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32 Cards in this Set
- Front
- Back
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Preganglionic NTs |
Acetylcholine (Ach)
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Postganglionic NTs
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Norepiniphrine, (Epinephrine too, but from adrenal medulla)
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Sympathomimetic
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acting like a sympathetic NT
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Catecholamine
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chemical structure like other sympathetic NTs
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Adrenergic
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having to do with adrenaline/epinephrine
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Receptor: pupil mydriases (dilation), constriction of veins and arterioles of skin/viscera/membranes, sex organs (ejaculation/orgasm)
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Alpha-1 receptors
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Receptor: presynaptic terminals, inhibit NT release
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Alpha-2 receptors
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Receptor: heart increase C.O., renin release from kidneys
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Beta-1receptors
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Receptor: Dilation of arterioles of heart/lung/muscle, bronchiodilator, uterus relaxation, glycogenolysis (liver and skeletal muscle). FIGHT OR FLIGHT
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Beta-2 receptors
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Receptor: kidney vasculature dilation
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Dopamine receptor pathway
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Adrenergeic agonists
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stimulate adregergic receptors, sympathomimetics. Ex) epinephrine, norepiniephrine, dopamine
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Glucogenolysis
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release of glucose from liver into bloodstream. Beta-2 action
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Extravasation
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leakage of drug out of IV site. Extravasation of sympathetic NT drugs can cause necrolysis due to vasoconstrictive effects
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COMT and MAO
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re-uptake enzymes in the liver for sympathetic NT
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Tachyphylaxis
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reduced response on repeated dosing - depletes supply of NT at site
Ex) Sudafed, Afrin |
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Chronotropic
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affects heart RATE
+ chronotropic increases rate - chronotropic decreases rate |
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Inotropic
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affects FORCE of heart contraction
+ chronotropic increases force - chronotropic decreases force |
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Epinephrine (Adrenalin, Epi-pen)
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Non-specific adrenergic agonist
vasoconstriction, + chrono & isotropic, bronchiodilation Monitor BP, pulse, cardiac rhythm, lung sounds, IV site, teaching |
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Phenylephrine (Neosynephrine, Sudaphed PE)
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Mixed acting adrenergic agonist (see also Epi)
IV to increase BP, nasal spray as decongestant, opthalmic drop for mydriasis (dilation) |
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Pseudoephedrine (Sudafed)
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Mixed acting adrenergic agonist (see also Epi)
OP as a decongestant |
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Alpha Adrenergenic Antagonists
(Alpha-1 blockers most common) |
Vasodilation. NO effect on cholesterol, C.O. or HR
Treat HTN, prostatic hypertrophy w/ urinary retention (relax bladder) Monitor BP, edema, orthostatic hypotension |
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Prozosin (Minipress)
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Alpha-1 blocker for HTN and BPH (benign prostatic hypertrophy)
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Beta-1 Agonists
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+ chrono & isotropic, increase A-V conduction, release renin
Adverse: tachycardia, dysrhythmias, angina |
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Beta-2 Agonists
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Bronchodilation, uterine relax (premature labor), glycogenolysis
Adverse: hyperglycemia |
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Dopamine (Intropin)
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+ chrono & inotropic. IV pump only for shock or severe CHF
Low dose: dopamine receptors Med dose: Beta-1 receptors High dose: Alpha receptors Monitor BP, C.O. IV site, cardiac rhythm, urine output (renal function) |
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Metaproterenol (Metaprel)
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non-specific beta agonist, bronchodilator for asthma
(less common due to unwanted beta-1 cardiac stimulation) Monitor lung sounds, pulse, tachycardia, tremors Teach not to over use |
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Albuterol (Proventil, Ventolin)
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Selective Beta-2 agonist
bronchodilator for asthma Teach not to over use |
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Salmeterol (Serevent)
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Selective Beta-2 agonist
bronchodilator for asthma Teach not to over use |
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Beta Adrenergic Antagonists (Beta Blockers)
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Reduce BP, dilate coronary arteries, - chrono & isotropic
May reduce renin-->angiotensin pathway Treat: HTN, angina, dysrhythmias, migranes, glaucoma, "state fright" or test anxiety Monitor BP (hold systolic <100), pulse (hold <60), edema, lung sounds, BG (diabetes) |
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Propranolol (Inderal)
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Nonselective beta blocker
Contra-indicated in asthma and COPD Treat HTN, angina, dysrhythmias, migranes, glaucoma Monitor BP, pulse, edema, lung sounds, BG (diabetes) |
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Metoprolol (Lopressor, Toprol)
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Beta-1 blocker (cardio-selective, lose that at higher doses)
Safer for COPD, asthma, diabetes Treat HTN, angina, dysrhythmias, migranes, glaucoma |
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Direct vs. indirect agonists
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Direct - stimulates receptor, Indirect - stimulates release or inhibits re-uptake/removal
Mixed exist too |
