Week 2 - Topics 6-9 Flashcards
Also known as the “Visceral System”
Autonomic Nervous System
Acts on the smooth muscle and glands. It also regulates the heart, respiratory system, GI tract, bladder, eyes and glands
Autonomic Nervous System
The 2 sets of neurons in the ANS
- Afferent neurons
- Efferent neurons
This neuron sends impulses to the CNS where they are interpreted
Afferent neurons
This neuron receives the impulses from the brain and transmits those impulses through the spinal cord to the effector organ cells
Efferent neurons
Also called the “Adrenergic system”
Sympathetic Nervous System
Also known as the “Cholinergic System”
Parasympathetic Nervous System
Alpha 1, Alpha 2, Beta 1, and Beta 2 are considered as:
a. Parasympathetic Nervous System
b. Adrenergic receptor organ cells
c. Adrecholinergic receptor organ cells
b. Adrenergic receptor organ cells
It dilates the pupils
a. SNS
b. PNS
a. SNS
It constricts the bronchioles
A. PNS
B. NSS
C. SNS
C. PNS (Parasympathetic Nervous System)
It dilates the bronchioles
A. PNS
B. SNS
B. SNS (Sympathetic Nervous System)
It constricts the pupils
A. PNS
B. SNS
A. PNS
Relaxes smooth muscles in the GI tract
A. PNS
B. SNS
B. SNS (Sympathetic Nervous System)
It contracts smooth muscles of the stomach, intestine, and the bladder
A. PNS
B. SNS
A. PNS (Parasympathetic Nervous System)
Constricts blood vessels and increases heart rate
A. PNS
B. SNS
B. SNS (Sympathetic Nervous System)
Dilates the blood vessels and decreases heart rate
A. PNS
B. SNS
A. PNS (Parasympathetic Nervous System)
Increases peristalsis
A. PNS
B. SNS
A. PNS (Parasympathetic Nervous System)
Constricts the bladder and increases salivation
A. PNS
B. SNS
A. PNS (Parasympathetic Nervous System)
Relaxes both the bladder and uterine muscles
A. PNS
B. SNS
B. SNS (Sympathetic Nervous System)
Acts on the receptor cells
Adrenergics or Sympathomimetics or Adrenergic Agonists
Drugs that stimulates the sympathetic nervous system
Adrenergics or Sympathomimetics or Adrenergic Agonists
it is the SNS neurotransmitter
Norepinephrine
Topic: Effects of Adrenergic at Receptor
Q: The following effects of adrenergic belongs to what specific receptor?
Increases force of heart contraction
Vasoconstriction increases blood pressure
Mydriasis occurs
Decreases salivation
Increases urinary relaxation and urinary sphincter contraction
A. Alpha 2 Receptor
B. Alpha 1 Receptor
C. Beta 2 Receptor
B. Alpha 1 Receptor
Topic: Effects of Adrenergic at Receptor
Q: The following effects of adrenergic belongs to what specific receptor?
Inhibits the release of norepinephrine
Dilates blood vessels
Produce hypotension
Decrease gastrointestinal motility and tone
A. Alpha 2 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
A. Alpha 2 Receptor
Topic: Effects of Adrenergic at Receptor
Q: The following effects of adrenergic belongs to what specific receptor?
Increases heart rate and force of contraction
Increases renin secretion
Increases blood pressure
A. Alpha 2 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
B. Beta 1 Receptor
Topic: Effects of Adrenergic at Receptor
Q: The following effects of adrenergic belongs to what specific receptor?
Dilates the bronchioles
Promotes gastrointestinal and uterine relaxation
Promotes glyogenolysis
Increase blood flow in the skeletal muscles
A. Alpha 2 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
C. Beta 2 Receptor
The 3 Classifications of Sympathomimetics
- Direct Acting
- Indirect Acting
- Mixed
Topic: Classifications of Sympathomimetics
Q: It stimulates adrenergic receptors
A. Direct Acting
B. Indirect Acting
C. Mixed
A. Direct Acting
Examples of Direct Acting
Epinephrine and Norepinephrine
Topic: Classifications of Sympathomimetics
Q: It stimulates the release of norepinephrine from the terminal nerve endings
A. Direct Acting
B. Indirect Acting
C. Mixed
B. Indirect Acting
Examples of Indirect Acting
Amphetamine
Example of Mixed Classification of Sympathomimetics
Ephedrine
It is nonselective and acts on Alpha 1, Beta 1, and Beta 2 adrenergic sites
Epinephrine
- Maybe administered SQ, IV, topically, or inhalation, intracardiac
- Metabolized in the liver
- Excreted in the urine
Pharmacokinetics of Epinephrine
- Used to treat anaphylaxis
- Inotropic
- Increases cardiac output
- Increases systolic BP, heart rate, bronchodilation
- High doses may result to cardiac dysrhythmias
- Onset and peak are rapid
Pharmacodynamics of Epinephrine
Topic: Other Adrenergic Drugs
Q: It is used for shock - IV
A. Dopamine (Intropin)
B. Norepinephrine (Levophed)
C. Albuterol (Ventolin)
B. Norepinephrine (Levophed)
Topic: Other Adrenergic Drugs
Q: It is used to correct hypotension - IV
A. Dopamine (Intropin)
B. Norepinephrine (Levophed)
C. Albuterol (Ventolin)
A. Dopamine (Intropin)
Topic: Other Adrenergic Drugs
Q: Instillation, nasal decongestant
A. Phenylephrine
B. Norepinephrine (Levophed)
C. Terbutaline sulfate
A. Phenylephrine
Topic: Other Adrenergic Drugs
Q: Nasal decongestant, PO
A. Phenylpropanolamine
B. Norepinephrine (Levophed)
C. Terbutaline sulfate
A. Phenylpropanolamine
Topic: Other Adrenergic Drugs
Q: To relieve bronchospasm
A. Dopamine (Intropin)
B. Norepinephrine (Levophed)
C. Albuterol (Ventolin)
C. Albuterol (Ventolin)
Topic: Other Adrenergic Drugs
Q: What is the two routes used for Terbutaline sulfate
A. IM, IV
B. IV, ID
C. PO, IV
D. Ibang lesson yung tanong
C. PO, IV
1) Record client’s vital signs
2) Check urinary output and assess bladder distention
3) Offer food when giving the drug
4) Evaluate blood glucose level
Nursing Responsibilities: Adrenergics/Antagonists
1) Instruct client to read the label of OTC meds
2) Advise nursing mothers not to take these drugs
3) Explain rebound congestion
4) Encourage to report side effects
Client Teaching: Adrenergics/Antagonists
Also called as “Antagonists” or “Sympatholytics”
Adrenergic Blockers
It blocks the effects of adrenergic neurotransmitters
Adrenergic Blockers
Topic: Effects of Adrenergic Blockers at Receptors
Q: The following effects of adrenergic blockers belongs to what specific receptor?
Decreases heart rate
Reduces force of contraction
A. Alpha 1 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
B. Beta 1 Receptor
Topic: Effects of Adrenergic Blockers at Receptors
Q: The following effects of adrenergic blockers belongs to what specific receptor?
Constricts bronchioles
Contracts uterus inhibits glycogenolysis
A. Alpha 1 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
C. Beta 2 Receptor
Topic: Effects of Adrenergic Blockers at Receptors
Q: The following effects of adrenergic blockers belongs to what specific receptor?
Vasodilation
Decrease BP
Miosis suppresses ejaculation
Reduces contraction of smooth muscles in the bladder and prostate gland
A. Alpha 1 Receptor
B. Beta 1 Receptor
C. Beta 2 Receptor
A. Alpha 1 Receptor
Topic: Alpha Adrenergic Blockers
Q: It blocks alpha 1
A. Non-selective Alpha Blockers
B. Selective Alpha Blockers
B. Selective Alpha Blockers
Topic: Alpha Adrenergic Blockers
Q: It blocks Alpha 1 and Alpha 2
A. Non-selective Alpha Blockers
B. Selective Alpha Blockers
A. Non-selective Alpha Blockers
Topic: Selective Alpha Adrenergic Blockers
Q: Used for Hypotension - PO
A. Doxazosin mesylate (Regitine)
B. Terazosin (Hytrin)
C. Prazosin HCL (Minipress)
B. Terazosin (Hytrin)
Topic: Selective Alpha Adrenergic Blockers
Q: Used for peripheral vascular disorder and hypertensive emergency
A. Doxazosin mesylate (Regitine)
B. Terazosin (Hytrin)
C. Prazosin HCL (Minipress)
A. Doxazosin mesylate (Regitine)
Topic: Selective Alpha Adrenergic Blockers
Q: Used for mild to moderate hypertension
A. Doxazosin mesylate (Regitine)
B. Terazosin (Hytrin)
C. Prazosin HCL (Minipress)
C. Prazosin HCL (Minipress)
Metropolol Tartrate
- PO, IV
- Hypertension
- Angina
- Myocardial Infarction
- Bradycardia
- Dizziness
Atenolol (Tenormin)
PO
Betaxolol (Kerlone)
PO, Hypertension, Glaucoma
- Obtain VS and ECG
- Assess whether with respiratory problems
- Record and I and O
- Note other drugs that the client is taking
Nursing Responsibilities: Adrenergic Blockers/Antagonists
- Advise client not to abruptly stop a beta blocker
- Instruct to comply with the drug regimen
- Monitor blood sugar level if in insulin therapy
- Teach how to monitor pulse and blood pressure
- Drugs may cause decrease libido
- Mood changes
- Slowly rise from bed
Client Education: Adrenergic Blockers/Antagonists
Topic: Beta Adrenergic Blockers - Non-Selective
PO, Hypertension, Angina pectoris
A. Propanolol (Inderal)
B. Penbutolol (Levatol)
C. Nadolol (Corgard)
D. Carvedilol (Coreg)
C. Nadolol (Corgard)
Topic: Beta Adrenergic Blockers - Non-Selective
PO, mild to moderate hypertension
A. Propanolol (Inderal)
B. Penbutolol (Levatol)
C. Nadolol (Corgard)
D. Carvedilol (Coreg)
B. Penbutolol (Levatol)
Topic: Beta Adrenergic Blockers - Non-Selective
PO, Angina pectoris, Myocardial Infarction, hypertension, dysrhythmias
A. Propanolol (Inderal)
B. Penbutolol (Levatol)
C. Nadolol (Corgard)
D. Carvedilol (Coreg)
A. Propanolol (Inderal)
Topic: Beta Adrenergic Blockers - Non-Selective
PO and Hypertension
A. Propanolol (Inderal)
B. Penbutolol (Levatol)
C. Nadolol (Corgard)
D. Carvedilol (Coreg)
D. Carvedilol (Coreg)
Mimics PNS acetycholine
Cholinergics/Parasympathomimetics
Two Types of Receptors
- Muscarinic
- Nicotinic
It stimulates smooth muscles and slows the heart rate
Muscarinic
It affects skeletal muscles
Nicotinic
- Well absorbed in the GI tract
- Crosses blood brain barrier and placenta
- Metabolized in the liver
- Half-life of 3-6hrs
Pharmacokinetics of Propanolol
Topic: Effects of Cholinergic Drugs
It decreases heart rate and lowers blood pressure
Cardiovascular
Topic: Effects of Cholinergic Drugs
Increases tone, motility, and peristalsis
Gastrointestinal or GI
Topic: Effects of Cholinergic Drugs
Miosis
Ocular
Topic: Effects of Cholinergic Drugs
Increases salivation
Glandular
Topic: Effects of Cholinergic Drugs
Bronchial contraction and increased secretion
Bronchial
Topic: Effects of Cholinergic Drugs
Maintains muscle strength and tone
Striated muscle
Acts on the receptor site to stimulate response
Direct Acting Cholinergic
Used for primarily to increase urination
Bethanechol chloride (Urecholine)
Increases gastric emptying
Metoclopramide HCL (Reglan)
Also known as the “Cholinesterase inhibitor” or “Acetylcholinesterase” or “Anti-cholinesterase”
Indirect Acting Cholinergic
Does not act on the receptors and it inhibits or inactivate cholinesterase
Indirect Acting Cholinergic
Topic: Indirect Acting Cholinergic
Q: Drug example that is used to increase muscle tone for clients with myasthenia gravis
Edrophonium Cl or Tensilon
1) Monitor VS Record I/O
2) Administer 1 hour before or 2 hours after meal
3) Check AST
4) Check for side effects
5) Auscultate for breath sounds
6) Have the antidote ready
7) Excessive perspiration may occur
8) Beware of cholinergic crisis
Nursing Responsibilities: Cholinergics and Anti-Cholinergics
It inhibits the action of acetylcholine by occupying the acetylcholine receptors
Anticholinergics or Parasympatholytics or Cholinergic Blocking Agents
Sympathetic nervous system dominates and has an opposite effects of cholinergic drugs
Anticholinergics or Parasympatholytics or Cholinergic Blocking Agents
Derived from Belladonna plant
Atropine sulfate
Act on the muscarinic receptor, little on nicotinic receptor
Atropine sulfate
Pre-operative medication to decrease salivary secretions
Atropine sulfate
Antispasmodic to treat PUD and it increases heart rate in case of bradycardia
Atropine sulfate
- Well absorbed orally and parenterally
- Crosses blood brain barrier
- Short half-life
Pharmacokinetics of Anticholinergics
1) Nausea
2) Headache
3) Dry skin
4) Abdominal distention
5) Impotence
6) Photophobia
7) Coma
Side Effects of Atropine sulfate
1) Monitor VS Determine I & O
2) Record bowel sound
3) Raise side rails
4) Provide mouth care
5) Advise client to avoid hot environment
6) Instruct not to drive a motor vehicle
Nursing Interventions: Atropine sulfate
1) Monitor VS Determine I & O
2) Record bowel sound
3) Raise side rails
4) Provide mouth care
5) Advise client to avoid hot environment
6) Instruct not to drive a motor vehicle
Nursing Interventions: Atropine sulfate
