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214 Cards in this Set
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Introduction to the Autonomic Nervous System
Charlene Gagliardi, RN, MSN Assistant Professor NUR 135 Central NS and Peripheral NS • Central Nervous System – brain and spinal cord |
Central NS and Peripheral NS
• Central Nervous System – brain and -------- cord |
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Central NS and Peripheral NS
• Peripheral Nervous system – 2 divisions ~ Somatic: motor nervous system that controls ------------- contraction (voluntary system) |
Central NS and Peripheral NS
• Peripheral Nervous system – 2 divisions ~ Somatic: motor nervous system that controls skeletal muscle contraction (voluntary system) |
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Central NS and Peripheral NS
• Peripheral Nervous system – 2 divisions ~ Autonomic: regulates ------ functions (involuntary) |
Central NS and Peripheral NS
• Peripheral Nervous system – 2 divisions ~ Autonomic: regulates body functions (involuntary) |
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Nervous System
Autonomic Nervous System (ANS) • Definition • Involuntary or ----------- nervous system |
Nervous System
Autonomic Nervous System (ANS) • Definition • Involuntary or visceral nervous system |
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Nervous System
Autonomic Nervous System (ANS) • Function • Mostly with little ----------- awareness of its activity |
Nervous System
Autonomic Nervous System (ANS) • Function • Mostly with little conscious awareness of its activity |
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Nervous System
Autonomic Nervous System (ANS) • Function • Regulatory or self-governing system for maintaining --------- |
Nervous System
Autonomic Nervous System (ANS) • Function • Regulatory or self-governing system for maintaining homeostasis |
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Nervous System
Autonomic Nervous System (ANS) • Function • Controls functions of the smooth muscle, ---------- muscle & -------- secretions |
Nervous System
Autonomic Nervous System (ANS) • Function • Controls functions of the smooth muscle, cardiac muscle & glandular secretions |
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Divisions of the ANS
• The ANS is divided into two branches • S------- • P------------ |
Divisions of the ANS
• The ANS is divided into two branches • Sympathetic • Parasympathetic |
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Divisions of the ANS
• The ANS is divided into two branches • Most organs are ------------ by both the sympathetic and parasympathetic branches and the opposing actions of each balance one another |
Divisions of the ANS
• The ANS is divided into two branches • Most organs are innervated by both the sympathetic and parasympathetic branches and the opposing actions of each balance one another |
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Parasympathetic System
(Cholinergic) • Functions mainly to conserve --------- and restore body resources |
Parasympathetic System
(Cholinergic) • Functions mainly to conserve energy and restore body resources |
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Parasympathetic System
(Cholinergic) • System of rest and ---------- • Acetylcholine is the main neurotransmitter that binds to a ----------- receptor |
Parasympathetic System
(Cholinergic) • System of rest and digestion • Acetylcholine is the main neurotransmitter that binds to a cholinergic receptor |
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Parasympathetic System
(Cholinergic) • Cholinergic receptors: ----------- (decreased BP & HR, increased saliva) or -------- (skeletal, increased BP, HR & peripheral vasoconstriction) |
Parasympathetic System
(Cholinergic) • Cholinergic receptors: muscarinic (decreased BP & HR, increased saliva) or nicotinic (skeletal, increased BP, HR & peripheral vasoconstriction) |
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Results of PSNS Stimulation
• Increased ------------ and secretions in the GI tract • Decreased heart rate and ----------- |
Results of PSNS Stimulation
• Increased motility and secretions in the GI tract • Decreased heart rate and contractility |
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Results of PSNS Stimulation
• Constriction of the ------------, with increased secretion • Relaxation of the ------------ and urinary bladder sphincters |
Results of PSNS Stimulation
• Constriction of the bronchi, with increased secretion • Relaxation of the GI and urinary bladder sphincters |
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Results of PSNS Stimulation
• ------------- constriction • Overstimulation: ----------- |
Results of PSNS Stimulation
• Pupillary constriction • Overstimulation: S L U D G E |
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Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • Mobilizes the body during ------------- and stress situations (fight of flight) • Functions involve the expenditure of ---------- |
Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • Mobilizes the body during emergency and stress situations (fight of flight) • Functions involve the expenditure of energy |
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Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • Norepinephrine is the main --------- • Other NT’s: -------------- and dopamine |
Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • Norepinephrine is the main neurotransmitter • Other NT’s: epinephrine and dopamine |
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Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • ---------- 1 & 2 and ------- 1 & 2 receptors |
Parasympathetic Responses
Sympathetic System (Adrenergic) (Sympathomimetic) • Alpha 1 & 2 and Beta 1 & 2 receptors |
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Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Blood vessels • Cause ------------ and increase peripheral resistance, raising blood pressure; decreased nasal congestion |
Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Blood vessels • Cause vasoconstriction and increase peripheral resistance, raising blood pressure; decreased nasal congestion |
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Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Iris • Cause --------- dilation |
Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Iris • Cause pupil dilation |
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Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Urinary bladder & ------- sphincters • Causes ------------ |
Sympathetic Responses
Adrenergic Effects Activation of Alpha1 Receptors • Urinary bladder & GI sphincters • Causes contraction |
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Activation of Alpha2 Receptors
• Nerve membranes • Prevent further release of ---------- (antiadrenergic effect) |
Activation of Alpha2 Receptors
• Nerve membranes • Prevent further release of norepinephrine (antiadrenergic effect) |
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Activation of Alpha2 Receptors
• Beta cells in the pancreas • Help to moderate the ---------- release stimulated by SNS activation |
Activation of Alpha2 Receptors
• Beta cells in the pancreas • Help to moderate the insulin release stimulated by SNS activation |
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Activation of Beta1 Receptors
• ---------- tissue • Can stimulate increased ------------ activity and increased heart rate |
Activation of Beta1 Receptors
• Cardiac tissue • Can stimulate increased myocardial activity and increased heart rate |
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Activation of Beta1 Receptors
• Responsible for increased ------------ or breakdown of fat for energy in --------- tissues |
Activation of Beta1 Receptors
• Responsible for increased lipolysis or breakdown of fat for energy in peripheral tissues |
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Activation of Beta2 Receptors
• Smooth muscle in blood vessels • Stimulation leads to -------- |
Activation of Beta2 Receptors
• Smooth muscle in blood vessels • Stimulation leads to vasodilation |
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Activation of Beta2 Receptors
• Bronchi • Can cause ------- |
Activation of Beta2 Receptors
• Bronchi • Can cause dilation |
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Activation of Beta2 Receptors
• Periphery • Increased --------- and liver breakdown of glycogen and -------- release of glucagon |
Activation of Beta2 Receptors
• Periphery • Increased muscle and liver breakdown of glycogen and increased release of glucagon |
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Activation of Beta2 Receptors
• Uterine muscle • Results in -------- uterine smooth muscle |
Activation of Beta2 Receptors
• Uterine muscle • Results in relaxed uterine smooth muscle |
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The “Fight or Flight” Response to Sympathetic Stress Reaction
Neurotransmitters & Receptors Comparison Of SNS & PSNS • Sympathetic and ----------- Effects on Body Tissues |
The “Fight or Flight” Response to Sympathetic Stress Reaction
Neurotransmitters & Receptors Comparison Of SNS & PSNS • Sympathetic and Parasympathetic Effects on Body Tissues |
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Cholinergic Agents
Cholinergic Drugs • Definition • Chemicals that act at the same site as the --------------- acetylcholine (ACh) |
Cholinergic Agents
Cholinergic Drugs • Definition • Chemicals that act at the same site as the neurotransmitter acetylcholine (ACh) |
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Cholinergic Agents
Cholinergic Drugs • Action • Often called ------------------ drugs, because their action mimics the action of the PSNS |
Cholinergic Agents
Cholinergic Drugs • Action • Often called parasympathomimetic drugs, because their action mimics the action of the PSNS |
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Cholinergic Agents
Cholinergic Drugs • Action • Not limited to a specific site; therefore associated with many undesirable ---------- effects |
Cholinergic Agents
Cholinergic Drugs • Action • Not limited to a specific site; therefore associated with many undesirable systemic effects |
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Cholinergic Receptor’s Locations
Effects of Cholinergic Drugs Types of Cholinergic Agonists • Direct-acting cholinergic agonists • Occupy receptor sites for ACh on the membranes of the effector cells of the ------------- cholinergic nerves |
Cholinergic Receptor’s Locations
Effects of Cholinergic Drugs Types of Cholinergic Agonists • Direct-acting cholinergic agonists • Occupy receptor sites for ACh on the membranes of the effector cells of the postganglionic cholinergic nerves |
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Cholinergic Receptor’s Locations
Effects of Cholinergic Drugs Types of Cholinergic Agonists • Direct-acting cholinergic agonists • Cause increased stimulation of the cholinergic receptor – mimic --------------- |
Cholinergic Receptor’s Locations
Effects of Cholinergic Drugs Types of Cholinergic Agonists • Direct-acting cholinergic agonists • Cause increased stimulation of the cholinergic receptor – mimic acetylcholine |
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Types of Cholinergic Agonists (cont.)
• Indirect-acting cholinergic agonists • React with the enzyme ------------ and prevent it from breaking down the ACh that was released from the nerve |
Types of Cholinergic Agonists (cont.)
• Indirect-acting cholinergic agonists • React with the enzyme acetylcholinesterase and prevent it from breaking down the ACh that was released from the nerve |
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Types of Cholinergic Agonists (cont.)
• Also called ------------- inhibitors • Cause increased stimulation of the ------------ receptor sites – prolong the effect of acetylcholine |
Types of Cholinergic Agonists (cont.)
• Also called cholinesterase inhibitors • Cause increased stimulation of the ACh receptor sites – prolong the effect of acetylcholine |
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Types of Cholinergic Agonists (cont.)
• Binds reversibly with ---------------- so effects will pass with time |
Types of Cholinergic Agonists (cont.)
• Binds reversibly with acetylcholinesterase so effects will pass with time |
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Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Irreversible acetylcholinesterase inhibitor • Nerve gas, ----------- |
Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Irreversible acetylcholinesterase inhibitor • Nerve gas, pesticides |
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Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • Leads to toxic accumulations of ACh at -------------- sites |
Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • Leads to toxic accumulations of ACh at cholinergic receptor sites |
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Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • Can cause ----------- crisis and muscle paralysis |
Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • Can cause parasympathetic crisis and muscle paralysis |
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Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • ____________ – antidote that reactivates cholinesterase that was inactivated |
Indirect Cholinergic Drugs
Direct & Indirect acting cholinergic drugs Continued… • Action • pralidoxime – antidote that reactivates cholinesterase that was inactivated |
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Examples of Direct-Acting Cholinergic Agonists and Their Indications
• -------------- (Duvoid, Urecholine) |
Examples of Direct-Acting Cholinergic Agonists and Their Indications
• bethanechol (Duvoid, Urecholine) |
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Examples of Direct-Acting Cholinergic Agonists and Their Indications
• bethanechol (Duvoid, Urecholine) • Treat --------------; neurogenic bladder atony • Diagnose and treat ------------- • • |
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• Examples of Direct-Acting Cholinergic Agonists and Their Indications • bethanechol (Duvoid, Urecholine) • Treat urinary retention; neurogenic bladder atony • Diagnose and treat reflux esophagitis • • |
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• Examples of Direct-Acting Cholinergic Agonists and Their Indications • ----------- (Miostat); ------------- (Pilocar) |
• Examples of Direct-Acting Cholinergic Agonists and Their Indications
• carbachol (Miostat); pilocarpine (Pilocar) |
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• Examples of Direct-Acting Cholinergic Agonists and Their Indications
• carbachol (Miostat); pilocarpine (Pilocar) • Induce ------- or pupil constriction • Relieve ------------- pressure of glaucoma |
• Examples of Direct-Acting Cholinergic Agonists and Their Indications
• carbachol (Miostat); pilocarpine (Pilocar) • Induce miosis or pupil constriction • Relieve intraocular pressure of glaucoma |
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• Examples of Direct-Acting Cholinergic Agonists and Their Indications
• carbachol (Miostat); pilocarpine (Pilocar) • Perform certain ----------- procedures |
• Examples of Direct-Acting Cholinergic Agonists and Their Indications
• carbachol (Miostat); pilocarpine (Pilocar) • Perform certain surgical procedures |
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Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Indications: Acute postoperative or ----------------- urinary retention; neurogenic atony of the bladder with retention; stimulates gastric motility in paralytic ileus |
Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Indications: Acute postoperative or postpartum nonobstructive urinary retention; neurogenic atony of the bladder with retention; stimulates gastric motility in paralytic ileus |
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Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Indications: Acute postoperative or postpartum nonobstructive urinary retention; neurogenic atony of the ----------- with retention; stimulates gastric motility in ------------ |
Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Indications: Acute postoperative or postpartum nonobstructive urinary retention; neurogenic atony of the bladder with retention; stimulates gastric motility in paralytic ileus |
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Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Actions: Acts directly on cholinergic receptors to mimic the effects of --------------; increases tone of detrusor muscles and causes emptying of the -------------; increases GI muscle tone |
Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Actions: Acts directly on cholinergic receptors to mimic the effects of acetylcholine; increases tone of detrusor muscles and causes emptying of the bladder; increases GI muscle tone |
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Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Actions: Acts directly on cholinergic receptors to mimic the effects of acetylcholine; increases tone of detrusor muscles and causes emptying of the bladder; increases --------- muscle tone |
Direct-Acting Cholinergic Agonists Prototype: bethanechol (Urecholine)
• Actions: Acts directly on cholinergic receptors to mimic the effects of acetylcholine; increases tone of detrusor muscles and causes emptying of the bladder; increases GI muscle tone |
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Myasthenia Gravis
• Definition • Chronic muscular disease caused by a defect in ------------- |
Myasthenia Gravis
• Definition • Chronic muscular disease caused by a defect in neuromuscular transmission |
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Myasthenia Gravis
• Definition • --------------- disease; patients make antibodies to ACh receptors, causing gradual ----------- of them |
Myasthenia Gravis
• Definition • Autoimmune disease; patients make antibodies to ACh receptors, causing gradual destruction of them |
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Myasthenia Gravis
• Symptoms • Progressive weakness & lack of muscle control with periodic ---------------; drooping of upper eyelid, double -------------; difficulty chewing & swallowing |
Myasthenia Gravis
• Symptoms • Progressive weakness & lack of muscle control with periodic acute episodes; drooping of upper eyelid, double vision; difficulty chewing & swallowing |
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Myasthenia Gravis
• Symptoms • Progressive weakness & lack of muscle control with periodic acute episodes; drooping of ------------, double vision; difficulty --------- & ----------- |
Myasthenia Gravis
• Symptoms • Progressive weakness & lack of muscle control with periodic acute episodes; drooping of upper eyelid, double vision; difficulty chewing & swallowing |
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Receptors in Myasthenia gravis
Acetylcholinesterase Inhibitors to Treat Myasthenia Gravis • ---------------- (Prostigmine): Has a strong influence at the neuromuscular junction • • |
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• Receptors in Myasthenia gravis • Acetylcholinesterase Inhibitors to Treat Myasthenia Gravis • neostigmine (Prostigmine): Has a strong influence at the neuromuscular junction • • |
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• Receptors in Myasthenia gravis • Acetylcholinesterase Inhibitors to Treat Myasthenia Gravis • ---------------- (Regonol, Mestinon): Has a longer duration of action than neostigmine; considered maintenance drug of choice for MG |
• Receptors in Myasthenia gravis
• Acetylcholinesterase Inhibitors to Treat Myasthenia Gravis • pyridostigmine (Regonol, Mestinon): Has a longer duration of action than neostigmine; considered maintenance drug of choice for MG |
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Prototype for Myasthenia Gravis: pyridostigmine
• Indications: Myasthenia -------------, antidote - increased survival after exposure to nerve gas |
Prototype for Myasthenia Gravis: pyridostigmine
• Indications: Myasthenia gravis, antidote - increased survival after exposure to nerve gas |
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Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of ---------- |
Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of acetylcholine |
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Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of acetylcholine • Drug of choice for ----------; improves muscle strength |
Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of acetylcholine • Drug of choice for MG; improves muscle strength |
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Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of acetylcholine • Antidote: ------------ (anticholinergic agent) |
Prototype for Myasthenia Gravis: pyridostigmine
• Actions: Reversible cholinesterase inhibitor that increases the levels of acetylcholine • Antidote: atropine (anticholinergic agent) |
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Alzheimer’s Disease
• A progressive disorder involving neural degeneration in the --------- • Leads to a marked loss of ----------- and of the ability to carry on activities of daily living |
Alzheimer’s Disease
• A progressive disorder involving neural degeneration in the cortex • Leads to a marked loss of memory and of the ability to carry on activities of daily living |
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Alzheimer’s Disease
• Cause of the disease is --------- • There is a progressive loss of --------------- neurons and their target neurons |
Alzheimer’s Disease
• Cause of the disease is not yet known • There is a progressive loss of ACh-producing neurons and their target neurons |
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Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • ---------- (Cognex) • First drug to treat Alzheimer’s dementia |
Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • tacrine (Cognex) • First drug to treat Alzheimer’s dementia |
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Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • tacrine (Cognex) • First drug to treat -------------’s dementia |
Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • tacrine (Cognex) • First drug to treat Alzheimer’s dementia |
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Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • galantamine (Reminyl) • Used to stop ------------ of Alzheimer’s dementia |
Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • galantamine (Reminyl) • Used to stop progression of Alzheimer’s dementia |
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Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • rivastigmine (Exelon) • Available in solution for ---------- ease |
Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • rivastigmine (Exelon) • Available in solution for swallowing ease |
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Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • donepezil (Aricept) • Has ----------- dosing |
Histologic Changes in Alzheimer’s Disease
Drugs Used to Treat Alzheimer’s Disease • donepezil (Aricept) • Has once-a-day dosing |
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Prototype for Alzheimer’s Disease: donepezil
• Indications: Treatment of ------------ to moderate Alzheimer’s disease |
Prototype for Alzheimer’s Disease: donepezil
• Indications: Treatment of mild to moderate Alzheimer’s disease |
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Prototype for Alzheimer’s Disease: donepezil
• Actions: Reversible cholinesterase inhibitor that causes elevated acetylcholine levels in the ----------------, which slows the -------------- degradation of Alzheimer’s disease |
Prototype for Alzheimer’s Disease: donepezil
• Actions: Reversible cholinesterase inhibitor that causes elevated acetylcholine levels in the cortex, which slows the neuronal degradation of Alzheimer’s disease |
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Prototype for Alzheimer’s Disease: donepezil
• Oral route: Onset varies; peak 2–______ hours • T½: _______ hours; metabolism is in the liver and excretion is in the ________ |
Prototype for Alzheimer’s Disease: donepezil
• Oral route: Onset varies; peak 2–4 hours • T½: 70 hours; metabolism is in the liver and excretion is in the urine |
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Adverse Effects of Acetylcholinesterase Inhibitors
• B------------ • H----------- |
Adverse Effects of Acetylcholinesterase Inhibitors
• Bradycardia • Hypotension |
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Adverse Effects of Acetylcholinesterase Inhibitors
• Increased ------------ secretions and activity • Increased ------------ tone |
Adverse Effects of Acetylcholinesterase Inhibitors
• Increased GI secretions and activity • Increased bladder tone |
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Adverse Effects of Acetylcholinesterase Inhibitors
• Relaxation of ------------ and genitourinary sphincters • B--------------- |
Adverse Effects of Acetylcholinesterase Inhibitors
• Relaxation of GI and genitourinary sphincters • Bronchoconstriction |
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Adverse Effects of Acetylcholinesterase Inhibitors
• ---------- constriction |
Adverse Effects of Acetylcholinesterase Inhibitors
• Pupil constriction |
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Prevalence of Alzheimer’s Disease
Anticholinergic Agents • Action • Used to block the effects of ---------- • Lyse, or block effects of the ---------; also called parasympatholytic agents |
Prevalence of Alzheimer’s Disease
Anticholinergic Agents • Action • Used to block the effects of acetylcholine • Lyse, or block effects of the PNS; also called parasympatholytic agents |
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Prevalence of Alzheimer’s Disease
Anticholinergic Agents • Uses (better drugs are available now) • Decrease -------- activity and secretions • • |
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• Prevalence of Alzheimer’s Disease Anticholinergic Agents • • Uses (better drugs are available now) • Decrease GI activity and secretions • • |
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• Prevalence of Alzheimer’s Disease Anticholinergic Agents • Uses (better drugs are available now) • Decrease --------------- activities to allow the sympathetic system to become more dominant • Widespread effects on body limit their -------------- value |
• Prevalence of Alzheimer’s Disease
Anticholinergic Agents • Uses (better drugs are available now) • Decrease parasympathetic activities to allow the sympathetic system to become more dominant • Widespread effects on body limit their clinical value |
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Anticholinergic Drugs
Anticholinergic (Parasympatholytics) • Derived from the plant ----------- • Block mainly the ------------ effectors in the PNS |
Anticholinergic Drugs
Anticholinergic (Parasympatholytics) • Derived from the plant Belladonna • Block mainly the muscarinic effectors in the PNS |
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Anticholinergic Drugs
Anticholinergic (Parasympatholytics) • Act by competing with acetylcholine for the -------------- acetylcholine receptor sites • Do not block the ------------- receptors |
Anticholinergic Drugs
Anticholinergic (Parasympatholytics) • Act by competing with acetylcholine for the muscarinic acetylcholine receptor sites • Do not block the nicotinic receptors |
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Belladona Plant
Types of Anticholinergic Agents and Their Indications • Atropine – prototype anticholinergic • Blocks ------------- effects in many situations |
Belladona Plant
Types of Anticholinergic Agents and Their Indications • Atropine – prototype anticholinergic • Blocks parasympathetic effects in many situations |
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Belladona Plant
Types of Anticholinergic Agents and Their Indications • ------------- (Detrol) • ------------ (Ditropan) |
Belladona Plant
Types of Anticholinergic Agents and Their Indications • tolterodine (Detrol) • oxybutin (Ditropan) |
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Belladona Plant
Types of Anticholinergic Agents and Their Indications • scopolamine (Hyoscine) • Treat -------------- sickness, preoperative --------- |
Belladona Plant
Types of Anticholinergic Agents and Their Indications • scopolamine (Hyoscine) • Treat motion sickness, preoperative amnesia |
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Belladona Plant
Types of Anticholinergic Agents and Their Indications • propantheline (Pro-Banthine) • Adjunct in the treatment of --------- |
Belladona Plant
Types of Anticholinergic Agents and Their Indications • propantheline (Pro-Banthine) • Adjunct in the treatment of ulcers |
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Actions of Atropine
• Depresses ------------- and bronchial secretions • Dilates the ----------- |
Actions of Atropine
• Depresses salivation and bronchial secretions • Dilates the bronchi |
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Actions of Atropine
• Inhibits --------- responses in the heart – incr HR • Relaxes the --------- and ------------ tracts –antispasmodic action |
Actions of Atropine
• Inhibits vagal responses in the heart – incr HR • Relaxes the GI and genitourinary tracts –antispasmodic action |
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Actions of Atropine
• Inhibits ----------secretions • Causes ------------ (dilated pupil) |
Actions of Atropine
• Inhibits GI secretions • Causes mydriasis (dilated pupil) |
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Actions of Atropine
• Causes ------------ (paralysis of ciliary muscles) |
Actions of Atropine
• Causes cycloplegia (paralysis of ciliary muscles) |
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Adverse Effects of Atropine
• ----------- vision • -------------, delusions |
Adverse Effects of Atropine
• Blurred vision • Confusion, delusions |
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Adverse Effects of Atropine
• P-------------- • P--------------, tachycardia |
Adverse Effects of Atropine
• Photophobia • Palpitations, tachycardia |
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Adverse Effects of Atropine
• -------------- mouth, altered taste perception • ------------- hesitancy and retention |
Adverse Effects of Atropine
• Dry mouth, altered taste perception • Urinary hesitancy and retention |
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Adverse Effects of Atropine
• Decreased ---------------; predisposition to heat prostration • ------------- face |
Adverse Effects of Atropine
• Decreased sweating; predisposition to heat prostration • Scarlet face |
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Implementation for Patients Receiving Anticholinergic Drugs
• Ensure --------- and appropriate administration of drug • Provide -----------/safety measures – oral care |
Implementation for Patients Receiving Anticholinergic Drugs
• Ensure safe and appropriate administration of drug • Provide comfort/safety measures – oral care |
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Implementation for Patients Receiving Anticholinergic Drugs
• Encourage ------------ to decrease risk of constipation • Provide ----------- teaching |
Implementation for Patients Receiving Anticholinergic Drugs
• Encourage fluids to decrease risk of constipation • Provide patient teaching |
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Implementation for Patients Receiving Anticholinergic Drugs
• Monitor blood ------------ and --------- and adjust doses as needed |
Implementation for Patients Receiving Anticholinergic Drugs
• Monitor blood pressure and pulse and adjust doses as needed |
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Evaluation of Patients Receiving Anticholinergic Drugs
• Monitor patient ----------- to the drug (improvement in disorder being treated) |
Evaluation of Patients Receiving Anticholinergic Drugs
• Monitor patient response to the drug (improvement in disorder being treated) |
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Evaluation of Patients Receiving Anticholinergic Drugs
• Monitor for adverse effects (-------------- changes, GI problems, ------------- effects, ---------------- hesitancy and retention, ----------- dilation and photophobia, decrease in sweating and heat intolerance) |
Evaluation of Patients Receiving Anticholinergic Drugs
• Monitor for adverse effects (cardiovascular changes, GI problems, CNS effects, urinary hesitancy and retention, pupil dilation and photophobia, decrease in sweating and heat intolerance) |
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Evaluation of Patients Receiving Anticholinergic Drugs
• Evaluate the effectiveness of the ------------- plan |
Evaluation of Patients Receiving Anticholinergic Drugs
• Evaluate the effectiveness of the teaching plan |
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Antiparkinsonism Agents
Progression of Parkinson’s Disease • Lack of ---------- • ------------ tremors |
Antiparkinsonism Agents
Progression of Parkinson’s Disease • Lack of coordination • Rhythmic tremors |
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Antiparkinsonism Agents
Progression of Parkinson’s Disease • Rigidity/----------- • Trouble maintaining ---------- or posture |
Antiparkinsonism Agents
Progression of Parkinson’s Disease • Rigidity/weakness • Trouble maintaining position or posture |
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Antiparkinsonism Agents
Progression of Parkinson’s Disease • B------------- • Problem ------------ |
Antiparkinsonism Agents
Progression of Parkinson’s Disease • Bradykinesia • Problem walking |
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Antiparkinsonism Agents
Progression of Parkinson’s Disease • ------------- and affected speech • ------------- expression |
Antiparkinsonism Agents
Progression of Parkinson’s Disease • Drooling and affected speech • Masklike expression |
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Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • ----------- to certain drugs • ------------- factors |
Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • Exposure to certain drugs • Environmental factors |
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Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • -----------% diagnoses are idiopathic |
Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • 85% diagnoses are idiopathic |
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Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • ----------------- (increase)/dopamine (decrease) imbalance |
Clinical Manifestations
Theories About the Cause of Parkinson’s Disease • Acetycholine (increase)/dopamine (decrease) imbalance |
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Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • ------------ (Cogentin) – useful with elderly who cannot tolerate Artane • ------------ (Akineton) - prototype |
Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • benztropine (Cogentin) – useful with elderly who cannot tolerate Artane • biperiden (Akineton) - prototype |
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Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • -------------- (Artane) – most frequently used |
Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • trihexyphenidyl (Artane) – most frequently used |
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Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • Only drugs that cross the -------------- barrier are used to treat PD; used alone early then in combination later in disease |
Dopamine degeneration
Anticholinergics Used to Treat Parkinson’s Disease • Only drugs that cross the blood-brain barrier are used to treat PD; used alone early then in combination later in disease |
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Anticholingeric Prototype:
biperiden (Akineton) • Indications: Adjunctive therapy of ---------------; relief of symptoms of extrapyramidal disorders |
Anticholingeric Prototype:
biperiden (Akineton) • Indications: Adjunctive therapy of parkinsonism; relief of symptoms of extrapyramidal disorders |
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Anticholingeric Prototype:
biperiden (Akineton) • Actions: Acts in the -------------, returning balance to the basal ------------ and reducing the severity of rigidity, akinesia, and tremors |
Anticholingeric Prototype:
biperiden (Akineton) • Actions: Acts in the CNS, returning balance to the basal ganglia and reducing the severity of rigidity, akinesia, and tremors |
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Anticholingeric Prototype:
biperiden (Akineton) • T½: 18.4–_______ hours |
Anticholingeric Prototype:
biperiden (Akineton) • T½: 18.4–24.3 hours |
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Dopaminergics Drugs To Treat Parkinson’s Disease
• Action • Increasing the levels of dopamine in the ------------- nigra • Directly stimulating the dopamine ------------ in that area |
Dopaminergics Drugs To Treat Parkinson’s Disease
• Action • Increasing the levels of dopamine in the substantia nigra • Directly stimulating the dopamine receptors in that area |
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Dopaminergics Drugs To Treat Parkinson’s Disease
• Action • Enhance ------------ of dopamine |
Dopaminergics Drugs To Treat Parkinson’s Disease
• Action • Enhance neurotransmission of dopamine |
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Dopaminergics Drugs To Treat Parkinson’s Disease
• Indication • Relief of the signs and symptoms of ------------- Parkinson’s disease |
Dopaminergics Drugs To Treat Parkinson’s Disease
• Indication • Relief of the signs and symptoms of idiopathic Parkinson’s disease |
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Dopaminergic Prototype: levodopa (Dopar)
• Indications: Treatment of --------- • • |
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• Dopaminergic Prototype: levodopa (Dopar) • Indications: Treatment of parkinsonism • • |
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• Dopaminergic Prototype: levodopa (Dopar) • Actions: Precursor of ---------; crosses the blood–brain barrier, where it is converted to dopamine and acts as a replacement -------------; effective for 2–________ years |
• Dopaminergic Prototype: levodopa (Dopar)
• Actions: Precursor of dopamine; crosses the blood–brain barrier, where it is converted to dopamine and acts as a replacement neurotransmitter; effective for 2–5 years |
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• Dopaminergic Prototype: levodopa (Dopar)
• Oral route: Onset varies; peak 0.5–________hours; duration 5 hours |
• Dopaminergic Prototype: levodopa (Dopar)
• Oral route: Onset varies; peak 0.5–2 hours; duration 5 hours |
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• Dopaminergic Prototype: levodopa (Dopar)
• T½: 1–________ hours; metabolized in the liver, excreted in the urine |
• Dopaminergic Prototype: levodopa (Dopar)
• Oral route: Onset varies; peak 0.5–2 hours; duration 5 hours |
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levodopa (Dopar)
• Mainstay of treatment for ----------- • Precursor of dopamine that crosses the blood–brain barrier, where a small portion is converted to ----------- |
levodopa (Dopar)
• Mainstay of treatment for parkinsonism • Precursor of dopamine that crosses the blood–brain barrier, where a small portion is converted to dopamine |
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levodopa (Dopar)
• Loss of effectiveness after 3 – ______ years • “On- _______” phenomenon |
levodopa (Dopar)
• Loss of effectiveness after 3 – 5 years • “On- off” phenomenon |
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levodopa (Dopar)
• Abrupt ________ – neuroleptic malignant syndrome |
levodopa (Dopar)
• Abrupt DC – neuroleptic malignant syndrome |
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carbidopa-levodopa (Sinemet)
• Most effective as a ----------- drug |
carbidopa-levodopa (Sinemet)
• Most effective as a combination drug |
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carbidopa-levodopa (Sinemet)
• levodopa given in combination form with --------------- as a fixed-combination drug (Sinemet) |
carbidopa-levodopa (Sinemet)
• levodopa given in combination form with carbidopa as a fixed-combination drug (Sinemet) |
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carbidopa-levodopa (Sinemet)
• Carbidopa decreases the amount of -------------- needed to reach a therapeutic level in the brain |
carbidopa-levodopa (Sinemet)
• Carbidopa decreases the amount of levodopa needed to reach a therapeutic level in the brain |
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carbidopa-levodopa (Sinemet)
• The dosage of levodopa can be decreased, reducing adverse side effects Other Dopaminergics Used in the Treatment of Parkinsonism • ------------------(Symmetrel) – early use, loses effectiveness after several months |
Other Dopaminergics Used in the Treatment of Parkinsonism
• amantadine (Symmetrel) – early use, loses effectiveness after several months |
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Other Dopaminergics Used in the Treatment of Parkinsonism
• ------------- (Parlodel) – more effective than amantadine |
Other Dopaminergics Used in the Treatment of Parkinsonism
• bromocriptine (Parlodel) – more effective than amantadine |
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Other Dopaminergics Used in the Treatment of Parkinsonism
• ---------------- (Permax) – helps reduce S&S of PD |
Other Dopaminergics Used in the Treatment of Parkinsonism
• pergolide (Permax) – helps reduce S&S of PD |
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Other Dopaminergics Used in the Treatment of Parkinsonism
• --------------- (Mirapex) – helps reduce S&S |
Other Dopaminergics Used in the Treatment of Parkinsonism
• pramipexole (Mirapex) – helps reduce S&S |
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Other Dopaminergics Used in the Treatment of Parkinsonism
• -------------- (Requip) – helps reduce S&S |
Other Dopaminergics Used in the Treatment of Parkinsonism
• ropinirole (Requip) – helps reduce S&S |
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Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Acute Pain related to GI, --------, and --------- effects |
Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Acute Pain related to GI, CNS, and GU effects |
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Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Disturbed Thought Processes related to ----- effects |
Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Disturbed Thought Processes related to CNS effects |
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Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Risk for Injury related to CNS effects and incidence of ----------------- • Deficient Knowledge regarding --------- therapy |
Drug Therapy for Parkinson’s
Examples of Nursing Diagnoses for the Patient Taking a Dopaminergic Drug • Risk for Injury related to CNS effects and incidence of orthostatic hypertension • Deficient Knowledge regarding drug therapy |
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Management of Care for Patients With Parkinson’s Disease
• Encourage patients to: • Be as --------- as possible • Perform ---------- • • |
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• Management of Care for Patients With Parkinson’s Disease • Encourage patients to: • Be as active as possible • Perform exercises • • |
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• Management of Care for Patients With Parkinson’s Disease • Encourage patients to: • Attend to their ----- care as long as they can • Follow drug ---------- |
• Management of Care for Patients With Parkinson’s Disease
• Encourage patients to: • Attend to their own care as long as they can • Follow drug protocols |
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• Management of Care for Patients With Parkinson’s Disease
• Caregivers should: • Monitor----------- effects • Provide --------------- and support |
• Management of Care for Patients With Parkinson’s Disease
• Caregivers should: • Monitor adverse effects • Provide encouragement and support |
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Implementation for the Patient Receiving a Dopaminergic Drug
• Assist pt with ---------- if prescribed • Evaluate and record disease progress and -------- and --------- • • |
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• Implementation for the Patient Receiving a Dopaminergic Drug • Assist pt with drug holiday if prescribed • Evaluate and record disease progress and signs and symptoms • • |
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• Implementation for the Patient Receiving a Dopaminergic Drug • Give the drug with meals to reduce --------- upset • Divide foods high in ----------- into several meals |
• Implementation for the Patient Receiving a Dopaminergic Drug
• Give the drug with meals to reduce GI upset • Divide foods high in protein into several meals |
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• Implementation for the Patient Receiving a Dopaminergic Drug
• Stand pt slowly to avoid ----------- |
• Implementation for the Patient Receiving a Dopaminergic Drug
• Stand pt slowly to avoid orthostatic hypotension |
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Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Monitor -----------, renal, and ------------- tests periodically |
Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Monitor hepatic, renal, and hematological tests periodically • Provide support services and comfort measures as needed |
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Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Provide support services and -------- measures as needed • Provide thorough ---------- teaching |
Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Provide support services and comfort measures as needed • Provide thorough patient teaching |
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Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Safety precautions for -------- or vision changes |
Implementation for the Patient Receiving a Dopaminergic Drug (cont.)
• Safety precautions for CNS or vision changes |
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Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Definition • Called --------------- drugs because they mimic the effects of the sympathetic nervous system (SNS) |
Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Definition • Called sympathomimetic drugs because they mimic the effects of the sympathetic nervous system (SNS) • |
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Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Therapeutic and adverse effects • Related to their stimulation of ------------ receptor sites – primarily emergency drugs |
Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Therapeutic and adverse effects • Related to their stimulation of adrenergic receptor sites – primarily emergency drugs |
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Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Therapeutic and adverse effects • Related to their stimulation of ------------- sites – primarily emergency drugs |
Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Therapeutic and adverse effects • Related to their stimulation of adrenergic receptor sites – primarily emergency drugs |
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Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Uses • Varies from --------- preparations for dilating pupils to ----------- preparations for shock |
Alternate Therapies
Adrenergic Agents Adrenergic Agonists • Uses • Varies from ophthalmic preparations for dilating pupils to systemic preparations for shock |
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Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • ------------- (Dobutrex): Congestive heart failure |
Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • dobutamine (Dobutrex): Congestive heart failure |
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Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • --------------- (Intropin): Increase renal perfusion; Shock • ---------------- (Levophed) - vasoconstrictor |
Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • dopamine (Intropin): Increase renal perfusion; Shock • norepinephrine (Levophed) - vasoconstrictor |
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Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • --------------- (Adrenalin, Sus-Phrine): Shock; glaucoma; prolongs effects of regional anesthetic; treatment of bronchospasm |
Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • epinephrine (Adrenalin, Sus-Phrine): Shock; glaucoma; prolongs effects of regional anesthetic; treatment of bronchospasm |
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Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • epinephrine (Adrenalin, Sus-Phrine): Shock; ----------; prolongs effects of regional anesthetic; treatment of --------------- |
Physiological Responses of Adrenergic Agonists
Alpha- and Beta-Adrenergic Agonists and Their Indications • epinephrine (Adrenalin, Sus-Phrine): Shock; glaucoma; prolongs effects of regional anesthetic; treatment of bronchospasm |
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Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • P------------ • T-------------- or ventricular fibrillation |
Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • Pheochromocytoma • Tachyarrhythmias or ventricular fibrillation |
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Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • H----------- • Halogenated ----------- general anesthetics |
Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • Hypovolemia • Halogenated hydrocarbon general anesthetics |
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Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • Caution should be used with ------------ vascular disease |
Effects of Epinephrine
Contraindications to Alpha- and Beta-Agonists • Caution should be used with peripheral vascular disease |
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Alpha- and Beta-Agonist Prototype: Dopamine
• Indications: Correction of ----------- imbalances present in shock |
Alpha- and Beta-Agonist Prototype: Dopamine
• Indications: Correction of hemodynamic imbalances present in shock |
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Alpha- and Beta-Agonist Prototype: Dopamine
• Actions: Acts directly and by the release of norepinephrine from -------------- nerve terminals; mediates dilation of vessels in the kidneys to maintain ------------ perfusion; higher doses increase CO and ----------- |
Alpha- and Beta-Agonist Prototype: Dopamine
• Actions: Acts directly and by the release of norepinephrine from sympathetic nerve terminals; mediates dilation of vessels in the kidneys to maintain renal perfusion; higher doses increase CO and BP |
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Alpha- and Beta-Agonist Prototype: Dopamine
• IV route: Onset 1–______ min; peak ______ min; |
Alpha- and Beta-Agonist Prototype: Dopamine
• IV route: Onset 1–2 min; peak 10 min; |
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Alpha- and Beta-Agonist Prototype: Dopamine
• T½: ---------- min |
Alpha- and Beta-Agonist Prototype: Dopamine
• T½: 2 min |
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Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Monitor patient response to the drug (improvement in -------- pressure, ---------- pressure, bronchial airflow) |
Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Monitor patient response to the drug (improvement in blood pressure, ocular pressure, bronchial airflow) |
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Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Monitor for adverse effects (------------ changes, decreased --------- output, headache, -------- upset, tissue necrosis with Levophed) |
Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Monitor for adverse effects (cardiovascular changes, decreased urine output, headache, GI upset, tissue necrosis with Levophed) |
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Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Evaluate the effectiveness of the ---------- plan • Monitor the effectiveness of comfort measures and compliance with -------- |
Evaluation of the Patient Receiving Alpha- and Beta-Agonists
• Evaluate the effectiveness of the teaching plan • Monitor the effectiveness of comfort measures and compliance with regimen |
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Alpha-Specific Adrenergic Agonists (Alpha-Agonists)
• Definition • Drugs that bind primarily to _________-receptors rather than to ________-receptors |
Alpha-Specific Adrenergic Agonists (Alpha-Agonists)
• Definition • Drugs that bind primarily to alpha-receptors rather than to beta-receptors |
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• Drugs in this class
• ----------- (Neo-Synephrine, Allerest, AK-Dilate, and others) • ------------ (Sudafed) |
• Drugs in this class
• phenylephrine (Neo-Synephrine, Allerest, AK-Dilate, and others) • pseudoephedrine (Sudafed) |
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• Drugs in this class
• ------------ (Catapres) |
• Drugs in this class
• clonidine (Catapres) |
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Alpha-Specific Adrenergic Agents and Their Indications
• ---------- (Catapres): Essential hypertension, chronic pain; ease opiate withdrawal |
Alpha-Specific Adrenergic Agents and Their Indications
• clonidine (Catapres): Essential hypertension, chronic pain; ease opiate withdrawal |
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Alpha-Specific Adrenergic Agents and Their Indications
• clonidine (Catapres): Essential ------------, chronic pain; ease ------------ withdrawal |
Alpha-Specific Adrenergic Agents and Their Indications
• clonidine (Catapres): Essential hypertension, chronic pain; ease opiate withdrawal |
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Alpha-Specific Adrenergic Agents and Their Indications
• phenylephrine (Neo-Synephrine): Cold and ---------; shock states, ------------- tachycardia; glaucoma; allergic ----------; otitis media |
Alpha-Specific Adrenergic Agents and Their Indications
• phenylephrine (Neo-Synephrine): Cold and allergies; shock states, supraventricular tachycardia; glaucoma; allergic rhinitis; otitis media |
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Alpha-Specific Adrenergic Agents and Their Indications
• ------------ (Sudafed) – related to ephedrine |
Alpha-Specific Adrenergic Agents and Their Indications
• pseudoephedrine (Sudafed) – related to ephedrine |
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Beta-Specific Adrenergic Agonists and Their Indications
• -----------(Isuprel) • Absorption best by ----------- or aerosol |
Beta-Specific Adrenergic Agonists and Their Indications
• isoproterenol (Isuprel) • Absorption best by injection or aerosol |
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Beta-Specific Adrenergic Agonists and Their Indications
• Stimulates both _______ 1 and ______ 2 receptors |
Beta-Specific Adrenergic Agonists and Their Indications
• Stimulates both beta 1 and beta 2 receptors • Treatment of shock, cardiac standstill, and heart block in transplanted hearts; prevention of bronchospasm during anesthesia; inhaled to treat bronchospasm |
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Beta-Specific Adrenergic Agonists and Their Indications
• Treatment of---------, ---------- standstill, and ---------- block in transplanted hearts; prevention of bronchospasm during anesthesia; inhaled to treat bronchospasm |
Beta-Specific Adrenergic Agonists and Their Indications
• Treatment of shock, cardiac standstill, and heart block in transplanted hearts; prevention of bronchospasm during anesthesia; inhaled to treat bronchospasm |
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Beta-Specific Adrenergic Agonists and Their Indications
• Treatment of shock, cardiac standstill, and heart block in transplanted hearts; prevention of ------------- during anesthesia; inhaled to treat --------------- |
Beta-Specific Adrenergic Agonists and Their Indications
• Treatment of shock, cardiac standstill, and heart block in transplanted hearts; prevention of bronchospasm during anesthesia; inhaled to treat bronchospasm |
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Therapeutic Effects of Isoproterenol
• Increased -------- rate • C--------- |
Therapeutic Effects of Isoproterenol
• Increased heart rate • Conductivity |
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Therapeutic Effects of Isoproterenol
• C--------- • B------------ |
Therapeutic Effects of Isoproterenol
• Contractility • Bronchodilation |
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Therapeutic Effects of Isoproterenol
• Increased blood flow to ------------ muscles and ------------ beds |
Therapeutic Effects of Isoproterenol
• Increased blood flow to skeletal muscles and splanchnic beds • Relaxation of the uterus |
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Therapeutic Effects of Isoproterenol
• Relaxation of the --------- |
Therapeutic Effects of Isoproterenol
• Relaxation of the uterus |
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Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Monitor patient response to the drug (improvement in condition, stabilization of blood pressure, prevention of ---------, ---------- stimulation) |
Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Monitor patient response to the drug (improvement in condition, stabilization of blood pressure, prevention of preterm labor, cardiac stimulation) |
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Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Monitor for adverse effects (--------- upset, --------- changes, --------- problems) |
Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Monitor for adverse effects (GI upset, CNS changes, respiratory problems) |
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Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Evaluate the effectiveness of the -------- plan • Monitor the effectiveness of --------- measures and compliance with the regimen |
Evaluation of the Patient Receiving Beta-Specific Adrenergic Agonists
• Evaluate the effectiveness of the teaching plan • Monitor the effectiveness of comfort measures and compliance with the regimen |
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Adrenergic Blocking Agents
Adrenergic Blocking Agents • Definition • Called ------------ drugs because they lyse, or block, the effects of the ------- |
Adrenergic Blocking Agents
Adrenergic Blocking Agents • Definition • Called sympatholytic drugs because they lyse, or block, the effects of the SNS |
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Adrenergic Blocking Agents
Adrenergic Blocking Agents • Therapeutic effects • Suppress ------------ responses to activity, stress or other stimuli |
Adrenergic Blocking Agents
Adrenergic Blocking Agents • Therapeutic effects • Suppress pathological responses to activity, stress or other stimuli |
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Adrenergic Blocking Agents
• Action • Prevent ----------- thus decrease sympathetic activity (i.e. decrease BP) |
Adrenergic Blocking Agents
• Action • Prevent norepinephrine thus decrease sympathetic activity (i.e. decrease BP) |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • ------------- (Coreg): Hypertension, congestive heart failure (adult) |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • carvedilol (Coreg): Hypertension, congestive heart failure (adult) |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • ------------ (Hylorel): Hypertension in adults not responding to thiazide diuretics |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • guanadrel (Hylorel): Hypertension in adults not responding to thiazide diuretics |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • ------------ (Ismelin): Hypertension and renal hypertension |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • guanethidine (Ismelin): Hypertension and renal hypertension |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • ------------ (Normodyne, Trandate): Hypertension, pheochromocytoma, clonidine withdrawal |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications • labetalol (Normodyne, Trandate): Hypertension, pheochromocytoma, clonidine withdrawal |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Monitor patient response to the drug (improvement in ----------- and CHF) |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Monitor patient response to the drug (improvement in blood pressure and CHF) |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Monitor for adverse effects (-------- changes, headache, -------- upset, -------------, liver failure) |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Monitor for adverse effects (CV changes, headache, GI upset, bronchospasm, liver failure) |
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Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Evaluate the effectiveness of the ---------- plan • Monitor the effectiveness of ------------ measures and compliance to the regimen |
Adrenergic Blockers
Alpha- and Beta-Adrenergic Blocking Agents and Their Indications Evaluation of the Patient Receiving Alpha- and Beta-Adrenergic Blocking Agents • Evaluate the effectiveness of the teaching plan • Monitor the effectiveness of comfort measures and compliance to the regimen |
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Alpha-Adrenergic Blocking Agent and Indications
• ------------ (Regitine) • P--------- • • |
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• Alpha-Adrenergic Blocking Agent and Indications • phentolamine (Regitine) • Prototype • • |
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• Alpha-Adrenergic Blocking Agent and Indications • Management of severe ------------- caused by pheochromocytoma • Prevention of cell death with IV infiltration of -------------- or Levophed |
• Alpha-Adrenergic Blocking Agent and Indications
• Management of severe hypertension caused by pheochromocytoma • Prevention of cell death with IV infiltration of norepinephrine or Levophed |
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• Alpha-Adrenergic Blocking Agent and Indications
• Blocks _______ 1 and ________ 2 receptors |
• Alpha-Adrenergic Blocking Agent and Indications
• Blocks alpha 1 and alpha 2 receptors |
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Alpha1-Selective Adrenergic Blocking Agents
• ------------ (Cardura): Used to treat hypertension; also effective in the treatment of benign prostatic hypertrophy |
Alpha1-Selective Adrenergic Blocking Agents
• doxazosin (Cardura): Used to treat hypertension; also effective in the treatment of benign prostatic hypertrophy |
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Alpha1-Selective Adrenergic Blocking Agents
• ------------ (Minipress): Used to treat hypertension, alone or in combination with other drugs |
Alpha1-Selective Adrenergic Blocking Agents
• prazosin (Minipress): Used to treat hypertension, alone or in combination with other drugs |
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Alpha1-Selective Adrenergic Blocking Agents
• ------------- (Hytrin): Used to treat hypertension as well as BPH |
Alpha1-Selective Adrenergic Blocking Agents
• terazosin (Hytrin): Used to treat hypertension as well as BPH |
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Alpha1-Selective Adrenergic Blocking Agents
• ------------ (Flomax) and -------------- (Uroxatral): Used only in the treatment of BPH |
Alpha1-Selective Adrenergic Blocking Agents
• tamsulosin (Flomax) and alfuzosin (Uroxatral): Used only in the treatment of BPH |
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Beta-Adrenergic Blocking Agents
• Treating --------- problems • H----------- |
Beta-Adrenergic Blocking Agents
• Treating cardiovascular problems • Hypertension |
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Beta-Adrenergic Blocking Agents
• A---------- • ----------- headaches |
Beta-Adrenergic Blocking Agents
• Angina • Migraine headaches |
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Beta-Adrenergic Blocking Agents
• Preventing ----------- after MI • Block --------- 1 and -------- 2 receptors |
Beta-Adrenergic Blocking Agents
• Preventing reinfarction after MI • Block beta 1 and beta 2 receptors |
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Beta-Blocker Prototype: propranolol (Inderal)
• Indications: Treatment of ---------, angina ----------, -------------- tachycardia, tremor; prevention of reinfarction after MI; adjunctive therapy in pheochromocytoma; prophylaxis of migraine headache; management of situational anxiety |
Beta-Blocker Prototype: propranolol (Inderal)
• Indications: Treatment of hypertension, angina pectoris, supraventricular tachycardia, tremor; prevention of reinfarction after MI; adjunctive therapy in pheochromocytoma; prophylaxis of migraine headache; management of situational anxiety |
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Beta-Blocker Prototype: propranolol (Inderal)
• Indications: Treatment of hypertension, angina pectoris, supraventricular tachycardia, tremor; prevention of reinfarction after --------; adjunctive therapy in -------------; prophylaxis of ------------ headache; management of situational anxiety |
Beta-Blocker Prototype: propranolol (Inderal)
• Indications: Treatment of hypertension, angina pectoris, supraventricular tachycardia, tremor; prevention of reinfarction after MI; adjunctive therapy in pheochromocytoma; prophylaxis of migraine headache; management of situational anxiety |
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Beta-Blocker Prototype: propranolol (Inderal)
• Actions: Decreases ------------ demand, ------------- contractility, HR and BP |
Beta-Blocker Prototype: propranolol (Inderal)
• Actions: Decreases oxygen demand, myocardial contractility, HR and BP |
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Beta1-Selective Adrenergic Blocking Agents
• Advantage • Do not usually block ___________-receptor sites, including the __________ bronchodilation |
Beta1-Selective Adrenergic Blocking Agents
• Advantage • Do not usually block beta2-receptor sites, including the sympathetic bronchodilation |
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Beta1-Selective Adrenergic Blocking Agents
• Advantage • Preferred for patients who ------------ or have asthma, obstructive ------------- disease, or seasonal or allergic rhinitis |
Beta1-Selective Adrenergic Blocking Agents
• Advantage • Preferred for patients who smoke or have asthma, obstructive pulmonary disease, or seasonal or allergic rhinitis • |
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Beta1-Selective Adrenergic Blocking Agents
• Uses • Hypertension, -----------, some ----------- arrhythmias |
Beta1-Selective Adrenergic Blocking Agents
• Uses • Hypertension, angina, some cardiac arrhythmias |
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Beta1-Selective Adrenergic Blocking Agents and Their Indications
• -------------- (Sectral): Hypertension and premature ventricular contractions • ------------- (Tenormin): MI, chronic angina, and hypertension |
Beta1-Selective Adrenergic Blocking Agents and Their Indications
• acebutolol (Sectral): Hypertension and premature ventricular contractions • atenolol (Tenormin): MI, chronic angina, and hypertension |
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Beta1-Selective Adrenergic Blocking Agents and Their Indication
• ------------------ (Lopressor): hypertension, angina, CHF • --------------- (Brevibloc) - tachycardia |
Beta1-Selective Adrenergic Blocking Agents and Their Indication
• metoprolol (Lopressor): hypertension, angina, CHF • esmolol (Brevibloc) - tachycardia • |
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Beta1-Selective Adrenergic Blocking Agents and Their Indication
• ------------- (Zebeta) Hypertension |
Beta1-Selective Adrenergic Blocking Agents and Their Indication
• bisoprolol (Zebeta) Hypertension |
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Adverse Effects of Beta-Adrenergic Blocking Agents
• --------- upset – N, V & D • --------- changes |
Adverse Effects of Beta-Adrenergic Blocking Agents
• GI upset – N, V & D • CNS changes |
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Adverse Effects of Beta-Adrenergic Blocking Agents
• Respiratory problems – SOB, ------------- • CV effects – bradycardia, ------------ hypotension |
Adverse Effects of Beta-Adrenergic Blocking Agents
• Respiratory problems – SOB, bronchospasm • CV effects – bradycardia, orthostatic hypotension |
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Adverse Effects of Beta-Adrenergic Blocking Agents
• Loss of --------- • I---------- |
Adverse Effects of Beta-Adrenergic Blocking Agents
• Loss of libido • Impotence |
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Adverse Effects of Beta-Adrenergic Blocking Agents
• H--------- |
Adverse Effects of Beta-Adrenergic Blocking Agents
• Hypoglycemia |
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Nursing Implications for the Patient Receiving Beta-Blockers
• R-------- • Environmental --------- |
Nursing Implications for the Patient Receiving Beta-Blockers
• Rest • Environmental control |
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Nursing Implications for the Patient Receiving Beta-Blockers
• Safety measures if---------- effects occur • Monitor blood ----------- |
Nursing Implications for the Patient Receiving Beta-Blockers
• Safety measures if CNS effects occur • Monitor blood glucose |
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Nursing Implications for the Patient Receiving Beta-Blockers
• Monitor ---------, HR • Withdraw drug --------- |
Nursing Implications for the Patient Receiving Beta-Blockers
• Monitor BP, HR • Withdraw drug slowly • |
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Nursing Implications for the Patient Receiving Beta-Blockers
• Avoid if pt has -----------, bronchospasm (non-selective drugs) |
Nursing Implications for the Patient Receiving Beta-Blockers
• Avoid if pt has COPD, bronchospasm (non-selective drugs) |
