Pharmacology Adrenergic/Cholinergic
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| Effects of parasympathomimetics on specific organs | Constricts pupils, bronchioles, and bladder. Increases secretions, peristalsis, and salivation. decreases heart rate. Dilates blood vessels.
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| Specific effects of Cholinergic Agonists for all organs | Stimulate bladder and GI tone, constrict pupils, increase neuromuscular transmission, decreased heart rate and blood pressure, increased salivary, GI, and bronchial glandular secretions.
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| Cholinergic Agonist: Bethanecol-Urecholine(administration) | Acts on the muscarinic receptor and is used primarily to increase urination (increase urine output). It is poorly absorbed by the GI tract. Client voids 30-90 min after administration. Should be taken on an empty stomach. SubQ or PO.
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| Cholinergic Agonist: Bethanecol-Urecholine (Side effects) | hypotension, bradycardia, blurred vision, excessive salivation, increased gastric acid secretion, abdominal cramps, diarrhea, bronchoconstriction, cardiac dysrhythmias, nausea, vomitting, sweating, flushing, frequent urination, miosis.
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| Cholinergic Agonist: Bethanecol-Urecholine (adverse effects) | orthostatic hypotension, bradycardia, muscle weakness, acute asthmatic attack, heart block, circulatory collapse, cardiac arrest
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| Cholinergic Agonist: Bethanecol-Urecholine (Contraindications/Interactions) | GI/GU obstruction, bradycardia, hypotension, COPD, asthma, peptic ulcer, parkinsonism, antidysrhythmics
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| Anticholinergics: Atropine (uses) | preoperative to reduce salivation, increase heart rate, dilate pupils, as an antispasmodic drug to treat peptic ulcers
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| Patient teaching with anticholinergics | Avoid hot temps,physical exertion,don't use in pts w/ glaucoma,drowsiness is common,avoid etoh,smoking,caffeine,aspirin,use sunglasses for photophobia,dry mouth,<urination,constipation,>fluids,urinate before taking, >oral hygeine, eyedrops=moisten, >fiber
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| Contraindications with anticholinergics | narrow-angle glaucoma, obstructive GI disorders, paralytic ileus, ulcerative colitis, tachycardia, BPH, myasthenia gravis, myocardial ischemia, Renal/hepatic disorders, COPD, heart failure
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| Adrenergic Agonists/Antagonists: Epinephrine (administration) | SubQ, IV, topical, inhalation No PO. Used in emergency to treat anaphylaxis.
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| Adrenergic Agonists/Antagonists: Epinephrine (Pharmacodynamics) | SubQ onset 3-5 min, peak 20 min, duration 1-4 hrs., IV onset immediate, peak 2-5 min, duration 5-10 min, inhal onset 1 min, peak 3-5 min, duration 1-3 hours. increase CO, vasoconstriction, BP, HR, bronchodilation, renal vasoconstriction, decreasing output
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| Adrenergic Agonists/Antagonists: Epinephrine (Indications) | to treat allergic reaction, anaphylaxis, asthma, bronchospasm, severe hypotension, cardiac arrest
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| Adrenergic Agonists/Antagonists: Epinephrine (nursing interventions) | Monitor BP,P,UO.Report tachycardia,palpitations,tremors,dizziness, HTN.Monitor IV infiltration.Antidote:phentolamine mesylate (Regitine)Avoid cold medicines & diet pills if HTN,DM,CAD,or dysrhythmic,when breastfeeding,continuous use of nasal sprays.
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| Adrenergic Agonists/Antagonists: Alpha adrenergic blocker expected response | Vasodilation, dec. BP, reflex tachycardia, miosis, suppresses ejaculation, reduces smooth muscle contraction in bladder neck and prostate gland.
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| Adrenergic Agonists/Antagonists: Nonselective beta adrenergic blocker expected response | decreases HR, reduces force of contractions, constricts bronchioles, contracts uterus, inhibits glycogenolysis (decrease BS)
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| Adrenergic Agonists/Antagonists: General sympathetic responses, specific effects for all organs | dilate pupils, bronchioles,increase HR, constrict blood vessels, relax GI, bladder, and uterus
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| Adrenergic Agonists/Antagonists:Patient teaching for adrenergic beta blockers | decrease HR & BP.Should be used with extreme caution with COPD or asthma.Side effects:bradycardia,hypotension,HA,dizziness, cold extremities, hypoglycemia,bronchospasm,dysrhythmias,flushing,weakness,impotence,dec. libido,depression,pulmonary edema
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| Adrenergic agonists/Antagonists: Lopressor – side effects and adverse reactions | fatigue, weakness, dizziness, n/v, diarrhea, mental changes, nasal stuffiness, impotence, decreased libido, depression, bradycardia, thrombocytopenia, complete heart block, bronchospasm, agranulocytosis
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| Adrenergic agonists/Antagonists: Adrenergic Receptor functions | Alpha1: the arterioles & venules contrict,increasing peripheral resistance & blood return to the heart. Alpha2: increases norepinephrine resulting in vasodilation and decrease BP.Beta1: increases myocardial contractility and HR. Beta2:
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| Know different names for same category: anticholinergics | cholinergic or muscarinic antagonists, antiparasympathetic agents, antimuscarinic agents, antispasmodics
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| Know different names for same category: adrenergic agonists | adrenergics, sympathomimetics, adrenomimetics
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| Know different names for same category: Adrenergic Blockers | adrenergic antagonists, sympatholytics
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| Know different names for same category: Cholinergic agonists | parasympathomimetics, cholinomimetics, cholinergic stimulants, cholinergic agonists
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| Cholinergic agonists: Cholinergic overdose antidote | IV atropine sulfate (0.6-1.2 mg) early signs of overdose include flushing, salivation, sweating, nausea, and abd. cramps
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| Adrenergic Agents: Drug selectivity – selective and nonselective | Selective: blocks alpha1/beta1
Nonselective: blocks alpha1 and alpha2/beta1 and beta2
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