Adrenergic & Cholinergic Drugs

Question 1

All tissues within the body, except skeletal muscles, are innervated by what?

Answer 1

Autonomic nervous system (Sympathetic or Parasympathetic)

Question 2

Sympathetic discharge causes…

Answer 2

Increased CO (increased HR & contractility)
Decreased visceral blood flow, increased skeletal blood
Peripheral vasoCONSTRICTION
Increased cellular metabolism
Bronchial RELAXATION (decreased resistance)

Question 3

Parasympathetic discharge causes…

Answer 3

Slowed heart rate and contractility
Increased digestion/absorption
Peripheral vasoDILATION
Bronchial CONSTRICTION (increased resistance)

Question 4

Neurotransmitters involved in ANS

Answer 4

Acetylcholine
Epinephrine & Norepinephrine (SNS - released from adrenal medulla)

Question 5

Cholinergic receptors include:

Answer 5

Nicotinic & Muscarinic receptors

Question 6

Adrenergic receptors include:

Answer 6

Alpha-1, Alpha-2, Beta-1, Beta-2 & Beta-3

Question 7

Cholinergic Stimulants

Answer 7

Direct - Bind to cholinergic receptors & activate them

Indirect - Increase activity at synapses by inhibiting acetylcholinersterase enzyme (enzyme that destroys ACh)

Question 8

What kind of conditions are Cholinergic Stimulants used to treat?

Answer 8

Alzheimer Disease, GI/Bladder issues, Glaucoma, Myasthenia Gravis, & Neuromuscular blockages

Question 9

Adverse Effects of Cholinergic Stimulants

Answer 9

GI distress, increased salivation, bronchoCONSTRICTION, bradycardia, difficulty with visual accomodation, & increased sweating

Question 10

What are Anti-Nicotinic (Anti-cholinergic) Drugs used for?

Answer 10

Hypertension, Block skeletal NMJ (anesthesia)

Question 11

What are Anti-Muscarinic (Anti-cholinergic) Drugs used for?

Answer 11

Gi disorders (IBS), Parkinson’s, Cardiovascular issues (Atropine), Motion sickness, Preoperative medications, UTI, RTI, and pupil dilation

Question 12

Anticholinergic Side Effects

Answer 12

Can’t see, Can’t pee, Can’t poo

Blurry vision, Urinary Retension, & Constipation
Dry mouth, Tachycardia, Confusion, Dizziness, Nervousness & Drowsiness

Question 13

Alpha-1 Selective Agonists

Answer 13

Bind directly to alpha-1 on smooth muscle receptors to activate them and cause vasoCONSTRICTION & CONTRACTION)

Treat: Hypotension, nasal congestion, and SVT by decreasing heart rate and constricting vasculature in upper respiratory mucosa

Question 14

Side Effects of Alpha-1 Agonists

Answer 14

Increased Blood Pressure
Headache
Decreased Heart Rate
Chest Pain
Difficulty Breathing
Nervousness

Question 15

Alpha-2 Selective Agonists

Answer 15

Bind directly to alpha-2 receptors at CNS synapses (Brain/SC)

Treat: Hypertension & spasticity

Question 16

Side Effects of Alpha-2 Agonists

Answer 16

Dizziness, drowsiness, dry mouth, difficulty breathing, unusually slow HR, fainting

Toxicity or overdose

Question 17

Beta-1 Selective Agonists

Answer 17

Bind to beta-1 receptors on myocardium and cause increased HR and myocardial contractility

Treat: Emergency situations and short term CHF requiring increased CO

Question 18

Side Effects of Beta-1 Agonists

Answer 18

Chest pain, cardiac arrhythmias, SOB, and difficulty breathing

Question 19

Beta-2 Selective Agonists

Answer 19

Bind to beta-2 receptors on bronchiole smooth muscle to cause relaxation and DILATION

Treat: Spasm and constriction associated with Asthma, Bronchitis, and Emphysema

Bronchodilator example: Ventolin

Question 20

Side Effects of Beta-2 Agonists

Answer 20

Nervousness, restlessness & trembling

Question 21

Mixed Alpha/Beta Agonists

Answer 21

Stimulate both receptors and cause nervous system excitability.

Examples: Epinephrine & ephedrine

Question 22

Side Effects of Mixed Alpha/Beta Agonists

Answer 22

Restlessness, Anxiety, HTN & Arrhythmias

Question 23

What are Adrenergic Antagonists referred to as?

Answer 23

Sympatholytic drugs – Block receptors that would normally cause sympathetic responses

Question 24

Alpha Antagonists

Answer 24

Reduce peripheral vascular tone - Cause VASODILATION by blocking receptors. Primarily used to treat HTN by reducing peripheral vascular resistance

Question 25

Beta Antagonists

Answer 25

Decrease contractility of the heart and decrease heart rate by blocking receptors. Used to treat HTN, arrhythmias, angina pectoris, s/p MI, CHF Cardioselective only bind to beta-1 receptors

Question 26

What occurs if a drug is not selective for beta or alpha receptors?

Answer 26

May bind to both receptor types and cause bronchoconstriction along with increased heart rate

Question 26

What occurs if a drug is not selective for beta or alpha receptors?

Answer 26

May bind to both receptor types and cause bronchoconstriction along with increased heart rate

Question 27

Adverse effects of Alpha Antagonists

Answer 27

Reflex Tachycardia (compensation for when BP drops) Orthostatic Hypotension (dizziness & syncope)

Question 28

Adverse effects of Beta Antagonists

Answer 28

Respiratory distress (when nonselective) Excessive depression of cardiac function Orthostatic Hypotension Depression, Lethargy, Sleep Disorders Blunted HR response to exercise