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83 Cards in this Set

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adrenergic
sympathetic. increase pupil, increase hr and contractility, bronshodilation, decrease stomach motility and gastric secretion, decrease pancreatic secretions, increase adrenalin, decrease intestinal motility, bladder walls relax
ans
regulatory or self governing system for maintaining the internal environment of the body at an optimal level (homeostasis). smooth muscle, cardiac muscle, glandular secretions- digestion, pressure of blood, bladder, respirations, etc
catecholamine
group of chemically related compounds- norepinephrine, epinephrine, dopamine
cholinergic
parasympathetic system- pupils decrease, lacrimal glands secrete, thin, watery saliva, decreased heart rate and contractility, broncoconstriction, increase stomach motility and gastrc secretion, increase pancreatic enzymes, increase intestinal motility, bladder contraction
feedback control mechanism
reflex action functions, operating from a receptor to an effector. to prevent extreme changes in function that could create a disturbance in internal environment.
muscarinic receptors
postganglionic sites- located in smooth muscle, cardiac muscle, and glands of parasympathetic fibers and the effector organs
neuroeffector junction aka synaptic junction
nerve impulse passes across
neurohumoral transmission
use of a chemical. sequence of events includes biosynthesis, storage, release, action, inactivation of the mediator
nicotinic receptor
appear in ganglia of parasymp and symp fibers, the adrenal medulla, and skeletal
reflex arch
automatic motor response to sensory stimuli. a nerve fiber conducts a nerve impulse which form the basis of communication through the nervous system
somatic nervouse system
innervates the voluntary or skelteal muscles
neurotransmitter
neurohormone that permits the action potential across the synaptic junction from one neuron to another or neuroeffector junction from neuron to effector
cholinergic (parasympathomimetic)
WET
act like mediators of parasympathetic nervous system. Stimulant effects- (nicotinic effects) resembles effects of nicotine- tachycardia, elevated BP, peripheral vasocontriction
(muscarinic effects)- intense vomit, diarrhea, nervousness, stomach pain, labored respirations, slow and irregular pulse, delirium- mimic effect of serious parasym stim.
cholinergic blocking
DRY
parasympatholytic, anticholinergic, antimuscarinic.
andrenergic (sympathomimetic)
DRY
act like mediators of sympathetic nervous system.
adrenergic blocking
WET
sympatholytic
nicotine
used to help reduce w/d symptoms in smoker.
tachycardia, n/v/d, excess saliva, belching, pruritis or erythema, sore throat, cough, dizzy, rash, nightmares
bethanechol
stimulate parasymp. postop/postpartum urinary retention, distention ab, gastric statis or reflux esophag- tachycardia, flush, d/n/v, saliva, tears, bronchospasm, diaphoresis
chemical warfare antagonist
atropine, pralidoxime cholride, diazepam (seizure prophy)
indirect v direct acting
indirect inhibit action of cholinesterase direct act like actylchol.
neuromuscular blockers
used in surgery or during processes in which voluntary muscle blockade is desirable. DO NOT CAUSE ANY SEDATION. imperative that pts recieve respiratory support, give sedatives and anxiolytics to prevent anxiety and impair memory
succinylcholine
depolarizing nm blocker.
has quick onset and short duration
respi paralysis so need support
bradycardia, excess saliva, increased ocular pressure
atropine
antagonist at muscarinic rec. small doses depress salivary, bronchial secretions and sweating, large doses cause dilation of pupils, increase hr. nursing role r/t toxicity and has cns absorption.
dry mouth- gum, ice, candy
dental hygiene
avoid high temp, exercising in hot weather, hot baths, etc bc heat stroke
dark glasses to protect eyes
scopolamine
drowsiness, euphoria, memory loss, relaxation, sleep and relieve fear- like atropine
tx of IBS, renal/ut cholic, dysrhy during surgery bc of vagal stim, motion sickness, laryngospasm, sedative/amnesia. DRY
dimenhydrinate (dramamine)
antiemtic or antivertigo. take before,
oxybutin (ditropan), tolterodine (detrol)
for bladder leakage
sympathomimetic
increase cardiac output, vasocontriction, bronchial dilation
alpha receptors
vasoconstrict
dilate pupils
relax gut
beta receptors
cardiac acceleration and increased contractility
bronchial relaxation
uterine relaxation
direct acting
work at receptors as agonists
epinephrine
increases HR, SV, Cardiac output. effective in tx of anaphylaxis bronchodil, vasoconstrict.
norepinephrine
does not change cardiac output, may decrease HR
inotropic effect
increase in contraction- result of calcium into cardiac fibers
dromotropic effect
increase in av conduction
caloringenic effect
capable of generating heat, which increases oxygen consumption
epipen
ok if shock is not present for anaphylaxis.
for circulatory shock
use dopamine, epi, norepi, dobutamine, isoproterenol
dopamine hydrocholride
b1 rec and in high doses alpha. use to tx acute HF and at high doses circ. shock
ad eff- headaches, nvd, decreased BP, ht, tachycardia,
dobutamine hydrochloride
HF. increase force of myocardial contraction
ad ef- headache, nvd, increased hr and bp, palpitations, respiratory distress
norepi bitartate
levophed
sign. hypotensive states- sepsis, sympathectomy, myocardial, blood transfusion
isoproternol hydrochloride
isoproternol sulfate
relieves bronchospasm assoc w asthma, emphysema, bronchitis. may discolor saliva red or pink
phenylephrine systemic
r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
ephedrine
stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
metaraminol
aramine
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
peripheral adrenergic inhibitors
block adrenergic receptors
vasoconstrict
used for migraines
ergots
fungus. good for migraines
wet symptoms
b blockers
drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen
beta blockers
used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
ad ef of b blockers
drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
propranolol
prototype b blocker. nonselective
imp to check apical pulse and hold if irregular
phenylephrine systemic
r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
phenylephrine systemic
r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
ephedrine
stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
metaraminol
aramine
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
ephedrine
stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
peripheral adrenergic inhibitors
block adrenergic receptors
vasoconstrict
used for migraines
ergots
fungus. good for migraines
wet symptoms
metaraminol
aramine
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
peripheral adrenergic inhibitors
block adrenergic receptors
vasoconstrict
used for migraines
b blockers
drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen
ergots
fungus. good for migraines
wet symptoms
beta blockers
used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
b blockers
drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen
ad ef of b blockers
drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
beta blockers
used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
propranolol
prototype b blocker. nonselective
imp to check apical pulse and hold if irregular
ad ef of b blockers
drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
propranolol
prototype b blocker. nonselective
imp to check apical pulse and hold if irregular
important features of parkinsons
prog debilitating do of the cns. characterized by resting tremor, bradykinesia, forward flexion of the trunk, muscle rigidity, weakness. prob in EPS of brain. degeneration of dopamine prod neurons
classes of drugs to treat parkinsons
1 drugs w central anticholinergic activity
2 drugs that affect brain dopamine levels or mimic dopamine to enhance dopaminergic action
anticholinergics in parkinsons
block effects of acetylcholine. effects are decreased salivation and relaxation of smooth muscles w decrease in tremors
akinesia
difficulty to initiate muscle movt
akathisia
restlessness and agitation
benzotropine
antidyskinetic. tx of tremor in parkinsons and drug induced eps assoc w typical antipsychotics. ad ef are blurry vision, constipation, dry skin, urinary hesitancy, pain w urination, n/v/photophobia, drowsiness, dysphagia
dont give anticholinergics w
antacids, alcohol,
xerostomia
reduction in volume of saliva
carbidopa-levodopa (sinemet)
offer symptom control
less likely than levopdopa alone to cause constipation, changes in hr, n/v
levodopa
parkinsons
ad effects- anxiety, nervousness, confusion, constipation, nightmares, dif urination, orthostatic hypo, mood changes, choreform/involuntary movt of body- face, tongue, arms, hands, head, upper body, severe nv
amntadine
dopamine releasing-antiviral that augments dopamine release- for antidyskinetic against influenzae type A.
ad ef- impaired concentration, dizzy, irritability, anorexia, n/v, nervous, redish blue mottling, hallucinations, mood. od if severe confusion, insomnia, nightmares, seizures
dopaminergic agonists
tx of parkinsons include ergot alkaloids, bromocriptine, pergolide, pramipexole, ropinirole
on off syndrome
complication following long term levadopa therapy. ct fluctuates from being symptom free to demonstrating full blown parkinsons symptoms. result of dopamine delivery. tx may be more freq admin, or addition of bromocriptine,
end of dose symptoms
agitation and chorieform movts seen shortly after dosing r/t dopamine hyperactivity. use cr or er instead
myasthenia gravis
loss or decrease in acetylcholine receptors. assoc w thymus gland