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192 Cards in this Set
- Front
- Back
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What is the autonomic nervous system apart of:
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peripheral nervous system
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Autonomic nervous system is considered:
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motor system
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Is autonomic nervous system voluntary or involuntary:
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involuntary
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Autonomic nervous system regulates:
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heart
respiratory GI Glands |
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ANS tasks:
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perserve internal homeostasis
emergency mechanism repair |
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ANS is divided into
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PNS and SNS
both will dominate at some point |
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SNS is primarily for
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"fight or flight" adrenergic
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What rx occur with SNS
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excitory
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SNS usually acts as a
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unit
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Is SNS essential for life?
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no
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Two neurotransmitters assoc. with SNS
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epinephrine and norepinephrine
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SNS will stimulate:
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Alpha or Beta cells through epienephrine or norepinephrine
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Alpha cells are excitory or inhibitory:
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excitory
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Beta cells are excitory or inhibitory:
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inhibitory, except heart
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What rx occur with PNS
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inhibitory
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PNS works on
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rest and digestion
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PNS restores:
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body to normal states
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Is PNS essential for life:
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yes
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If SNS and PNS are competing for life who will win:
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PNS
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PNS is specific to:
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particular organs...stomach eye etc.
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PNS is going to stimulate what cells:
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nicotinic cells (stimulatory)
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What is muscarinic:
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similar to poisonous types of effects (vomitting, diarrhea)
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What is the major neurotransmitter for PNS
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ACH
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Adrenergic drugs primarily correct:
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life threatening situations
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Situations that are corrected by adrenergic drugs
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increase cardiac output
constrict arteries & veins regulate body temp dilate bronchioles |
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3 types of adrenergic drugs
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direct acting
indirect acting dual acting |
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Example of direct acting adrenergic drug
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epinephrine
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example of indirect acting adrenergic drug
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amphetamine
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example of dual acting adrenergic drug
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ephedrine
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Epinephrine is used to treat:
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bronchospasms
glaucoma antiphylactic shock |
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Epinephrine can be used as a
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local anesthetic
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Epinephrine works by:
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stimulating alpha and beta receptors causing bronchodialation, CNS & cardiac stimulation, diuresis, gastric acid secretion
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When used as a local anesthetic epinephrine works by:
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blood vessels of the skin to cause vasoconstriction
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SE of epinephrine:
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nervousness
restlessness insomnia increase BP tachycardia urinary retention hyperglycemia |
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Adverse rx of epinephrine:
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cardiac arrhythmias
pulmonary edema CNS disturbances |
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Which way should epinephrine NOT be give
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orally
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Action of epinephrine:
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rapidly, make sure look up precautions
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Potency of epinephrine:
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very potent
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Can one develop a tolerence of epinephrine:
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yes
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What must be present if giving epinephrine by IV
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EKG monitoring
VS checked q 5min |
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What kind of drug is Isuprel:
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adrenergic drugs
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What does Isuprel do:
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dialates bronchioles
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How does Isuprel work:
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acts on 2 different adrenergic receptors
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What kind of drug is catapres:
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adrenergic drug
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Catapres is used to treat:
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hypertension
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What drug is commonly abused by athletes:
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ephedrine
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What kind of drug is ephedrine:
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adrenergic
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How does ephedrine:
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stimulates release of norepinephrine, acts directly on alpha & beta receptors
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What is ephedrine used for:
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dilate bronchioles
maintenance for chronic asthmatics increase motor functions (MG) |
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Ephedrine is taken on the streets to:
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stimulate CNS, more alert
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SE of ephedrine:
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increase BP
mood swings, hallucinations paranoia |
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Deaths from ephedrine were cause be:
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CV
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Where are parasympathetic fibers found:
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heart
spleen uterus vas deferens colon vessels of the skin muscles in GI tract |
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Direct acting parasympathetic:
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similar to ACH
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Indirect action parasympathetic:
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accumulate ACH at receptor sites
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How to cholinergic drugs work
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stimulate intestines and bladder post operatively to promote urination & peristalsis & decrease intraocular pressure
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Cholinergic promotes
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salivation
sweating |
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Cholinergic aid in
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general anesthetic
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Cholinergic treats
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MG symptoms
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Bethanechol Cl is used primarily in
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post op and post partum urinary retention
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Bethanechol Cl is sometimes used for:
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neurogenic bladder where nerves to the urinary bladder are not stimulated at all
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How does bethanechol cl work:
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similar to ACH, works on muscarinic receptor sites
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Muscarinic effects
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diarrhea and increased urination
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SE of bethanechol cl
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blurred vision
abdominal discomfort |
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How should bethanechol cl be given
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on an empty stomach to decrease GI irritation
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If giving bethanechol cl subQ
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monitor VS 1hr after
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Automatically monitor _ when giving bethanechol cl
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I/O
check for bladder distention BS |
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What are anticholinergics
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cholinergic blocking agents
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Anticholinergics work by
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prevent ACH from binding at the receptor sites & inhibiting cholinergic effects (parasympathetic)
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An example of anticholinergic is
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atropine sulfate
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Things that occur with anticholinergic
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increase HR
dilates pupils |
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Action of anticholinergics is
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dose related
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Why are anticholinergics given pre-op
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decrease salivations
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Small doses of anticholinergics
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decrease salivation bronchial secretions
sweating |
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Intermediate doses of anticholinergics
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dilate pupils
increase HR |
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High doses of anticholinergic
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decrease GI & GU motility
antispasmodic (IBS) |
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SE of anticholinergics
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dry mouth
dry eyes constipation urinary retention confusion |
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Why can glaucoma pts not have anticholinergic
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eye pain from increase intraocular pressure
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Why must pts be warned about exercising when taking anticholinergics
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hydration status
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What characteristics must be watched in atropine overdose from surgery
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hot,mad,red,dry
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Adverse effects of anticholinergics
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paralytic illeus
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When a pt is taking anticholinergics what does a nurse need to do concerning mouth
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rinse mouth
ice chips oral hygiene |
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What needs to be added to the diet of anticholinergic
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fiber, fluids, exercise
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Before administering anticholinergic:
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have patient void to prevent retention
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What kind of drug is nicotine
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ganglionic stimulation drug
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Does nicotine have a therapeutic value
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no
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What foods contain nicotine
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tomatoes
potatoes cauliflower eggplant |
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How is nicotine absorbed
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GI tract
skin resp mucous membranes |
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Small doses of nicotine act as
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stimulants
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large doses of nicotine act as
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depressants
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What does nicotine stimulate
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CNS (resp & basomotor)
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Large doses of nicotine cause
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tremors
convulsions death |
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How many mg of nicotine does it take to kill:
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40mg...1 cig contains 1mg
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What is the number one cause of death in females
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lung cancer
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Nicotine is associated with
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chronic health problems
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What kind of disorder is nicotine dependence
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psychiatric disorder
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Gum that contains nicotine is absorbed through
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buccal mucosa (slower rate)
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How long would one wear a nicotrol patch
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16 hours/day
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Action of nasal spray of nicotine
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faster onset
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How long can one use a nicotine spray
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3 months no longer than 6 months
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SE of nicotine spray:
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belching
increased HR mild HA increased appetite increased mouth watering sore throat/mouth difficulty sleeping irritability |
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SE of nicotine patches
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itching
skin irritability difficulty sleeping night mares |
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SE of nicotine gum
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injury to your mouth, teeth, dental work
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Signs of overdose of nicotine
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severe watering of mouth
severe abdominal pain cold sweats hearing/vision probs |
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Overdose of nicotine leads to:
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faiting
decrease BP difficulty breathing convulsions irregular pulse |
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If taking the nicotine gum no more than pcs/day
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30, continue to decrease over 3 month period
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Where to apply a nicotine patch
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front/back torso
outer upper arm NOT near heart rotate sites |
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Parkinson patients have
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decreased dopamine
too much ACH |
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Parkinson patients need a balance of
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dopamine and ACH, for posture, muscle tone, voluntary movement
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What can occur secondary to Parkinson's disease
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dementia
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5 types of drugs used to treat parkinson
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anticholinergics
dopaminergics dopamine agonists MAO-B inhibitor COMT inhibitor |
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What kind of drug is cogentin
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anticholinergic, used for parkinson
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congentin works on
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decreasing muscle rigidity and muscle tremors
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Congentin works by
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make bounds of dopamine and ACH more in balance
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Onset of congentin
oral/IV-IM |
very quick
oral 1-2 hours IM/IV:minutes |
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SE of congentin
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anticholinergic symptoms
pupil dilation confusion sedation/drowsiness |
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If giving congentin to a children under 3
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it can become toxic
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Watch adults for ___ if taking congentin
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glaucoma
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If giving congentin assess
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parkinson symptoms-how well working
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What can dopaminergics be used for
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Parkinson
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How does dopaminergics work
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convert to dopamine
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Levodopa is what kind of drug
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dopaminergic-used to treat Parkinson
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Levodopa is a precursor for
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dopamine
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How much of levodopa crosses the brain
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a small amount
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What size dose of levodopa is needed to be effective
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large doses
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Levodopa goes out to what part of the body
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all peripheral tissues
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How long does it take levodopa to become effective
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3wks to 6 months
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SE of levodopa
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anxiety,nervousness
confusion nightmares depression increased aggresiveness cardiac symptoms |
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If a person is on long term levodopa check for
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liver and kidney function
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Levodopa can not be taken with
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meals, decrease effectiveness
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When does one need to eat when taking levodopa
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1/2hr after
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What cant be taken with levodopa
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multi-vitamin...B6 interferes
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What intake needs to be monitored when taking levodopa
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protein
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What are the symptoms like with levodopa
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on/off, can go from mins to hours
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Why was sinemet developed
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to decrease the SE of peripheral tissues caused by levodopa
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Benefits of sinemet
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not as many SE
not as high dose |
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If on sinemet what time period needed to change to another
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8hr period
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What do dopamine agonists do
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stimulate dopamine receptors
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What is an example of dopamine agonists
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symmetrel
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What is symmetrel used for
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parkinson and antiviral
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What is a rare SE of symmetrel
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gambling
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Symmetrel enhances
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feeling of well being
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Which is more effective symmetrel or levodopa
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levodopa but symmetrel is more effective
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Symmetrel helps with what part of parkinson
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rididity and slow movements
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SE of symmetrel:
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anorexia
purple/red blotches on skin insomnia agitation/confusion |
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If symmetrel is taking at high dose what is a SE
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psychotic symptoms
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Why is it important to taper off symmetrel
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avoid parkinson crisis
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How long does it take for symmetrel to be effective
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2weeks
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Symmetrel loses its effectiveness after
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4-12wks
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MAOB inhibitor works by
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prolonging the action of levodopa
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Who would MAOB be given to
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new diagnosed parkinson pts
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The benefits of MAOB
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can delay of l-dopa for up to a year
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What foods need to be avoided when taking MAOB
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foods containing tyramine
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When is COMT inhibitors used
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in combination with levodopa these increase amt of levodopa concentration in the brain
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What patients would use COMT inhibitors
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parkinson patients
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Why do patients with alzheimer's need drugs
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they have less ACH which is needed for memory
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What do acetylcholinesterase inhibitors do
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make ACH more available in the brain
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Do alheizmer's drugs cure?
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no, just buy time
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What kind of drug is Tacrine
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alzheimer drug, acetylcholinestrease inhibitor
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What kind of drug is aricept:
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alheizmer drug, acetlychilinestrease inhibitor
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Aricept is used for
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mild-moderate cognitive impairment
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How does aricept work
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inhibits ACHE making more ACH available
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SE of aricept
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muscle cramping
insomnia nightmares |
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What can develop with aricept
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seizures
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What happens with MG
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loss receptors for ACH through resp
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What could happen with MG
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resp failure or aspiration pneumonia
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3 types of drugs used with MG
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anticholinesterase inhibitors
short, intermediate,long |
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What kind of drug is tensilon
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short acting anticholinesterase inhibitors
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Tensilon is primarily used for
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diagnostic purposes & determine if in MG crisis
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How does one know if in MG crisis
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symptoms get better, if symptoms get worse cholinergic crisis
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What kind of drug is mestinon
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cholinesterase inhibitor intermediate
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Mestinon prevents
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destruction of ACH
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SE of mestinon
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takes a while to get through all
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Adverse effects of mestinon
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hypertension
resp. depression |
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Mestinon should not be added to
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IV fluids
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Mestinon stays in the system
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3-6 hours
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Muscle/skeletal relaxants are usually sent to
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Peripheral tissue or other self-limitin treatments
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When are muscle/skeletal relaxants used
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if pt doesnt respond to 1st line of intervention
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Muscle/skeletal relaxants are mainly used for
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muscle spasms
muscle trauma MS CP cerebral or spinal spastic conditions |
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Central acting muscle/skeletal relaxants work on
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CNS in the brain stem relax striated muscles
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SE of muscle/skeletal relaxants
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extremely sleepy, lethargic
blurred vision light-headedness weakness |
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SE of large doses of muscle/skeletal relaxants
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heartburn
abdominal distress |
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Should not be on muscle/skeletal relaxants for more than
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3wks
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2 examples of muscle/skeletal relaxants
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Flexeril
Lioresal |
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Direct acting muscle/skeletal relaxant
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dantrium
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When is dantrium used
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very severe cases with muscle rigidity (spinal cord injury)
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Lower doses of dantrium
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may be given for maintenance but usually only in emergency
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SE of dantrium
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muscle weakness
drowsiness GI problems-severe diarrhea |
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If give dantrium monitor
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cardiac and urinary output
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Dantrium can cause
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photosensitivity
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Need to taper off dantrium because
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can cause rebound spasms
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Can only stay on dantrium for
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3wsk due to tolerence
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