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43 Cards in this Set

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