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51 Cards in this Set
- Front
- Back
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What is the site/response from the Alpha 1 Receptor
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activation of the receptors in arterioles of skin, viscera and mucous membranes and veins leading to vasoconstriction. "Think blood vessels"
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What is the site / repsonse for Beta 1
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heart stimulation leads to increased: heart rate, contractility, rate of conduction. Activation of receptors in kidney lead to release of renin. "Think we only have 1 heart"
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What is the site / response for Beta 2
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activation of aerterioles of heart, lungs and skeletal muscles leads to vasodilation. Bronchial stimulation leads to bronchodilation "think we have 2 lungs"
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What is the site/response from Dopamine
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activation of receptors in kidney cause renal blood vessels to dilate
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what are the 3 main neurotransmitters in ANS
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Acetylcholine is the main one for the parasympathetic nervous system
norepinephrine epinephrine main one for the sympathetic nervous system |
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what are the two types of receptors
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cholinergic / Adrenergic
Cholinergic has 3 types 1. Nicotinic N 2. Nictotinic M = muscles 3. Miscarinic = glands/mucous Adrenergic are the catcholamines 3 types 1. epinephrine 2. norepinephrine 3. dopamine |
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Two subdivisions of the ANS
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1. Parasympathetic Nervous system = rest and digest
2. Sympathetic Nervous system = fight or flight |
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Cholinergic Agonits Stimulate other names are
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cholinergic, cholinomimetic, cholinergic stimulant, parasympathetic agonist and parasympathomimetic copies
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Cholinergic Antagonits are drugs that block parasympathetic repectors other names are
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cholinergic blocker, anticholinergic, parasympathetic antagonist, parasympatholytic
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2 Mechanisms of actions of Chlinergic Agonist Agents
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1. Direct acting = acts direrctly at the chlinergic receptor site
2. indirect acting = acts by making more of the neruotransmitter "acetylcholine" by inhibiting the enzymes - cholinersterase / acetylcholinesterase |
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Direct acting cholinergic Agonist agents
3 examples |
1. Urecholine a muscarnic agonist works on muscle of bladeder contracts detrusor muscle relaxes sphincter = voiding
2. Akarpine = muscarinic agonist 3. nicotrol = nicontinic N & M agonist |
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indirect acting cholinergic agonist agents they bind to acetylcholinesterase either reversible bond or irreversible bond 2 examples
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!. neostigmine - reversible binding for a period of mintues to hours
2. phospholine iodine = irreversible = forms a permanent bond |
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what is the difference between acetycholinesterase and cholinesterase
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Acetycholinesterase is an enzyme that stops the action of acetylcholine
cholinesterase in an enzyme that catalyzes (speeds up the rate) they dydrolysis (split into similar compounds) of acetylcholinesterase |
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Urecholine is not used if there is any obstruction in bladder, GI ulcers/obstructions it is used for?
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Neurogenic atony and with retention
it increases esphagel motility pressure in the LES and tone and motility of GI tract |
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URECHOLINE adverse side effects
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CV: bradycardia/hypotention
GI: ab crampls, diarrhea Resp: increased bronchial secrestions, bronco and or larngospasms, Endo: excessive salivation, excessive sweating eye: miosis |
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what is the complication with Erecholine
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Cholinergic crisis, respiratory failure, antidote is Atropine
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Akarpine what does it do?
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contracts cilary muscles which ups the outflow of agueous humor lowering IOP, effect of miosis, ups secreation of salivary glands. used for open & closed angle glaucoma and xerostomia
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What is Akapine contraindicated for
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retinal detachment
antidote is Atropine |
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Nicotrol what does it do what is it for
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pleasureable stimulating effect in brain / CNS
activates vasopressin used to stop smoking |
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Side effects and contraindications for the use of nicotrol
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can case angina pectoris, tachycardia, HA, insomnia and nervousness. Do not usse with Post-MI, life threatening arrhythmias or severe or worsening angina
Antidotes Atropine |
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Direct acting cholinergic Agonist agents
3 examples |
1. Urecholine a muscarnic agonist works on muscle of bladeder contracts detrusor muscle relaxes sphincter = voiding
2. Akarpine = muscarinic agonist 3. nicotrol = nicontinic N & M agonist |
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indirect acting cholinergic agonist agents they bind to acetylcholinesterase either reversible bond or irreversible bond 2 examples
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!. neostigmine - reversible binding for a period of mintues to hours
2. phospholine iodine = irreversible = forms a permanent bond |
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Neostigmine reversible indirect acting cholnergic agonsit what is it for
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myasthenia gravis, reverse neuromuscular blocking agents, treat anticholinergic poisoning can cause a cholergic crisis
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Phospholine iodine irreversible indrect acting cholinergic what is it used for
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open and closed angle glaucoma and insecticides and chemical warfare agents, complication = DEATH
Antidotes = atropine, protopam and diazepam |
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what is a cholinergic crisis
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overstimulation at neruo musclar junctions d/t excess of acetylcholine = results from inactivity of acetlycholinesterase = respiratory failure
antidote is atropine and mechanical ventilation w/oxgen |
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Cholinergic Antagonists
think car bad as they act by competing w/acetylcholine for binding at the receptors once they bind they inhibit nerve transmission at the receptor site thus having an OPPOSITE effect on body |
C = Cogentin = parkinsons
A = Artane = parkinsons R = Robinul = PUD B = Bentyl = IBS A = Atropine D = Detrol = overactive bladder A = atrovent = bronchodialation S = Scopolamine = motion sickness |
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What are the actions of cholinergic antagonists or anticholinergic agents on the body
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CV: increases heart rate
GI: decreases secretions/ motility GU decreases bladder contractions and increases constriction of sphincter Resp: relaxes smooth muscles = decrease airway resistance and causes bronchial dilation / lowers bronchial secretions Eye = dilates pupils exocrine: lowers secretions saliva & resp CNS: lowers muscle ridigity and decreases tremors |
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What are the therapuetic uses of cholinergic antagonists / anticholinergic agent
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treat life threatening bradycardia, preanesthetic to prevent dangerous reduction of HR from general anesthesia, N&V, peptic ulcers, IBS, Chronic bronchitis, ashtma and COPD
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Two neuromuscular blocking agents that are used to prevent muscle fibers from being stimulated and does not allow for skeletal muscle conctractions
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1. Tubocurarine which is long acting
2. anectine which is ultra-short used for short procedures |
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Tubocurarine is contraindicated or used cautiously in
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myasthenia gravis, geriatric patients and CV diease
can cause prolonged apnea, respiratory paralysis CV collaspe |
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What is the antidote for tubocurarine
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neostigmine and cholinersterase inhibitor
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what complications can Anectine cause
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malignant hyerthermia do not use with hyperkalemia it can cause lethal arrhythmias.
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what are the two classifications of Adrenergic drugs
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Nonselective-acting stimulates mulptiple adrenergic subtype receptors IE: epineprhine and selective-acigin drugs that target a specific subtype receptor
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Additional names for adrenergic agonists
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adrenergic, sympathetic agonist, sympathomimetics, alpha-adrenergic agonist and beta-adrenergic agonist
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additional names for drenergic antagonists
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antiadrenergic, sympathetic antagonist, sympatholytics, alpha-adrenergic antagonists and or blocker, beta-adrenergic antagonists and/ blocker, beta blocker
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Epineprhine (adrenaline)
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all 4 recptors, treat anaphylatic shock, CPR resuscitation
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S/S and contraindications with epinephrine
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tachycardia and hypertension
hypersensitivity to sulfite, closed-angle glaucoma, labor, CVA HTN, Diabetes and organic CV disease |
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What to know when giving epinephrine
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SQ aspirate and massage 10 sec
IV: use large vein, antidote-regitine, on a pump, monitor VS frequently monitor urine output hourly antidote = Prazosin (minipress) |
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what are the 4 adrenergic agonists
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epineprhine
allerest (alpha1) catapres (alpha2) dapamine (beta1) |
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allerest uses and side effects
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used for nasal congestion and SHOCK
s/s reflex bradycardia after increase in BP, hypertension |
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Dopamine uses and nursing interventions
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SHOCK, beta 1 and dopamine increase CO & dilation renal blood vessels less risk of renal damage
close monitoring if IV titration monitor urine output hourly |
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adrenergic antagonists block sympathetic receptors what are additional names
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antidrenergic, sympathetic antagonist, sympatholytics, alpha-adrenergic antagonists or blocker, beta-adrenergic antagonists or blocker, alpha blocker, beta blocker
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Name three adrenergic antagonists
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Prazosin -alpha blocker
propranolol beta 1 and 2 blocker metoprolol beta 1 blocker only |
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Prazosin action, uses and side effects
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dilation of blood vessels , lowers urinary sphincter, lowers resistance to urinary outflow
antihypertensive, benign prostatic hyperplasia Cv: tachycardia, orthostatic hypotenstion and palpatations |
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what are the profound drug interactions with Prazosin
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hypotension, beta blockers, calcium channel blockers and diretics
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what are the nursing interventions with adrenergic antagonistics
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take at bedtime for 3 days, change positions slowly aka dangle feet, after the 3 days its s/b okay to take in the am
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Propranolol effects CV and lungs beta 1 and 2 blocker :
actions, uses and s/s |
blocks myocardial stimulation lowers contractile force which lowers heart rate = more 02 to
antianaginal, cardioprotective, anti-arrhytic, antihypertensive s/s rebound tachycardia with acure withdrawal, sweating, tachycardia, CHF, bradycardia, bronchioconstriction |
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Metroprolol is a beta 1 not a beta 2 so it can be used with diabetes mellitus and asthma
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Propranolol is a beta 1 and beta 2 blocker so it can not be used with diabetes mellitus nor with asthma
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