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49 Cards in this Set
- Front
- Back
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Adrenergics
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-stimulate SNS
-also called Adrenergic Agonists, Sympathomimietics |
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Catecholamines
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substances that can produce a sympathomimetic response
- NE, EP, DA, synthetic |
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Alpha Receptors
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produce excitatory response (except GI)
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Alpha 1
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POSTsynaptic
- vasoconstriction - uterus & bladder contraction - mydriasis (dilation) - ejaculation - GI relaxation |
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Alpha 2
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- control release of NT
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Alpha Side Effects
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- HTN
- Tachycardi, palpations, dysrythmias - dry mouth, N & V - anorexia |
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Beta Receptors
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produce inhibitory response (except in heart cells)
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Beta 1
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- located on heart (SA & AV nodes)
- positice inotropic, chronotropic, and dromotropic effects |
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Beta 2
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- located on bronchioles, arterioles, visceral organs
- bronchodilation - vasodilation - relax uterus & GI - increase glycogenolysis - increase renin secretion |
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Beta Side Effects
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- tremors, headache, nervous
- tachycardia, palpations |
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Dopaminergenic Receptors
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- stimulated by dopamine only
- vasodilation in renal, mesenteric, coranary, cerebral |
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Respiratory Indications
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Beta 2 (bronchiodilators)
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Topical Nasal Decongestants
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Alpha 1 (vasoconstrictors)
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Opthalmic Indications
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Alpha 1 (vasoconstrictors)
Beta 2 (vasodilators) |
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Vasoactive (Cardiac) Indications
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Beta 1 :Dobutamine, DA, EP
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Adrenergic Antagonists
Blockers |
block SNS stimulation by binding to androgenic receptors
- sympatholytics |
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Alpha Blockers
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- vasodilation
- miosis (constrict) - supress ejaculation |
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Alpha Blocker Drugs
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Ergotamines: vasoconstriction for migraines
Oxytocies: increase uterine contractions Prazosin: vasodilator to treat HTN |
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Beta 1 Blockers
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(cardioselective)
- decrease HR - slows conduction - decrease force of contraction to treat angina, HTN, dysrythmia |
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Beta 2 Blockers
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(nonselective)
also affects: - constrict broncholes (SOB) - vasoconstriction (HTN) |
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Beta BLocker Drug Interactions
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1. Antacids: decrease absorption
2. Anticholonergics: decrease effect 3. Diuretics / CV drugs: cause hypotension |
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Beta Blocker Drugs
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Atenolol & Metopranolol: cardioselective
Carvedilol & Propranolol: nonselective |
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Cholinergics
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- stimulate the PSNS (oppose SNS)
- ACh |
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Muscarinic Receptors
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- increase bronchi secretions, constriction
- vasodilation - miosis - increase GI tone & contractility - relax sphincter - increase gland secretion - salavary, lacrimal, sweat |
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Nicotinic Receptors
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- vasoconstriction
- miosis - increase GI tone & contractility - increase skeletal muscle contraction |
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Cholinergic Uses
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- weak bladder conditions
- GI disorders - eye pressure - mysthenia gravis - alzheimers |
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Cholinergic Antedote
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Atropine
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Cholinergic Blockers
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- peptic ulcers, gastritis
- antispasmic for urinary inc. - mydriasis (dilation) - hypotension - Parkinson's (decrease salvation, spastic muscles) |
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Diabetes Mellitus
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- defficency in insulin, resistance to insulin, or both
- causes impaired metabolism and hyperglycemia |
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Type I DM
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- insulin dependant
- autoimmune disorder - Beta cells destroyed and don't produce insulin |
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Type II DM
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- non insulin dependant
- major cause - obesity - increase in glucose, body doesn't make enough insulin to maintain metabolism |
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Insulin
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- glycogen synthesis: glucose storeage in liver
- decreased proteinolysis, lipolysis - decreased gluconeogenisis |
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Insulin Preperations
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Animal - not used
Human Analog: recombanant DNA, same as human insulin with the reversal of lysine & proline |
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Rapid Acting Insulin
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1. Humaog (lispro)
2. NovoRapid (aspart) starts in 10-15 min peaks in 1 - 1.5 hous duration 4 - 5 hours |
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Fast Acting Insulin
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1. Humalin - R
2. Novolin - Toronto starts in 30-60 min peaks in 2 - 4 hours duration 5 - 8 hours |
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Intermediate Acting Insulin
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1. Humalin - N
2. Humalin - L 3. Novalin - NPH starts in 1 - 3 hours peaks in 5 - 8 hours duration up to 18 hours |
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Long Acting Insulin
* watch for hyoglycemia at night |
1. Humalin - U
starts in 3 - 4 hours Peaks in 8 - 15 hours duration 22 - 26 hours |
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Extended Long Acting Insulin
*no peak (can't mix) |
1. Lantus
starts in 90 min duration 24 hours |
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Premixed
*ratio of Fast Acting and Inermediate Acting |
1. Humalog
2. Humulin 20/80, 30/70 3. Novolin 10/90, 20/80, 30/70... starts in 5 - 15 min peaks in .75 - 2.5 hours duration 18 - 24 hours |
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Lipodystrophy
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atrophy or hypertrophy of fat tissue at injection site
d/t overused site, cold meds |
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Hot & Dry....
Sugar High |
Cold & Clammy...
need some candy |
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Oral Hyperglycemic Agents
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- for Type II DM
1. Sulphonylureas 2. Non-Sulphonylureas |
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Sulphonylureas
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- stimulates B-cells to secrete insulin
- increase sensetivity to insulin - decrease glucose production |
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Sulphonylureas Contraindications
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- must have functioning B-cells
- no allergies to sulpha - not pregnant - Alcohol, ACE inh, NSAIDs, MAO's, steroids increase effects |
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Second Generation Sulphonylureas
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DiaBeta (glyburide)
onset 1-4 hours peak 2-4 hours duration 24 hours |
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Alpha Glucosidase Inhibitors
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1. Precose (acarbose)
2. Glyset (miglitol) - inhibits enzymes sucrase, maltase, amylase (decrease glucose digestion) - anti flatus drugs counteract them - if hypo take dextrose (not table sugar) |
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Biguanide
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1. metformin
- increase use of glucose - decrease gluscose production - decrease GI absorp of gluc. - digoxen increases effect (anticoag) |
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Glitazones (thiazolidenediones)
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- increase sensitivity of insulin receptors
- decrease gluconeogenisis - may take 6wks to effect blood sugar - fluid retention (CHF) |
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Meglitinides (CMBA's)
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1. Prandin (repaglinide)
- stimulate insulin secretion -peak & 1/2 life quick |
