week 1

Question 1

Parasympatholytics

Answer 1

Parasympatholytics (Anticholinergic Drugs)

MOA: competitive antagonist of muscarinic acetylcholine receptors, reduces the activity of the parasympathetic nervous system, increases HR, inhibits mucous glands

IND: bradycardia, shock, bronchospasms, hypotension,organophosphate poisoning

CONS: Tachy dysrhythmias, high degree heart blocks, glaucoma, cardiac ischemia

Adverse: tachy dysrhythmias, v-fib, dizziness, nausea, dissociative hallucinations, HTN, increases myocardial oxygen demand, anticholinergic toxidrome

Special: Will not work on transplant hearts (Vagus nerve is severed during transplant) May cause Bradycardia at incorrect doses

Examples: Atropine, Diphenhydramine, Atrovent, Spiriva

Question 2

Parasympathomimetics

Answer 2

Parasympathomimetics

MOA: Bind to cholinergic receptors, mimic the effects of parasympathetic nervous system

IND: Anxiety, Refractory vomiting, Gastroparesis, Alzheimer’s, HTN, Glaucoma, Myasthenia gravis, Anticholinergic overdose

CON: Bradycardia, Hypotension, GI bleeding, GI blockage

Adverse: Tardive Dyskinesia, Bradycardia, Hypotension, Diarrhea, SLUDGEM, Mydriasis

Special:

Examples: Nicotine, Aricept, Reglan, Clonidine, Atenolol, Propanolol, Minipress, Sain, VX, Tear gas, Organophosphate pesticides

Question 3

Sympathomimetics

Answer 3

Sympathomimetics

MOA: Bind to adrenergic receptors, mimic the effects of the sympathetic nervous system, activate the flight or flight response, raise HR and force of contractions, raise RR and depth, cause bronchodilation, peripheral vasoconstriction, coronary and skeletal muscle vasodilation

IND: Bradycardia, Hypotension, cardiac arrest, bronchospasm, shock

Con: MI, Tachy dysrhythmias, HTN, Heart failure, CAD, Hypersensitivity

Adverse: Tachycardia, Dysrhythmias, HTN, Palpations, Mydriasis, anxiety, tremors, increase myocardial workload, Cardiac ischemia, Cardiac arrest

Special: Use caution in Elderly PT’s, Do not mix with sodium bicarbonate(deactivates), Pregnancy class C, Half-life Minutes

Examples: Epinephrine, Norepinephrine, Dopamine, Albuterol, Amphetamines, Ritalin, Cocaine, Ephedrine/pseudoephedrine

Question 4

Calcium Channel Blockers

Answer 4

Calcium Channel Blockers

MOA: Blocks voltage-gated calcium channels in cardiac muscle and blood vessels, Decrease in intracellular calcium decreases cardiac conductivity, Arterial vasoconstriction leads to decreased SVR

IND: Hypertension, Seizure disorders, Supra-ventricullar tachycardias (a-fib, a-flutter, refractory PSVT), Migraines

CON: Hypotension, Bradycardia, Hypersensitivity, Pre-existing syndromes (WPW, LGL) AV blocks

Adverse: Reflex tachycardia, Bradycardia, Hypotension, Facial flushing, Peripheral edema.

Special: potentiated by magnesium

Examples: Cardizem, Norvasc, Verapamil

Question 5

Beta Blocker

Answer 5

Beta blocker

MOA: Block the actions of catecholamines on Beta 1 receptors Beta 2 receptors or both, Decrease effects of the sympathetic nervous system effecting bronchodilation, heart rate and force

IND: Tachy dysrthythmias, CHF, Glaucoma, Post-MI, Migrane prophylaxis, aortic dissection

CON: Coccaine or bath salts use, Asthma, Bradycardia, Hypersensitivity, Hypotension

Adverse: Bronchospasms, Hypotension, Bradycardia, Heart failure, Hallucinations, Hyperkalemia

Special: some can’t be given with calcium channel blockers

Examples: Labetolol, Atenolol, Metoprolol, Esmolol, Propanolol