha-1 antagonist
D. Phenylephrine, an alpha agonist

A

D. Phenylephrine, an alpha agonist

129
Q 
Q: Sympathomimetic drugs have similar physiologic effects as:
A. Anticholinergics.
B. Muscarinic agonists.
C. Parasympathomimetics
D. Adrenergic antagonists.
A

A. Anticholinergics.

130
Q

Q: Which of the following is NOT a way that pharmacology can prevent the decrease of neurotransmitters?
A. Preventing the reuptake of neurotransmitters
B. Preventing the dissemination of neurotransmitters
C. Preventing the action of enzymes

A

B. Preventing the dissemination of neurotransmitters

131
Q 
Q: Albuterol, a selective beta-2 agonist, is used for the treatment of:
A. Hyperglycemia
B. Hypertension
C. Asthma
D. Glaucoma
A

C. Asthma

132
Q

Q: A patient is being discharged to home with a prescription of Ditropan XL, a muscarinic antagonist. Which of the following is NOT an important teaching point?
A. Avoid fiber to prevent diarrhea
B. Report inability to urinate to your doctor
C. Chew gum to decrease dry mouth
D. Use eye drops for dry eyes

A

A. Avoid fiber to prevent diarrhea

133
Q

Q: What effects would stimulation of the sympathetic nervous system have on the heart, blood vessels, and lungs?
A. Bradycardia, hypotension, and bronchoconstriction
B. Bradycardia, hypertension, and bronchoconstriction
C. Tachycardia, hypertension, and bronchodilation
D. Tachycardia, hypotension, and bronchodilation

A

C. Tachycardia, hypertension, and bronchodilation

134
Q 
Q: A patient with COPD would need to be cautious about taking which type of medication?
A. A non-selective beta-blocker
B. A selective beta-2 agonist
C. An anti-cholinergic
D. A non-selective adrenergic agonist
A

A. A non-selective beta-blocker

135
Q

potential interactions of epinephrine

A

Beta blockers, alpha-adrenergic blockers

136
Q

prazosin classification

A

alpha1-adrenergic antagonist

137
Q

epinephrine classification

A

nonselective adrenergic agonist

138
Q

albuterol classification

A

beta2-adrenergic agonist

139
Q

phenylephrine classification

A

alpha adrenergic agonist

140
Q

propranolol classification

A

nonselective beta adrenergic blocker

141
Q

can you give bethanechol IM or IV

A

NO!

142
Q

pyridostigmine classification

A

indirect acting acetylcholinesterase inhibitor

143
Q

T/F: Nonsteroidal anti-infalmmatory drugs may be given for fevers in young children

A

T

144
Q

Q: A patient is being discharged to home with a new prescription for hydrocodone/acetoaminophen 5/325 mg po q4-6h prn. Which of the following statements by your pt leads you to believe that she has understood the teaching you have done about the relief of pain.
A. “after I take the medication, I will use distraction to lessen the pain until I start getting relief”
B. I will take the med only after the pain is severe”
C. If I think that I may have pain during the day, I will take a dose in the morning with breakfast”
D. After I take the med, I should get total relief in 5 minutes.”

A

A. “after I take the medication, I will use distraction to lessen the pain until I start getting relief”

145
Q 
Q: Which of the following is NOT a contraindication for the use of cholinergic agonist drugs?
A. asthma
B. diabetes mellitus
C. bradycardia
D. bowel obstruction
A

B. diabetes mellitus

146
Q 
Q: Atropine and atropine-like drugs are anticholinergics. Atropine is usually prescribed as one of the preoperative drugs. What is the primary use for atropine as a preoperative drug?
A. decrease urination
B. decrease GI motility
C. decrease salivation
D. decrease HR
A

C. decrease salivation (so they don’t aspirate)

147
Q

Q: a nurse is discharging a pt who is taking an anticholinergics med. Which of the following should the nurse include is the discharge teaching regarding the pt’s anticholinergic med?
A. Decrease fluid and fiber intake to avoid diarrhea
B. instruct the pt to use sunglasses in bright light
C. alert the pt that drowsiness may occur and to avoid driving a car
D. suggest hard candy, chewing gum, & oral hygiene for dry mouth

A

B. instruct the pt to use sunglasses in bright light
C. alert the pt that drowsiness may occur and to avoid driving a car
D. suggest hard candy, chewing gum, & oral hygiene for dry mouth

148
Q

Q: How does the student nurse explain the action of an agonist to a pt?
A. it produces a desired therapeutic effect
B. it blocks a cellular response
C. it produces a response similar to regular cellular function
D. it produces an idiosyncratic response

A

C. it produces a response similar to regular cellular function

149
Q

Q: The nurse was very busy and administered a new, unfamiliar med without looking it up first. Later the nurse looked up the med. How would the nurse manager evaluate this behavior?
A. an error could have occurred because the nurse was unfamiliar with the med
B. this was acceptable as long as the nurse looked up the action and side effects of the drug at some point
C. it was an error

A

A. an error could have occurred because the nurse was unfamiliar with the med

Pharmacology N2100 (26 decks)

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