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53 Cards in this Set
- Front
- Back
The transmission of nerve signals or impulses occurs b/c of the activity of chemical substances called?
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-NEUROTRANSMITTERS(transmitters of nerve impulses)
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AUTONOMIC NERVOUS SYSTEM:
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-maintains homeostatis (a constant internal environment)
-responds to emergency situations -means "self-governing" or "automatic" -has been called involuntary nervous system b/c we have little or NO control over it |
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The junction b/w one neuron & the next is called a ______.
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-SYNAPSE
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What are the 2 major NT of the ANS?
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-norepinephrine (sympathetic)
-acetylcholine (parasympathetic) |
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"Flight or Fight"
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SYMPATHETIC
(scared or stressed) |
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"Rest and Digest"
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-PARASYMPATHETIC
(peace) |
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SYMPATHETIC RESONSE:
1. EYE 2. HEART 3. BRONCHI (LUNGS) |
1. Mydriasis (causes dilation)
2. -dilation of coronary arteries -increases HR -increases the force of contraction -increase conduction velocity 3. bronchodilation |
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Also known as Sympathomimetic agents?
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-ADRENERGIC DRUGS
-mimics the action of the sympathetic ns |
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ADRENERGIC DRUGS:
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-release main NT- norepinephrine (sympathetic ns)
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SYMPATHETIC RESPONSE:
4. SALIVARY GLAND 5. STOMACH & INTESTINES 6. BLADDER 7. LUNGS |
4. weak stimulation of salivary flow
5. inhibition of peristalsis & secretion -decreased GI motility 6. relaxation of detrusor muscle (can't pee) -closed spinchter 7. bronchial muscle relaxation (airways open) |
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What receptors do Adrenergic Drugs effect?
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-Alpha-Adrenergic receptors
-Beta-Adrenergic receptors -Dopamine receptors |
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Alpha 1:
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-causes Vasoconstriction of blood vessels
-found in the Peripheral Smooth blood vessels |
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ALPHA 2:
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-modulators or regulators of Alpha 1 receptors: preventing further release of Norephinephrine
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BETA 1 receptors:
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HEART
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Stimulation of BETA 1 receptors causes?
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-increase HR
-increase force of contraction -increase in conduction |
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BETA 2 receptors are found where?
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-LUNGS:
-UTERUS -PERIPHERAL ARTERIAL BLOOD VESSELS |
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BETA 2 receptors causes:
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-Bronchodilation: airways open (ie. asthamatic pt)
-relaxation of Uterus (can give when a pt is in labor) |
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Where DOPAMINE RECEPTORS are found?
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-BRAIN
.parkinson's=decrease of dopamine in brain -KIDNEYS .better kidney perfusion(more blood supply to the kidneys) .resulting in increased urine output ie. pt with acute renal failure to help get more bld supply to kidneys |
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NT in the brain?
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-DOPAMINE
-Dopaminergic receptors improves the sx assoc. w/ parkinson's disease |
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What are the common side effects of ADRENERGIC drugs?
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-palpitations
-tachycardia -skin flushing -dizziness -tremors -hypertension |
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What is the Pre-Med Assessment for Adrenergic Agents?
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-V/S (HR & B/P)
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What ADRENERGIC agents side effects should be reported to health care provider STAT?
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-dysrhythmias
-chest pain -severe hypotension -hypertension -anginal pain -nausea -vomiting |
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What agents block the action of the sympathetic nervous system?
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-Adrenergic blocking Agents
ie. alpha-adrenergic blocking agents ie. beta-adrenergic blocking agents |
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ALPHA-ADRENERGIC BLOCKING agents
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-given if want VASODILATION of bld vessels in periphery
-used to treat hypertension ie. Raynaud's disease & Buerger's disease (both PVD) |
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Commonly called "beta blockers"?
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-BETA-ADRENERGIC BLOCKING AGENTS
-used for the heart to decrease the rate |
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What are BETA-ADRENERGIC BLOCKING agents used to treat?
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-hypertension
-post-myocardial infarction -angina pectoris -cardiac dysrhythmias -sx of hyperthyroidsm -"stage fright" |
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In what patients should Beta blockers be used w/ extreme caution?
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-RESPIRATORY conditions: bronchitis, emphysema, asthma or allergic rhinitis
-Diabetes -pt Susceptible to HYPOglycemia |
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ADRENALINE (R)
1. Classifications: 2. Actions 3. Uses: |
-Epinephrine
1. sympathomimetic 2. marked stimulation of alpha, beta-1 & beta-2 receptors (increase HR-beta) 3. -bronchial asthma (airways constricts) -anaphylatic shock (airways contricts |
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Adrenergic Drug:
PROVENTIL: 1. classification: 2. Action: 3. Uses: |
-Albuterol
1. sympathomimetic 2. -stimulates beta-2 receptors or the bronchi -minimal beta-1 activity -Bronchodilator 3. Bronchospasm -asthma -emphysema |
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MINIPRESS:
1. Classification: 2. Action: 3. Uses |
-prazosin hydrochloride
1. Alpha-Adrenergic Blocking Agents 2. produces selective blockade of post-synaptic, alpha 1 adrenergic receptors 3. used w/ other meds to treat mild/moderate Hypertension -Raynaud's disease (PVD) *Monitor B/P: possibly cause Orthostatic Hypotension |
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TOPROL XL
1. Classification 2. Action: 3. Uses: 4. Nursing Considerations: |
-metroprolol tartrate
-slows HR -beta 1 1. beta-adrenergic blocking agent 2. exerts mainly beta-1 adrenergic blocking activity although beta-2 receptors are blocked at high doses 3. Hypertension 4. check HR for bradycardia before admin -Monitor B/P & Pulse frequently |
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ADRENERGIC DRUG:
-INTROPIN 1. Classification: 2. Action: 3. Uses: |
-dopamine hydrochloride
1. sympathomemetic 2. -Vasopressor -direct stimulation of beta-1 receptors & variable (dose-dependent) stimulation of alpha receptors (peripheral vasoconstiction) -releases Norepinephrine from storage sites -increases renal perfusion(increase urinary output) 3. -vasopressor effect -increase renal perfusion -shock -hypotension -inotropic agent |
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What is the ONSET for Beta-Adreneric Blocking agents?
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-fairly rapid but often takes several days to weeks for a pt to show optimal improvement & become stablized
-counsel pt against poor adherence or sudden d/c (exacerbates anginal sx) -should be gradually reduced over 1 to 2 wks |
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What are the Adverse Effects assoc. w/ Beta-adrenergic blocking agents?
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-Dose related
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Also called the PARASYMPATHOMIMETIC AGENTS:
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-CHOLINERGIC DRUGS
-some act directly by stimulating the parasympathetic NS -releases the NT, Acetylcholine |
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Enyzme that metabolizes acetylcholine once it is released by the nerve ending?
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-ACETYLCHOLINESTERASE
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What are the side effects to expect w/ CHOLINERGIC AGENTS?
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-N/V
-Diarrhea -abdominal cramping -SOB -wheezing or tightness in chest -dizziness/ hypotension: monitor B/P & P |
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What are the side effects to Report w/ CHOLINERGIC AGENTS?
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-bronchospasm
-wheezing -bradycardia (withhold the next dose until pt is evaluated by a health care provider) |
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CHOLINERGIC DRUGS:
-2 Major Classes: a. Cholinergic Agonists, what is the Action? b. Anticholinerase Drugs, what is the Action? |
a. mimic action of the NT, acetylcholine
b. works by inhibiting the destruction of Acetylcholine at the cholinergic receptor sites |
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PARASYMPATHETIC RESPONSE:
1. EYE PUPIL: 2. HEART: 3. BRONCHI: |
1. Miosis (constriction of the pupil)
-increase lacrimal gland secretions 2. slow HR -decreases force of contraction & conduction -constricts coronary arteries 3. constriction (Bronchoconstriction) |
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PARASYMPATHETIC RESPONSE:
4. SALIVARY GLAND 5. STOMACH & INTESTINES: 6. BLADDER: 7. LUNGS: |
4. increase salivary flow
5. increases Peristalsis (go to BR more) -stimulates digestion & secretions 6. contraction of detrusor muscle (can go to BR) -opening of the spinchter 7. bronchial muscle contraction |
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What are the uses(what acetylcholine is doing) of CHOLINERGIC DRUGS?
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-urinary retention of after surgery
-postoperative abdominal distention -reduce eye intraocular pressure in pt w/ glaucoma -treat salivary gland hypofunction (ie after radiation therapy) -ie. oral cancer (hypofunctionsalivary gland) drys mouth so it increases moisture |
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What are 2 ie. of CHOLINERGIC DRUGS:
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1. pilocar
2. neostigmine |
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CHOLINERGIC DRUG:
-PILOCAR (BRAND): 1. uses: 2. action |
pilocarpine hydrochloride (eye drops)
1. used topically to treat glaucoma 2. to cause miosis of the pupil which reduces intraocular pressure |
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CHOLINERGIC DRUG:
-NEOSTIGMINE (generic) 1. USES: |
-PROSTIGMIN (BRAND)
-anticholinesterase 1. used to dx myasthenia gravis |
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ANTICHOLINERGIC agents are also known as:
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-cholinergic blocking agents & parasympatholytic agents
=blocks the action of acetylcholine in the parasympathetic nervous system) =blocks the effects of the parasympathetic NS =prevents acetylcholine from stimulating cholinergic receptors |
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What are the uses of ANTICHOLINERGICS?
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1.Treat spastic or hyperactive conditions
2. eye exams: causes mydriasis 3. Given before surgery to(pre-op drying agent): -reduce oral & gastric secretions -reduce respiratory secretions -prevent a drop in HR caused by vagal nerve stimulation during anesthesia or placement of endotracheal tube 4. bradycardia 5. parkinson disease 6. GU d/o |
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What are the common side effects for ANTICHOLINERGIC AGENTS?
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-(CAN'T PEE, SEE, SHIT)
-blurred vision (pt's safety) -constipation -urinary retention (assess for bladder distention) -dryness of the mucosa of the mouth, nose & throat |
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What are common ANTICHOLINERGIC meds to admin pre-op?
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-Atropine Sulfate (brand)
-Robinul (brand)/ gycopyrrolate (generic) |
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What is an ANTICHOLINERGIC med to admin for Irritable bowel syndrome?
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-Bentyl (brand)
dicyclomine (generic) |
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ATROPINE uses:
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-pre-op: to reduce salivation & bronchial secretions
-minimize bradycardia during intubation -tx of spastic conditions of GI tract -tx of urethral & biliary colic |
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BENTYL, dicyclomine Uses:
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-irritable bowel syndrome
-infant colic |
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ROBINUAL, glycopyrrolate Uses:
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-peptic ulcer disease
-pre-op: reduce salivation & bronchial secretions -minimize bradycardia during intubation |