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192 Cards in this Set

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