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Test 3->Pharmacology
ANS
| Question | Answer |
|---|---|
| all nervous tissue outside the CNS, sensory and motor divisions | peripheral nervous system |
| provides voluntary control over skeletal muscles | somatic nervous system |
| involuntary control over SNS and PNS | autonomic nervous system |
| this system is activated under condition of stress (fight or flight), vasoconstriction: causes increase in HR, BP, & glucose production by liver, more blood shunted to the skeletal muscle, broncho-dilation, increased circulation & pupil dilation | sympathetic nervous system |
| ____ ____ sympathomimetics bind directly to the receptor & causes a physiologic response (epinephrine) | direct acting |
| ____ ____ sympathomimetics is an adrenergic drug that when given, causes release of the catecholamine from the storage sites in the nerve endings which then binds to the receptors & causes a physiologic response | indirect acting |
| ___ ___ sympathomimetics both directly stimulate the receptor by binding to it & indirectly stimulates the receptor by causing the release of the neurotransmitter stored in the vesicles in the nerve endings (ephedrine) | mixed acting |
| known as sympathomimetics (mimic), stimulate SNS, norepinephrine, epinephrine, dopamine | adrenergic agents |
| norepinephrine, epinephrine, and dopamine are known as ____ | catecholamines |
| norepinephrine and epinephrine are ____ | neurotransmitters |
| ____-____ receptors cause vasoconstriction of the blood vessels & vasodilator pupils (mydriasis) | alpha-1 |
| ___-___ receptors increase HR and force of heart contraction and release of renin | beta-1 |
| ___-___ receptors are found in the lungs (bronchodilator) & peripheral blood vessel vasodilate | beta-2 |
| ___-___ receptors stimulate more than one type of adrenergic receptor sites | non-selective |
| adrenergic nerve endings release ____ when stimulated | norepinephrine |
| ____ attaches to adrenergic receptors | norepinephrine |
| norepinephrine then passes back into granules of nerve endings to be reused or destroyed by ___ | MAO |
| ___ is an enzyme within the adrenergic nerve that metabolizes norepinephrine | MAO |
| ___-___ receptors are used in the treatment of nasal congestion or hypotension, & causes mydriasis during an eye exam | alpha-1 |
| ___-___ receptors are bronchodilators, uterine relaxants, causes stimulation in the liver with glycogenolysis & increases renin secretion in the kidneys, vasodilates skeletal muscles of blood vessels | beta-2 |
| ___-___ adrenergic receptors when stimulated causes positive inotropic effect, chronotropic effect, dromotropic effect | beta-1 |
| these stimulate the nervous system, constricts peripheral blood vessels, increases HR, dilates pupils, & dilates the bronchial | catecholamines |
| these treat shock, cardiac arrest or respiratory difficult, reduces IOP | adrenergic drugs: sympathomimetic drugs: norepinephrine, epinephrine, dopamine |
| isoproterenol, dobutamine, & phyenylephrine are | synthetic adrenergic drugs |
| these drugs are agonists because they bind to receptors & cause a response | adrenergic drugs: norepinephrine and dopamine |
| releases by adrenal medulla, released during stress or fight/flight reactions, both stimulate internal organs & increase SNS | epinephrine & norepinephrine |
| increases BP, directly metabolizes to dopamine, used in treating hypotension and shock | norepinephrine |
| HA, restlessness, excitement, insomnia, euphoria, palpitations, HTN, hypotension, dry mouth, N & V, taste changes, dysrhythmias, tachycardia, anorexia, hyperglycemia are all side effects of | alpha adrenergic drugs |
| HA, tremors, nervousness, dizziness, increased HR, palpitations, dysrhythmias, BP fluctuations, N & V are all side effects of | beta adrengergic drugs |
| ___ drugs have no alpha properties but dilates bronchi and can affect body systemically | beta adrenergic |
| sympathomimetics, neurotransmitter in brain, known as dopaminergic receptor, the only receptor to stimulate these sites, precursor in synthesis of NE in adrenergic nerve endings: beta agonist/alpha agonist-dose dependent | dopamine/Intropin beta-1 adrenergic |
| a low dose dilates renal, brain, mesentery & heart vessels=increased blood flow: higher doses stimulate alpha receptors/vasoconstrictor, increase CO, improve contracility, renal vasoconstriction | dopamine |
| contraindications to dopamine include ____ ____ and ___ ___ | circulatory shock and low BP |
| a selective beta-2 adrenergic bronchodilator, short acting, used to relieve bronchospasm, asthma, COPD, protection against exercised-induced asthma, can induce hypokalemia in pts w/ renal failure | Albuterol Sulfate (proventil, ventolin) |
| this can cause tachycardia, shakiness, hyperkinesis, N & V, reactive bronchospasm, drowsiness, aggression, fluid retention, dry mouth, HTN, increased apetite, difficulty breathing, nose bleed, nightmares, rash, insomnia, anxiety, flushing, HA | albuterol sulfate (proventil, ventolin) |
| a long-acting beta2 adrenergic receptor agonist, a bronchodilator; works by relaxing muscles in the airways to improve breathing, currently prescribed for long term maintenance treatment of asthma & COPD, prevention of bronchospasms, not for active asthma | Salmeterol or Serevent |
| this drug is metabolized by the liver & should be used with caution in patients w/ liver dysfunction: it is also not meant to be used in treating acute asthma attacks, should be used 30-60 minutes before exercise, & does not take the place of corticoster. | Salmeterol |
| side effects of this drug include palpitations, tachycardia, elevated BP, tremor, nervousness, & HA: throat & upper airway irritation can occur | Salmeterol |
| this drug is a natural plant alkaloid that is obtained from the Ephedra plant, decongestant, sympathomimetic drug used as nasal decongestant that has both alpha & beta adrenergic properties, responsible for causing vasoconstriction in nasal mucosa | pseudoephedrine/ sudafed or afrin |
| produces shrinkage of the mucose which promotes easier nasal breathing & reduced nasal secretion, excessive use can lead to greater congestion b/c of rebound phenomenon that occurs when use of product is stopped | pseudoephedrine/ sudafed or afrin |
| do not use this drug if you are allergic, have DM, HTN, thyroid disorders, or enlargement of the prostate gland | pseudoephedrine/ sudafed or afrin |
| adverse effects of this drug include CNS stimulation, sleeplessness, nervousness, excitability, dizziness, anxiety, paranoid psychosis, tachycardia, stroke | pseudoephedrine/ sudafed or afrin |
| a sympathomimetic drug /vasoactive adrenergic, cardioselective effects->beta1 selective vasoactive drug, direct stimulation of beta1 receptors of SNS, only give IV, used in treatment of heart failure & cardiogenic shock, & to treat orthostatic hypotension | dobutamine |
| increases cardiac output by increasing contractility (positive inotropy) which increases stroke volume esp. in patients with heart failure | dobutamine |
| side effects of this drug include upset stomach, vomiting, tingling sensations, fever, leg cramps, HA, irregular heartbeat, increases BP & HR, chest pain, SOB, swelling of the lower legs & ankles, increased fatigue, dizziness, skin rash | dobutamine |
| blocking the receptor sites cause the site to be less receptive to the SNS drugs b/c they have a higher affinity for the alpha adrenergic receptors: competitive blockade is reversible | sympatholytic drugs or adrenergic blockers/antagonists |
| bind to the adrenergic receptor & in turn block stimulation of SNS at the alpha receptors which leads to vasodilation (relaxing of vascular smooth muscle), decreases BP, miosis or constricts pupils | alpha adrenergic blockers/ sympatholytics |
| ____ dilated arterioles in the brain are often responsible for causing vascular headaches such as migraines | constricting |
| ____ arteries in the brain causes the migrain headache | dilated |
| these are used to control postpartum & post abortion bleeding caused by uterine relaxation & enlargement: these drugs will increase the uterine contraction & induce local vasoconstriction | alpha blockers |
| can cause both arterial & venous dilation, given to pts w/ BPH to decrease resistance to urinary outflow & reduces urinary obstruction, used to treat skin necrosis & sloughing after extravasations of vasopressors like norep. & ep. | alpha blockers |
| drug blocks alpha1 adrenergic receptors, reduces peripheral vascular resistance, decreases BP by dilating arterial & venous blood vessels, reduces urinary obstruction in men w/ BPH, treats HTN, relaxes smooth muscles | prazosin/minipress |
| 1st time on this drug, pts get very lightheaded & can pass out which causes orthostatic hypotension, initial dose taken at bedtime, miosis/constriction, nasal congestion/vasodilation, increased GI activity, tachycardia, fainting | prazosin/minipress |
| alpha blocker that reduces peripheral vascular resistance used to treat HTN, BP, & in diagnosis of a catecholamine secreting tumor, used to treat skin necrosis, given SQ in a circular fashion | phentolamine |
| blocks epi. & norep., decreases HR, slows conduction through AV node, prolongs SA node recovery, decreases myocardial O2 demand & contractility, lowers BP by vasodilating arterioles, treats angina, causes bronchioles to constrict (SOB) | beta blockers |
| the _____ can impair secretion of insulin from the pancreas and increase ___ ___ and increase levels of triglycerides | nonspecific beta blocker: blood glucose |
| nonselective beta1 & beta2 blocking drug used for the treatment of angina, HTN, tachydysrhythmias assoc. w/ cardiac glycoside intoxication & treats hypertrophic subaortic stenosis, pheochromocytoma, thyrotoxicosis, migraines: | propranolol/inderal |
| do not give this to bronchial asthma patients | propranolol/inderal |
| also known as Lopressor or Toprol XL, a beta1 blocker used in post MI pts, has shown to increse survival after MIs | metaprolol |
| cardioselective beta blocker that is used to prevent future MIs in pts who have had an MI, used in treatment of HTN and angina, given oral and IV | Atenolol Tenormin |
| very potent short acting beta1 blocker, used in acute situations to provide rapid temporary control of the ventricular rate in pts w/ supraventricular tachydysrhythmias such as a-fib and a-flutter, has a short half-life so give IV | esmolol |
| neurotransmitter of parasympathetic nervous system is ____ | acetylcholine |
| ____ is produced and stored w/in cholinergic nerve endings, attaches to cholinergic receptors, increses bodily activity | acetylcholine |
| inactivates/breaks down Ach only when outside a nerve ending, & not on a receptor | acetylcholinesterase |
| ___ ___ is responsible for breakdown of Ach | cholinesterase enzyme |
| ____ ____ is not used because it is destroyed immediately by administration | straight Ach |
| Ach effects all 3 receptors which are called ___,___,& ___ | muscarinic, nicotinic I, & nicotinic II |
| these drugs regulate, stimulate, & increse bodily functions, works mainly during rest, digestion, & waste elimination | cholinergic drugs |
| these drugs are used to reduce intraocular pressure in pts w/ glaucoma, treat various GI & bladder disorders, diagnose & treat miasthenia gravis, treat alzheimer's dz, & dry mouth | cholinergic drugs |
| cholinergic poisoning = _____ | SLUDGE (salivation, lacrimation, urinary incontinence, diarrheae, GI cramps, & emesis |
| directly bind to Ach receptors and causes stimulation | direct acting PNS cholinergic agonist |
| protects Ach from being broken down by ACHE (acetylcholinesterase) making more of this neurotransmitter action | indirect acting PNS cholinergic agonist |
| inhibits the action of acetylcholinesterase, the enzyme responsible for breaking down Ach, known as cholinesterase | PNS cholinergic agonists |
| direct acting parasympathomimetic/cholinergic drug, interacts w/ muscarinic receptor to cause PSN stimulation, affects the digestive & urinary tracts, stimulates smooth muscle contraction, helps pt to void, causes sphincter relaxation, never IM/IV | Bethanechol HCL (Urecholine) |
| do not give this to pts w/ hyperthyroidism, peptic ulcers, active bronchial asthma, cardiac dz or CAD, epilepsy, parkinsonism | Bethanechol HCL (Urecholine) |
| causes increased salivation, sweating, abdominal cramping, hypotension, fainting | Bethanechol HCL (Urecholine) |
| work by making more Ach at receptor site, inhibit the enzyme cholinesterase & allow accumulation of Ach at receptor sites, improves muscle strength & reduce IOP in pts w/ glaucoma, treatment of bladder disorders & myasthenia gravis, can cause insomnia | indirect acting cholinergic agonists/cholinesterase inhibitors |
| drug works by increasing Ach concentration at the receptor sites stimulating the effector cells, cause skeletal muscle contraction, improves muscle strength, ability to inhibit AChE | physostigmine/Antilirium (indirect acting cholinergic drug) |
| the antidote for anticholinergic poisoning and irreversible cholinesterase inhibitors, do not give to pts w/ hyperthyroidism,PUD, active asthma, CV dz, epilepsy, bradycardia, give IV & topically | physostigmine/Antilirium (indirect acting cholinergic drug) |
| used in treatment of alzheimer's dz, works centrally in brain by increasing Ach levels in brain by inhibiting AChE, given once a day PO | Donepezil Aricept (indirect acting anticholinesterase drug) |
| used in treatment of myasthenia gravis, useful for reversing effects of nondepolarizing agents after surgery, do not give to pts w/ hyperthyroidism, PUD, asthma, CV dz, epilepsy, bradycardia, PO or IV | pyridostigmine (mestinon) (indirect acting cholinergic drug) |
| when there is not enough Ach to adequately stimulate receptors to skeletal muscle tone & help to reverse severe muscle weakness; therefore, an anticholinesterase drug is given to increase the availability of Ach | myasthenia gravis |
| in the initial treatment of myasthenia gravis, oral ___ or ___ should be started at a dosage smaller than that required to produce maximum strength, & daily dosage gradually increased at intervals of 48 hrs or more | Pyridostigmine (mestinon): Neostigmine (Prostigmin) |
| protect Ach from being broken down by AChE making more neurotransmitter to act with receptor | cholinesterase inhibitors (indirect acting parasympathomimetics) |
| increasing muscle weakness, thorough involvement of the muscles of respiration, may cause death, fever, visual changes, difficulty swallowing, psychomotor agitation | cholinergic crisis |
| agents that block the action of neurotransmitter Ach at the muscarinic receptors in the PSNS | cholinergic blocking agents |
| heart, respiratory tract, GI tract, urinary, bladder, eyes, exocrine glands are major sites of ____ | anticholinergics |
| large doses of cholinergic blocking agents ____ HR. small doses of cholinergic blocking agents ____ HR. | increase/decrease |
| dilates pupils (mydriasis), increases IOP, decrease secretions of gastric acid, slow intestinal motility, GU system decreased bladder contraction (urinary retention), relaxation of bronchi (bronchial dilation), dry mucus membranes | cholinergic blocking agents |
| treats PUD, IBS, improved asthma, COPD, chronic bronchitis, treats incontinence, parkinson dz by decreasing muscle rigidity & diminishing tremors, GI hypersecretion | cholinergic blocking agents |
| adverse effects include increased HR, CNS excitation, dilated pupils, photophobia, urinary retention, dry mouth & eyes, decreases GI & respiratory secretions | cholinergic blocking agents |
| the immediate use of ___ is recommended in cholinergic crisis | atropine (antimuscarinic) |
| drug may also be used to abolish GI side effects or other muscarinic reactions: but overuse can lead to inadvertent induction of cholinergic crisis | atropine (antimuscarinic) |
| muscarinic receptor blockade, blocks parasympathetic actions of Ach, treats muscarinic agonist poisoning, treats overdose of Bethanechol, cholinesterase inhibitors or ingestion of mushrooms, treats hypermotility dz of GI/IBS, treats bradycardia | atropine(antimuscarinic) |
| dilates pupils for eye exam, used preoperatively to reduce salivation & GI secretions, do not give to pts with angle closure glaucoma, certain types of asthma, liver or renal dysfunction, given IV, tablet, PO, eye solutions | atropine (antimuscarinic) |
| side effects of this include dry mouth, constipation, urinary retention, increased HR, contraindicated in pts with glaucoma | atropine (antimuscarinic) |
| synthetic anticholinergic drug resembles both atropine & diphenhydramine (Benadryl), has anticholinergic & antihistamine properties, used to treat parkinson's dz, phenothiazine induced extrapyramidal reactions | Benztropine Mesylate/Cogentin |
| do not give this to pts with narrow angle glaucoma, myasthenia gravis, urinary retention, hx of PUD, megacolon or prostate hypertrophy, or in children under 3 | Benztropine Mesylate/Cogentin |
| new muscarinic receptor blocker now widely promoted to treat urinary frequency, urgency,& urge, incontinence caused by bladder detrusor over activity, causes lower incidence of dry mouth, do not give to pts w/ narrow angle glaucoma or liver problems, PO | Tolterodine or Detrol |
| constipation, urinary retention, impaired oral mucous membrane, decreased cardiac output are all Nursing Dx. for ____ | anticholinergics |
Created by:
jennk4
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