Adrenergics & Cholinergics

Question 1

What affect do Adrenergic Drugs have on the body?

Answer 1

• will give a “fight-or- flight” response
• “can’t see, can’t pee, can’t spit, can’t shit”
• increased HR, BP, dilated pupils, bronchodilation, decreased urination, decreased GI motility, decreased uterine contraction, and decreased salivation

Question 2

What effect do Cholinergic drugs have on the body?

Answer 2

• “feed, breed, pee, poo”
• promote rest and digest
• decrease HR/ BP
• bronchoconstriction/ vasodilation
• increased urination
• increased GI motility
• increased Uterine contraction
• increased salivation

Question 3

What effect do Adrenergic Blockers have on the body?

Answer 3

Adrenergic blockers will act the SAME as cholinergic drugs.

- will promote a rest and digest response

Question 4

What effect do anticholinergics have on the body?

Answer 4

Anticholinergic drugs will act the SAME as Adrenergic drugs.
- will promote a “fight-or-flight” response

Question 5

Non- selective
Increased HR and BP
Promotes bronchodilation
Is used for allergic reactions and to increase cardiac function.
My side effects include HTN, Tachycardia, & hypoventilation.
What am I?

Answer 5

Epinephrine

Question 6

What are the four types of adrenergic receptors? What do they act on?

Answer 6

Alpha 1- arteriole vasoconstriction, dilates pupils, increases cardiac contractility, increases bladder and prostate contraction
Alpha 2- inhibits norepi relase, promotes vasodilation & dec. BP; decreases GI motility and tone
Beta 1- increases HR, CO, & BP
Beta 2- dilates bronchioles & skeletal muscle blood vessels, inc. blood glucose, dec. GI tone & motility

Question 7

I am Beta 2 receptor selective and promote bronchodilation. I am used to open airways. My side effects include nervousness, jitters, and tachycardia. What drug am I?

Answer 7

Albuterol

Question 8

What nursing interventions should be implemented for patients taking Albuterol?

Answer 8

• assess O2 sat
• monitor respirations
• inform patient that they may feel shakiness or jittery

Question 9

I am selective for an Alpha 2 receptor.
I promote vasodilation and treat HTN.
What drug am I?

Answer 9

Clonidine

Question 10

What nursing interventions should be implemented for patients taking Clonidine?

Answer 10

• assess BP before and after administration of medication

- have patient rise slowly to avoid orthostatic HTN

Question 11

What class of drugs are Alpha 1 Blockers?

Answer 11

• zosin drugs (Prazosin & Doxazosin)

Question 12

What effect will -zosin drugs have on the body? (How they will act, use, side effects, & nursing interventions)

Answer 12

• adrenergic blockers so they will act like cholinergics
• used to treat HTN & BPH
• side effect includes hypotension
• monitor BP and teach patients to rise slowly

Question 13

-OLOL drugs

Answer 13

Beta blockers

Question 14

What affect to Beta 1 blockers have on the body?

Answer 14

• will act like cholinergics
• beta 1 acts on the heart
• beta 1 blockers will decrease BP, & P

Question 15

Metoprolol & Atenolol are two types of ______?

Answer 15

Beta 1 Blockers; they will decrease BP and P

Question 16

For what individuals is Propranolol contraindicated? Why?

Answer 16

Propranolol is contraindicated in individuals with respiratory problems because it promotes bronchoconstriction.

Question 17

Propranolol is a non-selective beta blocker. What does this mean?

Answer 17

This means that propranolol will act on both beta 1 and beta 2 receptors to decrease BP and P and to promote bronchoconstriction.

Question 18

What are the two different types of Cholinergic receptors? What type of tissue do they act on?

Answer 18

Muscarinic- acts on smooth muscle

Nicotinic- acts on skeletal muscle

Question 19

List 3 cholinergics that are selective for Muscarinic receptors.

Answer 19

1. Metoclopramide
2. Pilocarpine
3. Bethanechol

Question 20

Use of Metoclopramide

Answer 20

Increase gastric emptying

Question 21

Use of Pilocarpine?

Answer 21

Promotes pupillary constriction to relieve glaucoma pressure

Question 22

Use for Bethanechol?

Answer 22

used to stimulate urination

Question 23

List 3 nicotinic receptors and their duration of action

Answer 23

1. Neostigmine- short acting
2. Pyridostigmine- moderate acting
3. Edrophonium- short acting for Dx purposes

Question 24

What are the uses of cholinergics that are selective for nicotinic receptors?

Answer 24

• to increase muscle strength in myasthenia gravis

Question 25

What are the major side effects of cholinergics that are selective for nicotinic receptors (neostigmine, pyridostigmine, edrophonium)

Answer 25

- bradycardia | - increased bronchial secretions

Question 26

What is the action and use of Atropine? What class of drugs does it fall under?

Answer 26

Atropine is an anticholinergic so it will act like an adrenergic. - increases P, decreases motility and salivary secretions - used to treat bradycardia, peptic ulcers, used preoperatively to decrease salivation. - Atropine is also the ANTIDOTE for cholinergic crisis.

Question 27

What are the major side effects of the anticholinergic, Atropine? What are the nursing interventions associated with this medication?

Answer 27

Tachycardia, palpitations, blurred vision, dry mouth, abdominal distention, impotence, urinary retention, anticholinergic crisis Monitor v/s, urine output, bowel sounds, & encourage/ provide oral hygiene

Question 28

What are the s/s of anticholinergic crisis?

Answer 28

“Hot as a hare, mad as a hatter, red as a beet, and dry as a bone” - increased temp - confusion, delirium - flushed face - decreased secretions; thirsty

Question 29

What is the primary action of anticholinergics used to treat parkinsonism?

Answer 29

- decreased involuntary movements, tremors, & muscle rigidity

Question 30

Name 2 anticholinergics used to treat Parkinsonism. What are their primary side effects?

Answer 30

Benztropine Trihexyphenidyl S/e similar to other cholinergics

Question 31

``` What are the uses of antihistamines such as scopolamine and dimenhydrinate? What class of drugs do these fall under? ```

Answer 31

Used to tx motion sickness They are anticholinergics

Question 32

What is the primary side effect of Clonidine?

Answer 32

Hypotension

Question 33

What is the affect of dopaminergic receptors? Where are these receptors found?

Answer 33

Located in the renal, mesenteric, coronary, and cerebral arteries Dopaminergic receptors promotes vasodilation to increase blood flow.

Question 34

What are Direct-acting adrenergic agonists? Give two examples

Answer 34

Directly stimulate adrenergic receptors | Ex. Epinephrine, and norepi

Question 35

What are indirect acting adrenergic agonists? Give an example

Answer 35

Indirect acting agonists stimulate the release of norepinephrine from terminal nerve endings. Ex. Amphetamine

Question 36

What are mixed acting adrenergic agonists? Give an example

Answer 36

Stimulate adrenergic receptor sites and stimulates release or norepi at terminal nerve endings.

Question 37

Another name for adrenergic agonist

Answer 37

Sympathomimetics

Question 38

What contraindications and cautions should the nurse be aware of with Epinephrine?

Answer 38

Contraindicated for cardiac dysrhythmias, HTN, hyperthyroidism, DM, & pregnancy

Question 39

Inotropic

Answer 39

Strengthens myocardial contraction, increasing CO

Question 40

Side effects/ adverse rxns of Epinephrine

Answer 40

Cardiac dysrhythmias, palpitations | Tachycardia, HTN, Dizziness, HA, sweating, insomnia, restlessness, tremors, Hyperglycemia

Question 41

Possible drug interactions for Epinephrine and the effect

Answer 41

Beta blockers: dec. epi action Digoxin: cause cardiac dysrhythmias TCAs and MAOIs intensify and prolong the effects of Epi

Question 42

What are sympathomimetics?

Answer 42

Adrenergic agonists

Question 43

Potential drug interactions for Albuterol?

Answer 43

May increase effect with other sympathomimetics (adrenergic agonists), MAOIs, and tricyclic antidepressants Antagonize effect with beta blockers

Question 44

Effects of Alpha 1 Antagonist at receptor site

Answer 44

Adrenergic antagonists will act like cholinergics (“rest and digest affect”) - vasodilation, dizziness - orthostatic HTN, reflex tachycardia - pupil constriction - suppress ejaculation - reduce contraction of smooth muscles in bladder neck and prostate

Question 45

What are the side effects commonly associated with beta blockers?

Answer 45

- bradycardia, hypotension, HA, dizziness, cold extremities, hypoglycemia, and bronchospasm

Question 46

What drug should the nurse have available to treat extravasation and tissue necrosis as a result of IV dopamine complications?

Answer 46

The antidote for IV extravasation of dopamine is phentoamine mesylate (Regitine)

Question 47

SE of Bethanechol

Answer 47

Blurred vision, miosis, Hypotension, bradycardia, sweating, increased salivation and gastric acid, N/V, diarrhea, abdominal cramping, bronchocontriction, cardiac dysrhythmias

Question 48

Nursing interventions for bethanechol

Answer 48

Monitor BP/ HR, teach to rise slowly, auscultate breath sounds for rales, crackles from fluid congestion, monitor for possible cholinergic crisis (OD)

Question 49

For what individuals would a indirect acting cholinergic agonist be contraindicated?

Answer 49

Those with intestinal or urinary obstruction due to increased GI motility and urination

Question 50

For which individuals would Atropine be contraindicated?

Answer 50

Those with glaucoma