114 Pharm Midterm, Ch 13

Front 1

Anticholinergic effects:

Back 1

confusion, disorientation, and impaired recent memory

Front 2

Extrapyramidal symptoms (EPS):

Back 2

parkinson's like movements, restlessness

Front 3

Signs of tardive dyskinesia:

Back 3

lip pursing, blinking rapidly, lip licking

Front 4

Anticholinergic effects, Extrapyramidal symptoms, and tardive dyskinesia are all effects of _______ and ____ _____ commonly found with little old people.

Back 4

polypharmacy
drug interactions

Front 5

PNS divided into ___ and ___ divisions

Back 5

afferent and efferent

Front 6

Efferent neurons are subdivided into _____ and _____

Back 6

somatic and Autonomic (ANS)

Front 7

Autonomic Nervous System is divided into ___ and ____

Back 7

SNS- aka adrenergic
PSNS- aka cholinergic

Front 8

SNS aka

Back 8

adrenergic

Front 9

PSNS aka

Back 9

cholinergic

Front 10

agonists are

Back 10

Drug molecules that attach to a receptor and STIMULATE a cell to act --> PROMOTING a function

Front 11

Antagonist

Back 11

By attaching to a receptor, these drug molecules PREVENT something else from attaching, thus BLOCKING or PREVENTING an effect.

Front 12

The sympathetic nervous system is the....

Back 12

fight or flight system... vessels constrict

Front 13

The parasympathetic nervous system is the....

Back 13

ho-hum, relaxed system.... vessels dilate

Front 14

In the ANS, the actual connection between the neurons and effector organs or tissues relies on _____ & ______ _____

Back 14

neurotransmitters and synaptic transmission

Will be on test

Front 15

An effector organ is...

Back 15

an organ or cell that carries out a response to a nerve impulse

Front 16

Why do the transmissions of impulses in the elderly not work as efficiently in the elderly?

Back 16

Because dopamine and Acetyl choline are diminished in the elderly

Will be on test

Front 17

The neurotransmitters in the ANS include _____, _____, and _____

Back 17

acetylcholine (ACh), norepinephrine (NE), and epinephrine (Epi)

Front 18

What is acetylcholine (ACh)?

Back 18

An excitatory neurotransmitter that decreases HR

Front 19

What is norepinephrine (NE)?

Back 19

A neurotransmitter that increases HR, constricts vessels, increases BP, and constricts bronchi

Front 20

In the SNS, preganglionic transmission is mediated by _____, whereas postganglionic transmission is mediated by _________

Back 20

acetylcholine

norepinephrine

Will be on test

Front 21

Adrenergic

Back 21

Related to SNS

Front 22

Cholinergic

Back 22

Related to PSNS

Front 23

Where are Alpha 1 receptors located???

Back 23

Male sex organs

Will be on test

Front 24

There are Beta 1 receptors located?

Back 24

In hear and Kidneys

Will be on test

Front 25

There are Beta 2 receptors located?

Back 25

Found in lungs

Will be on test

Front 26

Beta 1 ___ 2 ____

Back 26

1 heart, 2 lungs

Will be on test

Front 27

Alpha-1 and beta-1 receptors respond to ___, ___, and ____

Back 27

epinephrine, norepinephrine, and dopamine

Will be on test

Front 28

Alpha-2 receptors respond to ____ and _____

Back 28

epinephrine and norepinephrine

Will be on test

Front 29

Beta-adrenergic receptors are also called

Back 29

Beta-2 receptors

Will be on test

Front 30

beta-2 receptors respond only to ______

Back 30

epinephrine

Will be on test

Front 31

The therapeutic uses of ____ drugs are R/T providing extra-adrenergic stimulation or blockade of normal ANS functioning

Back 31

sympathetic drugs

Front 32

One of the most frequent indications for adrenergic agonist drugs is

Back 32

shock

Front 33

___ is the result of inadequate tissue perfusion. Leaving the cells without the oxygen and nutrients they need to function normally and survive

Back 33

Shock

Front 34

Adrenergic agonists are classified in 2 groups, _____ and _____

Back 34

catecholamine and noncatecholamine

Will be on test

Front 35

Sympathomimetic: mimic ____

Back 35

SNS

Will be on test

Front 36

Catecholamine:

Back 36

fight or flight hormones

*cannot cross blood brain barrier*

Ex: dopamine, epi, and norepi

Will be on test

Front 37

Adrenergic agonists exert their effects by ___ or ____ stimulation of adrenergic receptors

Back 37

direct or indirect

Front 38

Nonselective adrenergic agonists stimulate what?

Back 38

both alpha and beta receptors

Front 39

Prototype drug nonselective adrenergic agonist:

Back 39

epinephrine

Front 40

The sympathetic nervous system produces what type of response?

Back 40

Adrenergic

Front 41

Dopamine, epi, and norepi all have similar chem structure but have short duration. Because of this they cannot be given through which ROUTE?

Back 41

CANNOT be given PO

Front 42

Epinephrine is ___ and stimulates what receptors?

Back 42

nonselective
alpha 1 and 2, as well as
beta 1 and 2

Front 43

Epinephrine is given for a wide variety of indications including, ___ and ___

Back 43

SHOCK and asthma

Will be on test

Front 44

Most COMMON Adverse effects os epinephrine:

Back 44

fatigue, sleep disturbances, tremor, weakness, dizziness

Front 45

Most SERIOUS Adverse effects os epinephrine:

Back 45

cardiovascular stimulation (and CNS stimulation)

Front 46

Drug interaction with epinephrine?

Back 46

Beta blockers

Front 47

Does epinephrine stimulate dop;amine receptors?

Back 47

NO

Front 48

The alpha-1 adrenergic agonists are drugs that stimulate the alpha-1 receptor ____

Back 48

directly

Front 49

alpha-1 adrenergic agonist prototype drug:

Back 49

phenylephrine (Allerest)

Front 50

phenylephrine (Allerest) is a.... and is use for....

Back 50

alpha-1 adrenergic agonist

used topically for relief of nasal mucous congestion

Front 51

Direct-acting drugs are drugs that...

Back 51

directly stimulate the receptor

Front 52

indirect-acting drugs are drugs that...

Back 52

stimulate release of norepinephrine from nerve endings into synapse

Front 53

Selective drugs are used most frequently to....

Back 53

maximize therapeutic effects and minimize adverse effects

Front 54

Epinephrine can not be given through what route?

Back 54

PO

Front 55

How do Alpha-2 adrenergic agonists affect BP?

Back 55

They LOWER BP

Front 56

Stimulation of alpha-2 receptors in the CNS decreases sympathetic outflow by ____ the release of _____ (thereby ___ BP )

Back 56

inhibiting

norepinephrine

lowering (vasodilation)

Front 57

Prototype Alpha-2 adrenergic agonist?

Back 57

Clonidine

Front 58

What is clonidine and how is it used?

Back 58

It is an Alpha-2 adrenergic agonist and it is a SUPPLEMENTAL med- 2nd line- used to LOWER BP (usually PRN)

Front 59

Most common adverse effects of clonidine?

Back 59

dry mouth, drowsy, dizziness, sedation, constipation
Transdermal: dry mouth and drowsiness

Front 60

Most serious adverse effects of clonidine?

Back 60

rebound hypertension (with abrupt stopping)

Front 61

most important teaching about clonidine?

Back 61

Do not stop abruptly. Must go through a slow withdrawl to avoid rebound hypertension

Front 62

Beta adrenergic agonists mimic the action of the ____

Back 62

SNS

Front 63

Prototype Beta adrenergic agonist?

Back 63

dopamine (Intropin)

Front 64

What route can you give dopamine through?

Back 64

IV only

Front 65

dopamine is used to correct the ____ _____ present in shock

Back 65

hemodynamic imbalances

Front 66

dopamine stimulates ___ and __ receptors resulting in increased ___ ___

Back 66

alpha-1 and beta-1 receptors,

increased cardiac output (more O2 to other parts of the body)

Front 67

Is dopamine a selective or nonselective drug?

Back 67

Selective

Front 68

How does dopamine work to correct the hemodynamic imbalances present in shock?

Back 68

By constricting blood vessels and increasing BP

Front 69

Dopamine contraindications and precautions

Back 69

ventricular fibrillation

Front 70

Most common adverse effects of Dopamine

Back 70

ECTOPIC BEATS, nausea, vomiting, tachycardia, angina, palpation, dyspnea, headache, hypotension, and vasoconstriction

Front 71

Most serious adverse effects of Dopamine

Back 71

ventricular arrhythmias

Front 72

Dopamine is given only in what kind of setting?

Back 72

Acute care, where BP can be monitored while being admin

Front 73

Important teaching about clonidine?

Back 73

Close monitoring and frequent assessment sis necessary

Front 74

Clonidine treatment is effective if ___ stabilizes, ___ ____ returns to normal, and ___ ___ returns to normal

Back 74

blood pressure
urinary output
cardiac output

Front 75

Dopaminergic agonists stimulation of DA1 and DA2 receptors results in ____ _____

Back 75

peripheral vasodilation

Front 76

Only ____ (___) and _____ (___) receptors mediate responses in the adrenergic nervous system

Back 76

dopamine-1 (DA1) and dopamine-2 (DA2)

Front 77

Alpha-adrenergic antagonists ____ the stimulation of ___ receptors

Back 77

block

alpha

Front 78

alpha receptors produce ___ effects

Back 78

excitatory

Front 79

Alpha-1a receptors mediate human ___ smooth muscle contraction

Back 79

prostatic

Front 80

Alpha-1b and alpha-1d receptors are involved in ___ smooth muscle contraction

Back 80

vascular

Front 81

Beta-Adrenergic Antagonists are commonly known as __ ___ and they __ HR

Back 81

beta blockers

decrease HR

Front 82

Beta-Adrenergic Antagonists are grouped according to their specificity of ___ at the beta-1 and beta-2 receptors

Back 82

action

Front 83

Beta-Adrenergic Antagonist's stimulation of beta-1 receptors only, produces issues in the ____

Back 83

heart- tachycardia, inotropy

Front 84

What happens when beta-1 and beta-2 receptors are blocked?

Back 84

vasodilation, bronchodilation, and decreased peripheral resistance

Front 85

Beta-Adrenergic Prototype drug:

Back 85

Propranolol

Front 86

what is Propranolol used for?

Back 86

Treatment of hypertension, angina, irregular cardiac rhythms, pheochromocytoma, and migraine

Front 87

How is Propranolol administered?

Back 87

parenterally and orally

Front 88

How does Propranolol work?

Back 88

decreases HR and BP, slows conduction and suppression of automaticity

Front 89

Contraindications and precautions for Propranolol

Back 89

Severe bradycardia, cardiogenic shock, airway diseases

Front 90

Most common Adverse effects of Propranolol

Back 90

POSTURAL HYPOTENSION

Front 91

Most serious Adverse effects of Propranolol

Back 91

MI --> Heart Attack

Front 92

Most important teaching for Propranolol

Back 92

Slow withdrawl to prevent rebound symptoms;

Front 93

Drug interaction with Beta-Adrenergic Antagonists?

Back 93

*Epinephrine*

Front 94

Beta-Adrenergic Antagonists work as a ____ and _____

Back 94

bronchodilator and a vasodilator

Front 95

Nursing Interventions to Minimize adverse effects with Propranolol

Back 95

Prior to dose: check apical ad peripheral pulses

Monitor BP and cardiac rhythm