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316 Pharmacology > Exam 1: Drug classifications for ANS > Flashcards

Exam 1: Drug classifications for ANS Flashcards

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1
Q

Drug classification for ANS

A
  • Adrenergic agonists
  • Adrenergic antagonists
  • Cholinergic agonists
  • Anticholinergics
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2
Q

Adrenergic agonists

A

mimic the effects of the Sympathetic nervous system

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3
Q

Adrenergic antagonists

A

inhibit or block the effects of the sympathetic nervous system

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4
Q

Cholinergic agonists

A

mimic the effects of the parasympathetic nervous system

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5
Q

Anticholinergics

A

block the effects of the parasympathetic nervous system

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6
Q

Drug classification of epinephrine

A

adrenergic agonists; sympathomimetics

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7
Q

Indication of epinephrine (adrenalin)

A 
anaphylactic reactions
cardiopulmonary resuscitation 
bradycardia 
bronchospasm 
acute asthma 
hypotension 
shock
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8
Q

Mechanism of action for epinephrine

A

Alpha 1
Beta 1
Beta 2

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9
Q

Primary effect on the body for epinephrine

A

Alpha 1 - increases blood pressure (vasoconstrictive pressor effect)
Beta 1 - cardiac stimulation
Beta 2 - promotes bronchodilator; vasodilation of skeletal muscle vasculature

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10
Q

Routes of administration for epinephrine

A 
IV push, continuous IV infusion 
Intramuscular, Subcutaneous
INH
Intracardiac 
topical, instillation 
DO NOT GIVE PO
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11
Q

Side effects of Epinephrine

A
  • palpitations, tachycardia, angina, hypertensive crisis, pallor, anxiety, cardiac dysrhythmias
  • cerebral hemorrhage, anxiety, tremors
  • hyperglycemia (increases glycogenolysis)
  • pulmonary edema, dyspnea
  • tissue necrosis (extravasation)
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12
Q

ISMP High alert medication

A

A drug which has heightened risk of causing significant patient harm when used in error

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13
Q

epinephrine use caution when

A

Cerebrovascular disease, diabetes, hyperthyroidism, prostate enlargement or urinary retention, glaucoma

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14
Q

Drug interactions to consider when using epinephrine

A
  • Beta blockers, alpha blockers
  • Tricyclic antidepressants (TCAs) because they inhibit neuronal uptake of NE and 5HT
  • MAO inhibitors- because they block uptake of catecholamines and potentiate effects of epinephrine leading to hypertensive crisis
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15
Q

Drug Classification of dopamine (intropin)

A

Adrenergic agonist, sympathomimetics

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16
Q

Indication for dopamine

A
  • improve hemodynamic status in patients with shock & heart failure
  • acute renal failure
  • profound hypotension
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17
Q

trade name for epinephrine

A

Adrenalin, sus-phrine

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18
Q

Trade name for dopamine

A

Intropin

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19
Q

routes of administration for dopamine

A

IV (continuous infusion, administered as mcg/kg/min)

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20
Q

Method of action for dopamine

A

alpha 1
beta 1
Dopaminergic receptor

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21
Q

Low doses of dopamine (2-5 mcg/kg/min) stimulates

A

Dopaminergic receptos

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22
Q

what happens to the body when given low doses of dopamine

A
  • dilation of renal and mesenteric vasculature
  • increase renal perfusion
  • increase urinary output
  • decrease risk of acute renal failure
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23
Q

Moderate doses (5-15 mcg/kg/min) stimulates

A

dopaminergic and beta 1

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24
Q

what happens to the body when given moderate doses of dopamine

A

increase heart rate
increase contractility
increase cardiac output

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25
high doses of dopamine (>20mcg/kg/min) stimulates
Dopaminergic Beta 1 Alpha 1
26
What happens to the body when given high doses of dopamine
Peripheral vasoconstriction | Increase BP
27
Side effects of dopamine
``` Tachycardia Anginal pain Palpitations hypertension cardiac dysrhythmias N/V Tissue necrosis ```
28
drug interactions to consider with dopamine
TCAs & MAO inhibitors: intensify effects of dopamine | Alpha and beta blocking agents: Antagonize effects of dopamine
29
What should be corrected when administering dopamine
correct hypovolemic state before drug is administered
30
administer dopamine via...
Infusion pump only
31
What drug classification is albuterol
adrenergic agonist, sympathomimetics
32
Trade name for albuterol
Proventil | Ventolin
33
Indication for albuterol
Bronchospasm Asthma Bronchitis COPD
34
Routs of administration for albuterol
Inhalation | PO, tablet, syrup
35
Mechanism of action for albuterol
Selective stimulation of BETA 2 receptors | BRONCHODILATION
36
side effects of albuterol
``` tachycardia palpitations cardiac dysrhythmias Increase BP paradoxical bronchospasm (respiratory distress) tremor restlessness Insomnia Headache Nausea/vomiting Fatalities reported with excessive use ```
37
albuterol : systemic and severe run are more common when
Drug is administered PO rather than INH
38
Albuterol: beta 2 stimulation is
relative
39
Albuterol possible beta 1 stimulation may occur and cause
cardiac disease hypertension diabete mellitus glaucoma
40
Drug interaction consideration for albuterol
Caffeine MAOIs and TCAs may increase vasoconstriction actions and cause HTN Effects of beta blocking drugs will be blunted Decrease digoxin levels additive effects with other sympathomimetic drugs
41
Drug classification for phenylephrine
Adrenergic agonists, sympathomimetics
42
Trade name for phenylephrine
Neo-synephrine
43
indication for phenylephrine
used topically as a nasal decongestant systemic decongestant hypotension/shock
44
Routes of administration for phenylephrine
Intranasal/topically (OTC) PO (OTC) IV, in critical care settings to treat severe hypotension and shock
45
Mechanism of action for phenylephrine
selective alpha 1 adrenergic agonists sympathomimetic decongestant -Binds with alpha adrenergic receptor on nasal blood vessels leading to local arterial nasal congestion through the shrinkage or swollen membranes -topical administration produces rapid and intense response
46
side effects of phenylephrine
- Rebound congestions with prolonged topical use - CNS stimulation if topical agent taken in excess - alpha agonist that causes blood vessel constriction, causing BP to increase by systemic vascular resistance - increase peripheral vascular resistance (HR), leading to increase cardiac output - used when coming out of anesthesia
47
Adrenergic blockers that are A through N are
B1 selective
48
Adrenergic blockers that are O through Z
B1 and B2 non selective
49
Drug classification for propranolol
adrenergic blockers
50
Trade name for propranolol
Inderal
51
propranolol is a .....
- non selective beta blocker
52
Indications for propranolol
Hypertension Angina MI (Prevention of repeat infarction Dysrhythmias
53
Route of administration for propranolol
IV | PO
54
Mechanism of action for propranolol
- Blocks beta 1 and Beta 2 receptor - Decrease sympathetic outflow to periphery and suppresses RAAS - decrease BP, HR, force of contraction, CO, and glycogenolysis
55
Side effects for propranolol
Bradycardia, heart block, hypotension, heart failure drowsiness, vertigo mask symptoms of hypoglycemia
56
use propranolol with caution with patients who are
Diabetic severe allergies heart failure depressed
57
Black box warning for propranolol
beta blocker therapy should not be withdrawn abruptly | -Can lead to rebound tachycardia/hypertension
58
Propranolol blocks...
Both beta 1 and beta 2
59
Drug classification for phentolamine
Adrenergic antagonists,
60
Phentolamine blocks
alpha 1
61
trade name for phentolamine
regitine
62
indications for phentolamine
- treatment of pheochromocytoma - prevention of tissue necrosis following extravasation of drugs - hypertensive tyramine crisis with MAO inhibitor
63
Drug classifications that effects the sympathetic nervous system
Adrenergic agonists and antagonists
63
Drug classifications that effects the sympathetic nervous system
Adrenergic agonists and antagonists
64
Drug classifications that effects the sympathetic nervous system
Adrenergic agonists and antagonists
65
Drug classifications that effects the parasympathetic nervous system
Cholinergic agonists and anticholinergics
66
drug classification for bethanechol
cholinergic agonist
67
Trade name for bethanechol
Duvoid, Urecholine
68
Bethanechol is a
Cholenergic agent, parasympathomimetic agent, muscarinic agonist
69
Indication for bethanechol
Treatments of non obstructive urinary retention
70
Route of administration for bethanechol
PO only (SQ preparation has been withdrawn; circulatory collapse if given IV)
71
Mechanism of action for Bethanechol
- acts directly on muscarinic receptors (especially heart), exocrine glands, smooth muscle (Bladder, GI system), and eyes - Includes contraction of the detrusor muscle and relaxation of the external sphincter (leading to micturition)
72
Side effects fo bethanechol
- Bradycardia; Vasodilation, and decrease in BP - Exocrine glands: increased sweating, salivation, bronchial secretions, and gastric acid secretion - Smooth muscles of the lung and GI tract: contraction of the bronchi, increased tone and mobility of GI smooth muscle - Pupil constriction (miosis) and contraction of the ciliary muscle, leading to blurred vision
73
MNEMONIC FOR EFFECTS OF CHOLINERGIC AGENTS
Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction
74
What do cholinergic agents do
Mimic the primary parasympathetic neurotransmitter ACETYLCHOLINE
75
What do anticholinergic agents do?
Inhibit the action of primary parasympathetic neurotransmitter ACETYLCHOLINE
76
Method of action phentolamine
blocks alpha 1 adrenergic Produces brief antagonist of circulating epinephrine and NE, helping to control hypertension brought on by high levels of circulating catecholamine
77
Alpha 1
Vasoconstriction Increase BP increase blood return to heart increase circulation
78
Alpha 2
Inhibits release of NE Decrease vasoconstriction Decrease BP
79
Beta 1
Targets the heart | increase heart rate and contraction
80
Beta 2
Targets the lungs | Relaxation of smooth muscle in bronchi, uterus, peripheral blood vessels
81
subtype of nicotinic receptor
Neuronal | Non-Neuronal
82
Neuronal nicotinic
CNS stimulation | Adrenal medulla stimulation
83
Non-neuronal nicotinic
stimulates contraction of skeletal muscles
84
Muscarinic
- Inhibits cardiac muscle (decrease in HR, contractility, and AV conduction) - Stimulates smooth muscle to contract (pupils, intestine, bronchioles_) - Exocrine glands (respiratory secretion, salivation, lacrimation, sweat
85
What happens when anticholinergics target muscarinic receptors?
Inhibiting muscarinic receptors can lead to vasodilation, inhibit secretion, and inhibit exocrine glands
86
Drug class for atropine
Anticholinergic
87
Indications for atropine
- Over active bladder - Pupillary dilation - Overdose by any Muscarinic agonist - Antidote for organophosphate poisoning - Treatment for heart block, sinus bradycardia or bradycardia caused by anesthetic agents - Pre-operative medication to prevent excessive respiratory secretions and saliva
88
Route of administration for atropine
PO IM IV Instillation
89
Mechanism of action for atropine
``` Muscarinic receptors (cardiac/smooth muscle, exocrine glands) -Blocking all muscarinic effects ```
90
Effects on the body atropine
- increase HR - Decrease GI motility, secretory activity, and GU muscle tone - Ophthalmic mydriasis
91
Side effects for atropine
- Tachycardia/palpitation - nasal congestion, dry mouth, thickening of bronchial secretions - hot, dry, flushed skin; hyperthermia - blurred vision, photophobia' elevated IOP - Nausea, abdominal distention, constipation - Urinary retention - Crosses BBB! Agitation, restlessness, hallucinations, paranoid behavior
92
Mneumonics Atropine side effects
``` A norexia B lurry vision C onstipation/confusion D ry mouth S edation/stasis of urine ```
93
Drug classification: Tolterodine
Anticholinergics
94
Trade name for tolterodine
Detrol
95
Can Epinephrine be given PO?
NO!
96
Drugs that are given IV can cause?
Tissue Necrosis
97
What do you have to be considerate of when giving beta blockers
Whether the patient has diabetes
98
Hypotension can cause
Dizziness Nausea Fatigue
99
High alert medication
Epinephrine | Dopamine
100
what can effect a patient that is taking albuterol
- Caffeine because it may increase risk for adverse effects - Ephedra increases CNS stimulation - St. Johns wort decreases effects of albuterol
101
nursing consideration for phenylephrine
Holiday every 5 days to avoid rebound congestion
102
Phenylephrine can offset symptoms of ?
Anethesia
103
Tolterodine indication
Overactive bladder
104
What does tolterodine do?
Decrease urination frequency, urgency, and incontinence
105
Tolterodine route
PO
106
MoA tolterodine
Blocks muscarinic receptors in the wall of the bladder causing relaxation of urinary bladder tone
107
Tolterodine side effects
``` Dry mouth Dizziness Urinary retention (UTI!!) HTN, Chest pain Abdominal pain Aggravation of dementia Blurred Vision ```
108
What may increase the bioavailability of tolterodine?
Food@
109
What food may increase the serum level of tolterodine
Grapefruit juice
110
Clonidine MoA
Alpha 2
111
Clonidine treats
Hypertension Cancer pain ADHD
112
Levodopa/Caridopa
Treat Parkinson's - Levodopa is converted to dopamine - Caridopa helps prevent levodopa break down
113
Isoproterenol MoA
Beta 1 and Beta 2
114
Isoproterenol helps treat
Bradycardia Asthma/Bronchospasm Heartblock
115
Norepinephrine Moa
Alpha 1 | Beta 1
116
Norepinephrine helps treat
Septic Shock | Hypotension
117
Hypertension may cause
Headache Nausea Fatigue
118
Carvedilol and Labetalol MoA
Beta 1 Beta 2 Alpha 1
119
Carvedilol and Labetalol can treat
Hypertension Tachycardia Broncodilation
120
Atenolol MoA
Beta 1
121
Atenolol can treat
Tachycardia
122
Alpha 1
Vasoconstriction Increase BP Increase Circulation
123
Alpha 2
Inhibits release of NE Vasodilation Decrease BP Decrease Circulation
124
Beta 1
Increase Heart rate | Increase contractility
125
Beta 2
Vasodilation bronchial, Uterus, Peripheral blood vessel
126
Types of nicotinic receptors
Neuronal | Non-Neuronal
127
Neuronal
CNS and adrenal medulla stimulation
128
Non neuronal
Stimulates contraction of skeletal muscle
129
Muscarinic receptors
``` Inhibits Cardiac muscle (Decrease HR, Contractility, av conduction) Stimulates smooth muscle to contract (pupils, intestine, bronchioles) Exocrine glands (Respiratory secretions, salivation, lacrimation, sweat) ```
130
Inhibiting muscarinic can lead to
Vasodilation Pupils dilate, intestine and bronchioles dilate Increased HR, Contractility, AV conduction Inhibits saliva, lacrimation, sweat
131
Prazosin + doxazosin MoA
inhibit alpha 1 ---> vasodilation, decrease HR, decrease Contractility
132
Proazosin and doxazosin help treat
hypertension
133
pyridostigmine MoA
Inhibits cholinesterase which prolongs ACH, increasing stimulation
134
Pyridostigmine causes
Increase muscle tone/improved muscle function Prevention of woman nerve gas toxicity Bradycardia Bronchial/uterine constriction
135
Route of pyridostigmine
PO, IV, IM
136
Donepezil MoA
inhibits acetycholinsterase and stimulates by making more ACH
137
pyridostigmine acts on
Both nicotinic and muscarinic
138
Donepezil helps treat
Dementia, but does not cure it
139
route fo donepezile
PO
140
Ipatropium MoA
Reduces bronchial secretion by acting as a antagonist to Ach
141
Ipatropium indication
Secondary to albuterol, used for asthma, bronchospasm, COPD
142
Tolterodine MoA
Blocks muscarinic receptors on bladder
143
Tolterodine treats
Overactive bladder and decreases urine frequency, urgency, and incontinence
144
Route for tolterodine
PO
145
Side effects for anticholinergic
Cant see, pee, spit, shit
146
Scopolamine moA
Inhibits muscarinic activity | Balances ACH & NE
147
Scopolamine indication
Motion sickness, Excessive oral secretion, motion sickness, drooling
148
Scopolamine route
PO, Transdermal
149
The Parasympathetic nervous system stimulates cranial nerve X, which is responsible for
slowing the heart rate, constricting the airway, and stimulating digestion.
150
Is propanolol lipophilic or lipophobic
lipophilic!! Highly lipid soluble
151
Is carvedilol lipophilic or lipophobic
Lipophilic! it is highly lipid soluble
152
Pheochromocytoma
Over secretion of epinephrine and norepinephrine
153
Side effects phentolamine
Reflex tachycardia | Orthostatic hypotension

316 Pharmacology (19 decks)

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