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83 Cards in this Set
- Front
- Back
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adrenergic
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sympathetic. increase pupil, increase hr and contractility, bronshodilation, decrease stomach motility and gastric secretion, decrease pancreatic secretions, increase adrenalin, decrease intestinal motility, bladder walls relax
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ans
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regulatory or self governing system for maintaining the internal environment of the body at an optimal level (homeostasis). smooth muscle, cardiac muscle, glandular secretions- digestion, pressure of blood, bladder, respirations, etc
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catecholamine
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group of chemically related compounds- norepinephrine, epinephrine, dopamine
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cholinergic
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parasympathetic system- pupils decrease, lacrimal glands secrete, thin, watery saliva, decreased heart rate and contractility, broncoconstriction, increase stomach motility and gastrc secretion, increase pancreatic enzymes, increase intestinal motility, bladder contraction
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feedback control mechanism
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reflex action functions, operating from a receptor to an effector. to prevent extreme changes in function that could create a disturbance in internal environment.
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muscarinic receptors
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postganglionic sites- located in smooth muscle, cardiac muscle, and glands of parasympathetic fibers and the effector organs
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neuroeffector junction aka synaptic junction
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nerve impulse passes across
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neurohumoral transmission
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use of a chemical. sequence of events includes biosynthesis, storage, release, action, inactivation of the mediator
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nicotinic receptor
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appear in ganglia of parasymp and symp fibers, the adrenal medulla, and skeletal
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reflex arch
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automatic motor response to sensory stimuli. a nerve fiber conducts a nerve impulse which form the basis of communication through the nervous system
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somatic nervouse system
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innervates the voluntary or skelteal muscles
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neurotransmitter
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neurohormone that permits the action potential across the synaptic junction from one neuron to another or neuroeffector junction from neuron to effector
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cholinergic (parasympathomimetic)
WET |
act like mediators of parasympathetic nervous system. Stimulant effects- (nicotinic effects) resembles effects of nicotine- tachycardia, elevated BP, peripheral vasocontriction
(muscarinic effects)- intense vomit, diarrhea, nervousness, stomach pain, labored respirations, slow and irregular pulse, delirium- mimic effect of serious parasym stim. |
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cholinergic blocking
DRY |
parasympatholytic, anticholinergic, antimuscarinic.
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andrenergic (sympathomimetic)
DRY |
act like mediators of sympathetic nervous system.
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adrenergic blocking
WET |
sympatholytic
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nicotine
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used to help reduce w/d symptoms in smoker.
tachycardia, n/v/d, excess saliva, belching, pruritis or erythema, sore throat, cough, dizzy, rash, nightmares |
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bethanechol
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stimulate parasymp. postop/postpartum urinary retention, distention ab, gastric statis or reflux esophag- tachycardia, flush, d/n/v, saliva, tears, bronchospasm, diaphoresis
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chemical warfare antagonist
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atropine, pralidoxime cholride, diazepam (seizure prophy)
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indirect v direct acting
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indirect inhibit action of cholinesterase direct act like actylchol.
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neuromuscular blockers
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used in surgery or during processes in which voluntary muscle blockade is desirable. DO NOT CAUSE ANY SEDATION. imperative that pts recieve respiratory support, give sedatives and anxiolytics to prevent anxiety and impair memory
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succinylcholine
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depolarizing nm blocker.
has quick onset and short duration respi paralysis so need support bradycardia, excess saliva, increased ocular pressure |
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atropine
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antagonist at muscarinic rec. small doses depress salivary, bronchial secretions and sweating, large doses cause dilation of pupils, increase hr. nursing role r/t toxicity and has cns absorption.
dry mouth- gum, ice, candy dental hygiene avoid high temp, exercising in hot weather, hot baths, etc bc heat stroke dark glasses to protect eyes |
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scopolamine
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drowsiness, euphoria, memory loss, relaxation, sleep and relieve fear- like atropine
tx of IBS, renal/ut cholic, dysrhy during surgery bc of vagal stim, motion sickness, laryngospasm, sedative/amnesia. DRY |
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dimenhydrinate (dramamine)
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antiemtic or antivertigo. take before,
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oxybutin (ditropan), tolterodine (detrol)
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for bladder leakage
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sympathomimetic
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increase cardiac output, vasocontriction, bronchial dilation
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alpha receptors
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vasoconstrict
dilate pupils relax gut |
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beta receptors
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cardiac acceleration and increased contractility
bronchial relaxation uterine relaxation |
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direct acting
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work at receptors as agonists
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epinephrine
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increases HR, SV, Cardiac output. effective in tx of anaphylaxis bronchodil, vasoconstrict.
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norepinephrine
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does not change cardiac output, may decrease HR
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inotropic effect
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increase in contraction- result of calcium into cardiac fibers
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dromotropic effect
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increase in av conduction
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caloringenic effect
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capable of generating heat, which increases oxygen consumption
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epipen
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ok if shock is not present for anaphylaxis.
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for circulatory shock
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use dopamine, epi, norepi, dobutamine, isoproterenol
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dopamine hydrocholride
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b1 rec and in high doses alpha. use to tx acute HF and at high doses circ. shock
ad eff- headaches, nvd, decreased BP, ht, tachycardia, |
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dobutamine hydrochloride
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HF. increase force of myocardial contraction
ad ef- headache, nvd, increased hr and bp, palpitations, respiratory distress |
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norepi bitartate
levophed |
sign. hypotensive states- sepsis, sympathectomy, myocardial, blood transfusion
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isoproternol hydrochloride
isoproternol sulfate |
relieves bronchospasm assoc w asthma, emphysema, bronchitis. may discolor saliva red or pink
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phenylephrine systemic
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r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
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ephedrine
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stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
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metaraminol
aramine |
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
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peripheral adrenergic inhibitors
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block adrenergic receptors
vasoconstrict used for migraines |
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ergots
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fungus. good for migraines
wet symptoms |
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b blockers
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drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen |
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beta blockers
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used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
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ad ef of b blockers
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drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
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propranolol
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prototype b blocker. nonselective
imp to check apical pulse and hold if irregular |
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phenylephrine systemic
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r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
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phenylephrine systemic
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r/t epi. used for severe hypotension not responsive to fluids. ineffective to treat shock by loss of blood
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ephedrine
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stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
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metaraminol
aramine |
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
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ephedrine
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stimulates release of norepi. use for hypotension unresponsive to fluid replacement, position changes, and drug od. vasopressor. relieve nasal mucosal congestion. mood changes common risk for heart attack, stroke, death.
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peripheral adrenergic inhibitors
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block adrenergic receptors
vasoconstrict used for migraines |
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ergots
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fungus. good for migraines
wet symptoms |
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metaraminol
aramine |
contricts blood vessels, increases peripheral vascular resistance. raises bp prevents tx acute hypotension w surgery, drug reactions, shock. doesnt cause dysrhythmias, lacks cns effects, like norepi but less potent
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peripheral adrenergic inhibitors
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block adrenergic receptors
vasoconstrict used for migraines |
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b blockers
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drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen |
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ergots
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fungus. good for migraines
wet symptoms |
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beta blockers
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used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
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b blockers
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drugs that only inhibit b1 or b2 are called cardioselective.
beta blockers are used for antidysrhy effect and ability to reduce myocardial demands for oxygen |
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ad ef of b blockers
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drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
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beta blockers
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used for angina pectoris, HT, cardiomyopathy, tremors, anxiety, prevent or treat dysrhythm, prevent second MI, tx of vascular headaches, mitral valve prolapse
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propranolol
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prototype b blocker. nonselective
imp to check apical pulse and hold if irregular |
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ad ef of b blockers
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drowsiness, weakness, dif sleep, anxiety, nasal congestion, ab distress, bradycardia, n/v, depression, cold hands/feet, sex dys, bronchospasm
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propranolol
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prototype b blocker. nonselective
imp to check apical pulse and hold if irregular |
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important features of parkinsons
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prog debilitating do of the cns. characterized by resting tremor, bradykinesia, forward flexion of the trunk, muscle rigidity, weakness. prob in EPS of brain. degeneration of dopamine prod neurons
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classes of drugs to treat parkinsons
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1 drugs w central anticholinergic activity
2 drugs that affect brain dopamine levels or mimic dopamine to enhance dopaminergic action |
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anticholinergics in parkinsons
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block effects of acetylcholine. effects are decreased salivation and relaxation of smooth muscles w decrease in tremors
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akinesia
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difficulty to initiate muscle movt
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akathisia
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restlessness and agitation
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benzotropine
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antidyskinetic. tx of tremor in parkinsons and drug induced eps assoc w typical antipsychotics. ad ef are blurry vision, constipation, dry skin, urinary hesitancy, pain w urination, n/v/photophobia, drowsiness, dysphagia
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dont give anticholinergics w
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antacids, alcohol,
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xerostomia
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reduction in volume of saliva
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carbidopa-levodopa (sinemet)
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offer symptom control
less likely than levopdopa alone to cause constipation, changes in hr, n/v |
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levodopa
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parkinsons
ad effects- anxiety, nervousness, confusion, constipation, nightmares, dif urination, orthostatic hypo, mood changes, choreform/involuntary movt of body- face, tongue, arms, hands, head, upper body, severe nv |
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amntadine
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dopamine releasing-antiviral that augments dopamine release- for antidyskinetic against influenzae type A.
ad ef- impaired concentration, dizzy, irritability, anorexia, n/v, nervous, redish blue mottling, hallucinations, mood. od if severe confusion, insomnia, nightmares, seizures |
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dopaminergic agonists
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tx of parkinsons include ergot alkaloids, bromocriptine, pergolide, pramipexole, ropinirole
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on off syndrome
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complication following long term levadopa therapy. ct fluctuates from being symptom free to demonstrating full blown parkinsons symptoms. result of dopamine delivery. tx may be more freq admin, or addition of bromocriptine,
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end of dose symptoms
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agitation and chorieform movts seen shortly after dosing r/t dopamine hyperactivity. use cr or er instead
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myasthenia gravis
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loss or decrease in acetylcholine receptors. assoc w thymus gland
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