Pharm Test 3 Autonomic Ns

Front 1

The transmission of nerve signals or impulses occurs b/c of the activity of chemical substances called?

Back 1

-NEUROTRANSMITTERS(transmitters of nerve impulses)

Front 2

AUTONOMIC NERVOUS SYSTEM:

Back 2

-maintains homeostatis (a constant internal environment)
-responds to emergency situations
-means "self-governing" or "automatic"
-has been called involuntary nervous system b/c we have little or NO control over it

Front 3

The junction b/w one neuron & the next is called a ______.

Back 3

-SYNAPSE

Front 4

What are the 2 major NT of the ANS?

Back 4

-norepinephrine (sympathetic)
-acetylcholine (parasympathetic)

Front 5

"Flight or Fight"

Back 5

SYMPATHETIC
(scared or stressed)

Front 6

"Rest and Digest"

Back 6

-PARASYMPATHETIC
(peace)

Front 7

SYMPATHETIC RESONSE:
1. EYE
2. HEART
3. BRONCHI (LUNGS)

Back 7

1. Mydriasis (causes dilation)
2. -dilation of coronary arteries
-increases HR
-increases the force of contraction
-increase conduction velocity
3. bronchodilation

Front 8

Also known as Sympathomimetic agents?

Back 8

-ADRENERGIC DRUGS
-mimics the action of the sympathetic ns

Front 9

ADRENERGIC DRUGS:

Back 9

-release main NT- norepinephrine (sympathetic ns)

Front 10

SYMPATHETIC RESPONSE:
4. SALIVARY GLAND
5. STOMACH & INTESTINES
6. BLADDER
7. LUNGS

Back 10

4. weak stimulation of salivary flow
5. inhibition of peristalsis & secretion
-decreased GI motility
6. relaxation of detrusor muscle (can't pee)
-closed spinchter
7. bronchial muscle relaxation (airways open)

Front 11

What receptors do Adrenergic Drugs effect?

Back 11

-Alpha-Adrenergic receptors
-Beta-Adrenergic receptors
-Dopamine receptors

Front 12

Alpha 1:

Back 12

-causes Vasoconstriction of blood vessels
-found in the Peripheral Smooth blood vessels

Front 13

ALPHA 2:

Back 13

-modulators or regulators of Alpha 1 receptors: preventing further release of Norephinephrine

Front 14

BETA 1 receptors:

Back 14

HEART

Front 15

Stimulation of BETA 1 receptors causes?

Back 15

-increase HR
-increase force of contraction
-increase in conduction

Front 16

BETA 2 receptors are found where?

Back 16

-LUNGS:
-UTERUS
-PERIPHERAL ARTERIAL BLOOD VESSELS

Front 17

BETA 2 receptors causes:

Back 17

-Bronchodilation: airways open (ie. asthamatic pt)
-relaxation of Uterus (can give when a pt is in labor)

Front 18

Where DOPAMINE RECEPTORS are found?

Back 18

-BRAIN
.parkinson's=decrease of dopamine in brain
-KIDNEYS
.better kidney perfusion(more blood supply to the kidneys)
.resulting in increased urine output
ie. pt with acute renal failure to help get more bld supply to kidneys

Front 19

NT in the brain?

Back 19

-DOPAMINE

-Dopaminergic receptors improves the sx assoc. w/ parkinson's disease

Front 20

What are the common side effects of ADRENERGIC drugs?

Back 20

-palpitations
-tachycardia
-skin flushing
-dizziness
-tremors
-hypertension

Front 21

What is the Pre-Med Assessment for Adrenergic Agents?

Back 21

-V/S (HR & B/P)

Front 22

What ADRENERGIC agents side effects should be reported to health care provider STAT?

Back 22

-dysrhythmias
-chest pain
-severe hypotension
-hypertension
-anginal pain
-nausea
-vomiting

Front 23

What agents block the action of the sympathetic nervous system?

Back 23

-Adrenergic blocking Agents
ie. alpha-adrenergic blocking agents
ie. beta-adrenergic blocking agents

Front 24

ALPHA-ADRENERGIC BLOCKING agents

Back 24

-given if want VASODILATION of bld vessels in periphery
-used to treat hypertension

ie. Raynaud's disease & Buerger's disease (both PVD)

Front 25

Commonly called "beta blockers"?

Back 25

-BETA-ADRENERGIC BLOCKING AGENTS
-used for the heart to decrease the rate

Front 26

What are BETA-ADRENERGIC BLOCKING agents used to treat?

Back 26

-hypertension
-post-myocardial infarction
-angina pectoris
-cardiac dysrhythmias
-sx of hyperthyroidsm
-"stage fright"

Front 27

In what patients should Beta blockers be used w/ extreme caution?

Back 27

-RESPIRATORY conditions: bronchitis, emphysema, asthma or allergic rhinitis
-Diabetes
-pt Susceptible to HYPOglycemia

Front 28

ADRENALINE (R)
1. Classifications:
2. Actions
3. Uses:

Back 28

-Epinephrine
1. sympathomimetic
2. marked stimulation of alpha, beta-1 & beta-2 receptors (increase HR-beta)
3. -bronchial asthma (airways constricts)
-anaphylatic shock (airways contricts

Front 29

Adrenergic Drug:
PROVENTIL:
1. classification:
2. Action:
3. Uses:

Back 29

-Albuterol
1. sympathomimetic
2. -stimulates beta-2 receptors or the bronchi
-minimal beta-1 activity
-Bronchodilator
3. Bronchospasm
-asthma
-emphysema

Front 30

MINIPRESS:
1. Classification:
2. Action:
3. Uses

Back 30

-prazosin hydrochloride
1. Alpha-Adrenergic Blocking Agents
2. produces selective blockade of post-synaptic, alpha 1 adrenergic receptors
3. used w/ other meds to treat mild/moderate Hypertension
-Raynaud's disease (PVD)

*Monitor B/P: possibly cause Orthostatic Hypotension

Front 31

TOPROL XL
1. Classification
2. Action:
3. Uses:
4. Nursing Considerations:

Back 31

-metroprolol tartrate
-slows HR
-beta 1
1. beta-adrenergic blocking agent
2. exerts mainly beta-1 adrenergic blocking activity although beta-2 receptors are blocked at high doses
3. Hypertension
4. check HR for bradycardia before admin
-Monitor B/P & Pulse frequently

Front 32

ADRENERGIC DRUG:
-INTROPIN
1. Classification:
2. Action:
3. Uses:

Back 32

-dopamine hydrochloride
1. sympathomemetic
2. -Vasopressor
-direct stimulation of beta-1 receptors & variable (dose-dependent) stimulation of alpha receptors (peripheral vasoconstiction)
-releases Norepinephrine from storage sites
-increases renal perfusion(increase urinary output)
3. -vasopressor effect
-increase renal perfusion
-shock
-hypotension
-inotropic agent

Front 33

What is the ONSET for Beta-Adreneric Blocking agents?

Back 33

-fairly rapid but often takes several days to weeks for a pt to show optimal improvement & become stablized

-counsel pt against poor adherence or sudden d/c (exacerbates anginal sx)
-should be gradually reduced over 1 to 2 wks

Front 34

What are the Adverse Effects assoc. w/ Beta-adrenergic blocking agents?

Back 34

-Dose related

Front 35

Also called the PARASYMPATHOMIMETIC AGENTS:

Back 35

-CHOLINERGIC DRUGS
-some act directly by stimulating the parasympathetic NS
-releases the NT, Acetylcholine

Front 36

Enyzme that metabolizes acetylcholine once it is released by the nerve ending?

Back 36

-ACETYLCHOLINESTERASE

Front 37

What are the side effects to expect w/ CHOLINERGIC AGENTS?

Back 37

-N/V
-Diarrhea
-abdominal cramping
-SOB
-wheezing or tightness in chest
-dizziness/ hypotension: monitor B/P & P

Front 38

What are the side effects to Report w/ CHOLINERGIC AGENTS?

Back 38

-bronchospasm
-wheezing
-bradycardia
(withhold the next dose until pt is evaluated by a health care provider)

Front 39

CHOLINERGIC DRUGS:
-2 Major Classes:
a. Cholinergic Agonists, what is the Action?
b. Anticholinerase Drugs, what is the Action?

Back 39

a. mimic action of the NT, acetylcholine
b. works by inhibiting the destruction of Acetylcholine at the cholinergic receptor sites

Front 40

PARASYMPATHETIC RESPONSE:
1. EYE PUPIL:
2. HEART:
3. BRONCHI:

Back 40

1. Miosis (constriction of the pupil)
-increase lacrimal gland secretions
2. slow HR
-decreases force of contraction & conduction
-constricts coronary arteries
3. constriction (Bronchoconstriction)

Front 41

PARASYMPATHETIC RESPONSE:
4. SALIVARY GLAND
5. STOMACH & INTESTINES:
6. BLADDER:
7. LUNGS:

Back 41

4. increase salivary flow
5. increases Peristalsis (go to BR more)
-stimulates digestion & secretions
6. contraction of detrusor muscle (can go to BR)
-opening of the spinchter
7. bronchial muscle contraction

Front 42

What are the uses(what acetylcholine is doing) of CHOLINERGIC DRUGS?

Back 42

-urinary retention of after surgery
-postoperative abdominal distention
-reduce eye intraocular pressure in pt w/ glaucoma
-treat salivary gland hypofunction (ie after radiation therapy)
-ie. oral cancer (hypofunctionsalivary gland) drys mouth so it increases moisture

Front 43

What are 2 ie. of CHOLINERGIC DRUGS:

Back 43

1. pilocar
2. neostigmine

Front 44

CHOLINERGIC DRUG:
-PILOCAR (BRAND):
1. uses:
2. action

Back 44

pilocarpine hydrochloride (eye drops)
1. used topically to treat glaucoma
2. to cause miosis of the pupil which reduces intraocular pressure

Front 45

CHOLINERGIC DRUG:
-NEOSTIGMINE (generic)
1. USES:

Back 45

-PROSTIGMIN (BRAND)
-anticholinesterase
1. used to dx myasthenia gravis

Front 46

ANTICHOLINERGIC agents are also known as:

Back 46

-cholinergic blocking agents & parasympatholytic agents

=blocks the action of acetylcholine in the parasympathetic nervous system)
=blocks the effects of the parasympathetic NS
=prevents acetylcholine from stimulating cholinergic receptors

Front 47

What are the uses of ANTICHOLINERGICS?

Back 47

1.Treat spastic or hyperactive conditions
2. eye exams: causes mydriasis
3. Given before surgery to(pre-op drying agent):
-reduce oral & gastric secretions
-reduce respiratory secretions
-prevent a drop in HR caused by vagal nerve stimulation during anesthesia or placement of endotracheal tube
4. bradycardia
5. parkinson disease
6. GU d/o

Front 48

What are the common side effects for ANTICHOLINERGIC AGENTS?

Back 48

-(CAN'T PEE, SEE, SHIT)
-blurred vision (pt's safety)
-constipation
-urinary retention (assess for bladder distention)
-dryness of the mucosa of the mouth, nose & throat

Front 49

What are common ANTICHOLINERGIC meds to admin pre-op?

Back 49

-Atropine Sulfate (brand)
-Robinul (brand)/ gycopyrrolate (generic)

Front 50

What is an ANTICHOLINERGIC med to admin for Irritable bowel syndrome?

Back 50

-Bentyl (brand)
dicyclomine (generic)

Front 51

ATROPINE uses:

Back 51

-pre-op: to reduce salivation & bronchial secretions
-minimize bradycardia during intubation
-tx of spastic conditions of GI tract
-tx of urethral & biliary colic

Front 52

BENTYL, dicyclomine Uses:

Back 52

-irritable bowel syndrome
-infant colic

Front 53

ROBINUAL, glycopyrrolate Uses:

Back 53

-peptic ulcer disease
-pre-op: reduce salivation & bronchial secretions
-minimize bradycardia during intubation