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43 Cards in this Set
- Front
- Back
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Adrenergic agents' action
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Stimulate the Sympathetic Nervous System (SNS).
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Adrenergic receptors
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Blood vessels
- alpha 1 constriction, beta 2 dilation Cardiac muscle - Positive inotropic effect - beta 1 increased contractility - AV Node - Positive chronotropic effect - beta 1 increased heart rate Bladder - alpha 1 constriction Uterus - beta 2 relaxation Bronchial muslces - beta 2 dilation GI System - decreased motility |
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Catecholamines
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- Norepinephring, epinephrine, dopamine
- Produced by SNS - Stored in the nerve ends - Nerve stimulated = Catecholmine released into synaptic cleft - Causes organ to respond - Stopped by enzymes or reuptake of neurotransmitter |
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Drug effects of the beta 2 specific drugs
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- bronchodilation
- long term matintenence treatment of asthma - prevention of bronchospasm |
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Sudafed/Afrin action
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Decongestant
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Therapeutic used of Adrenergic Agents
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- Anorexiant
- Bronchodilator - Glaucoma - Mydriasis - Ophthalmics - Vasoactives/Pressors/Inotropes |
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Stress Hormone
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Epinephrine
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Neurotransmitters of the Sympathetic Nervous System
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- Norepinephrine
- Epinephrine - Dopamine |
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Adrenergic-blocker agents
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- Work primarily on SNS
- antagonists - sypatholytics - Alpha and Beta blockers - Block stimulation of SNS receptors |
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Dobutrex
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- Beta 1 selective
- Increases cardiac output - Increases stroke volume, contractility - Used for CHF - Increased blood flow = increases O2 to body parts - IV only |
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Inotropic, Chronotropic, Dromotropic Effects
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- Inotropic - increase the force of myocardial contratction
- Chronotropic - increase the rate at which the heart beats - Dromotropic - accelerate conduction |
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Tenormin
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- prevention of furture MI's
- hypertension - angina |
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Cholingergic agent actions
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- act on the PSNS
- direct acting - stimulate receptor - indirect acting - prevent Ach breakdown |
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Anticholingeric Side Effects
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- dry mouth
- urinary retention - blurred vision - constipation - arrythmias |
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Bee Sting Kits
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??
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Serevent
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- new beta 2 agonist
- long-term maintenence treatment of asthma - prevention of bronchospasm - not for asthma attacks |
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Ergostat
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- constricts blood vessels in brain
- treatment for Migrains - contraindicated - peripheral vascular disease, coronary artery disease, hypertension, pregnancy. |
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Minipress
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- alpha blocker
- orthostatic hypotension associated - treat - hypertension, bph (increased prostate size) |
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Lopressor
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- Adrenergic Beta blocker
- popular for post-MI patients - shown increase in survival rates of post-MI patients |
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Urecholine
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- direct acting cholinergic agent
- smooth muscle of the bladder - used for post-partum or post-surgical urine retention - Oral |
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Aricept
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- cholinergic agent
- increase leved of Ach by blocking breakdown, indirect acting - used to treat Alzheimers |
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Elderly patients taking Anticholinergics
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- more suseptible to the side effects
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Anticholinergic side effects
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- dry mouth
- urinary retention - blurred vision - constipation - arrythmias |
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Cardiac Glycosides
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- help heart perform its duties
- restores heart to normal sinus rhythm - Digoxin |
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Apical Pulse/Cardiac Glycosides
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Must take the apical pulse before giving a Cardiac Glycoside. If it is less than 60, hold the dose, contact MD.
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Digibind
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Given to stop effects of Cardiac Glycosides in a case of toxicity/overdose.
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Normal Heart Contractions
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??
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Lidocaine
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- class Ib antidysrhythmic agent
- drug of choice for Ventricular Dysrhythmias - IV - Adverse Effects: CNS toxicities, decreasees HR, BP and respirations. - Monitor vitals carefully |
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Health teaching for Digoxin
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- take at the same time each day
- never double up or skip doses - don't change brands - watch for side effects - high potassium foods |
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Predisposition to digitalis toxicity
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- bradycardia, any dysrhythmias, anorexia
- N + V, headache, fatigue, confusion - visual disturbances |
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Therapeutic Digoxin Levels
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0.5 - 2.0
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Potassium levels effect on digitalis activity
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low potassium levels increase toxicity
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Adverse effects of Quinidine
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- cause prolonged QT interval on EKG, means the heart is too slow.
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Condarone
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- class III anytidysrhythmic
- inhibit repolarization - indicated for life-threatening ventricular tach. or ventricular fib. when resistant to other drug therapy. |
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Calan
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- prevents recurrence of PSVT
- class IV antidysrhythmic |
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Categories of antidysrhythmics
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- class Ia and Ib - Membrane stabilizing
- class II - beta blockers - class III - inhibit repolarization - class IV - calcium channel blockers (CCB's) |
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Ejection fraction
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amount of blood ejected with each contraction compared with the total amount of blood in the ventricle before contraction. Should be at least 65% ejected.
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SA Node
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- pacemaker of the heart
- causes atrium to contract |
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Bundle of His
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- located in the ventricular septum
- important in sending impulses to the heart |
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Drug of choice for ventricular dysrhythmias
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Lidocaine
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Adrenelin - most common route
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Parenterally
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Anticholinergic agent actions
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- blocks or inhibit Ach
- blocks PSNS, allows SNS to dominate. |
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Congestive Heart Failure
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- Heart is unable to pump, increased blood in the ventricle = back-up of blood = increased pressure = pulmonary congestion.
- Left ventricle back-up into the lungs = dyspnea, SOB, gurgline, cough - Right ventricle back-up into the venae cavae = edema in lower extremities, hepatic congestion = abdominal pain, acities. |
