The Finny- PHARM Flashcards
(311 cards)
1
Q
What is pharmacology?
A
Study of drugs that alter functions of living organisms
• Includes pharmacotherapy, pharmacokinetics, pharmacodynamics
2
Q
Which health care providers are involved in the management, distribution, and education of pharmacology?
A
Doctors
Dietitians
Pharmacists
PAs
NPs
Nurses
RTs
CNAs
3
Q
4 major concepts that assist in understanding pharmacology
A
-Nursing management of drug therapy
-Medication
-Core drug knowledge
-Core patient variables
4
Q
What is core drug knowledge
A
Pharmacotherapeutics
Pharmacokinetics
Pharmacodynamics
Precautions/contraindications
Drug interactions
adverse/side effects
Patient/family teaching
5
Q
What are the core patient variables
A
Culture
Health status
Inherited traits
Life style
Diet
Life span
Environment
Habits
Gender
CHILD LEHG
6
Q
What is nursing management of drug therapy
A
Education and safety
7
Q
How do we maximize therapeutic effects
A
Promote absorption
Appropriate time
Lab values
8
Q
How do we minimize adverse effects
A
Modify admin
Allergies
Contraindications
Safety checks
Assess pt
Lab values
Adverse effects
DC/withhold
MAC SALAD
9
Q
Sources/ types of medications
A
Animal
Plant
Minerals
Synthetic
Semi-synthetic
10
Q
What are the 3 classifications of drug nomenclature
A
therapeutic
physiologic
chemical
11
Q
What classification is categorized by the disease state it is used to treat
A
Therapeutic classification
12
Q
Which classification is categorized by the drugs MOA
A
Pharmacologic
13
Q
Which drug names are lowercase
A
generic
14
Q
Which drug names are uppercase
A
Brand-Trade names
15
Q
What is the USP-NF
A
The United States Pharmacopeia - National Formulary
16
Q
What is the purpose of the USP-NF
A
Sets the standards for drugs / reviews drugs
Not a government agency
17
Q
What information about drugs should be included during pt teaching?
A
Drug name
Reason drug was prescribed
Intended effects
Adverse/ side effects
18
Q
7 parts of a med order
A
Pt name
Order date/time
Name of drug
Dosage
Route
Frequency
HCP signature
19
Q
7 rights of med administration
A
Right:
Pt
Med
Dose
Route
Time
Reason
Documentation
20
Q
What is Pharmacotherapeutics
A
Achievement of the desired therapeutic goal from drug therapy
The indication for giving the drug- right reason
21
Q
What is Pharmacokinetics
A
Effects of the BODY on the drug
absorption
distribution
metabolism
excretion
22
Q
What is Pharmacodynamics
A
The effects of the DRUG on the body
Variables that affect drug action
Toxicology
23
Q
What is enteral
A
By way of the intestines
24
Q
What is Parenteral
A
By way other than the intestines
25
What is absorption
movement of the drug from the site of administration into the bloodstream
26
What factors affect absorption
Dosage
Route
GI Function
Lipid solubility
Blood flow
Surface area
pH
Food
Dr. GLBS fish food
27
What route is absorbed faster than IM and Subcut
IV
28
Geri pH is
more alkaline
29
Geri GI motility is
Slowed
Reduced blood flow
30
What is distribution
Movement of drug into cell
31
What factors affect distribution
Tissue availability
Blood flow
Protein binding
Solubility
32
Does the blood brain barrier have a low or high selectivity
Highly selective
33
Geris lean body mass is
Decreased
34
Geris fat is
Increased
35
Geris body water content is
Reduced
36
Geris protein binding sites are
Reduced
37
Geris BBB is
Less effective
38
What is metabolism
Conversion of the drug into another substance or substances
Metabolites
39
What effect limits drugs effect due to break down by liver
Hepatic first pass effect
40
What INCREASES metabolism
Inducers
41
What DECREASES metabolism
Inhibitors
42
Geris liver is
Decreased in size/ mass
Decreased blood flow- decreased metabolism
43
What is excretion
Removal of the drug
44
What is clearance
Rate of disappearance
Both renal and hepatic
45
Geris renal filtration is
Decreased- reduced blood flow/ decrease in nephrons
46
What is half life
Time it takes for 50% of drug to be eliminated
47
Protein binding
60-89%
Moderate
48
Protein binding
Above 89%
High
49
Protein binding
Below 30%
Low
50
The relation between the effective dose and lethal dose
Therapeutic index
51
In between peak and trough
Therapeutic index
52
Adverse effect can happen if there is not enough_____
for drugs to attach to
Albumin
53
Po drugs absorb where
small intestine
54
What is an agonist
Promote function
Stimulate the cell to act
55
What is an antagonist
Block function
Block something else from attaching to and causing an effect
Antidotes
56
What factors contribute to distribution
Protein binding
Blood flow
Tissue availability
57
Drugs ability to leave the body depends on what
Protein binding
58
What factors affect metabolism
First pass effect
Inducers
Inhibitors
Liver damage/aging
59
Name some inhibitors
Benadryl/ grapefruit
60
Name some inducers
Tobacco/ St. John’s wort
61
A damaged liver causes what
High levels of active drug / toxicity
62
The main mechanism drugs use to cause their effect on the body
Binding with receptors
63
What is the study of biological, chemical, physiologic interactions of a drug in the body
Pharmacodynamics
64
What is receptor theory
Drugs exert their effects by binding with receptors
65
What is a Physiochemical reaction
Binding either stimulates or inhibits normal cell functions
(Agonist vs. antagonist)
Direct
66
Describe changes in the permeability of cell membrane to one or more ions:
Ion channels open or close
(Calcium channel antagonists)
Direct
67
Drugs that modify the synthesis, release, or inactivation of neurohormones that regulate physiologic processes
Acetylcholine
Norepinephrine
(Indirect)
68
Non receptor drugs
Antacids- act chemically
Anticancer Drugs- structurally similar to nutrients required by the body; interfere with normal cell function
Osmotic diuretics- increase osmolarity
Metal chelating agents- combine with toxic metals
69
Variables that affect drug action
Potency
Serum drug level
Therapeutic index
Efficacy
Maintenance vs. loading dose
MEC
P STEMM
70
Drug-diet admin times
30 mins before or after meal
Specific drugs: 1hr before or 2 hrs after
71
What are additive effects
Combine to create a bigger effect than what was originally desired
72
What is synergism
Help each other produce the desired effect
73
What is displacement
When drugs that are high protein bound fight compete for protein binding
One drug displaces another
74
Pt related variables
Preexisting conditions
Ethnicity
Psych factors
Genetics
Weight
Age
Gender
PEP G SWAG
75
What occurs with to much therapeutic effect
Adverse effects
76
What are adverse effects
Undesired response to a drug
77
What drugs have adverse effects
All drugs
78
What is the strongest FDA warning
Black box warning
79
Toxicity results from what
Excessive amounts of a drug
May damage body tissue
80
Name different types of toxicity
cardiotoxicity
ototoxicity
ocular damage
immunotoxicity
hepatotoxicity,
nephrotoxicity,
neurotoxicity
81
Subcut landmarks
the upper posterior area of the arm
Anterior aspects of the thighs
abdomen 2 inches away from the navel
lateral abdomen
82
Subcut needle length and gauge
25-30 G
3/8” - 1”
83
IM landmarks
84
IM needle length and gauge
20-25 G
5/8”-1.5”
85
3 purposes for intra dermal injections
Skin testing (drug/allergy sensitivities)
Determine presence of microorganism
Local anesthesia
86
Intradermal landmarks
Lightly pigmented, thinly keratinized, hairless skin (thinner skin)
Ventral forearm
Outer aspect of the upper arms
Scapular area of back
Upper chest
87
Intradermal equipment
TB or 1mL syringe
1mL calibrated in 0.01 increments (usually 0.01 to 0.1mL injected)
TB syringe most common
26 -27 G
3/8” - 5/8”
88
How do you hold the skin for an intradermal injection
Taut
89
What angle do you insert the needle during an intradermal injection
5-15 degrees
90
Which way should the bevel face during an intradermal injection
Up
91
What should be visible during an intradermal injection
The needle should be visible under the skin
92
What is a bleb or wheal
The bubble that forms during an intradermal injection
93
How should you inject & remove the needle during an intradermal injection
Slowly
94
How long should you massage the area after an intradermal injection
NEVER
95
What is pain
A sensory and emotional experience associated with actual or potential tissue damage
Whatever the patient says it is
96
Pain is based on what
The individuals previous experience and social, environmental, and cultural influences
97
What are noiceptors
Afferent neurons
Place where the sensation of peripheral pain begins
98
Where are nociceptors found
Skin
Muscle
Connective tissue
99
What are the 2 types of nociceptors
A-Delta fibers
C-fibers
100
What fibers are small
A-Delta
101
Which fibers respond to mechanical stimuli
A-Delta
102
Which fibers sense dull pain
C-fibers
103
Which fibers sense sharp pain
A-Delta fibers
104
Which fibers sense burning pain
C-fibers
105
Which fibers respond quickly to acute pain
A-Delta fibers
106
Which fibers are myelinated
A-Delta fibers
107
Which fibers sense pinching pain
A-Delta fibers
108
Which fibers sense stinging pain
A-Delta fibers
109
Which fibers are slow
C-fibers
110
Which fibers are unmyelinated
C-fibers
111
Which fibers respond to mechanical stimuli
A-Delta fibers
112
Which fibers respond to mechanical chemical stimuli
C-fibers
113
Which fibers respond to hormonal stimuli
C-fibers
114
Which fibers respond to thermal stimuli
C-fibers
115
Which fibers sense aching pain
C-fibers
116
Which fibers transmit sensations with touch or temp
A-Delta fibers
117
What med is used for fever pain and inflammation
Ibuprofen
118
What med is used for fever, mild pain, and has no anti-inflammatory actions
Acetaminophen
Para-aminophenol derivative
119
Which med is 99% protein binding
Ibuprofen or acetaminophen
Ibuprofen
120
High doses of acetaminophen can cause what
Compromised renal function
121
What is the antidote for acetaminophen
Acetylcysteine
122
What can increase risk for bleeding in patients taking ibuprofen
(Drug-natural)
Ginger
Garlic
Ginko
Chamomile
123
What pain med is the best choice for those on blood thinners
Acetaminophen
124
What med is the best choice for those with hypersensitivity to aspirin, NSAIDs, and are intolerant to GI
Acetaminophen
125
What legislation:
Designated drugs that must be prescribed by a HCP and separated into prescription and non-prescription classes
1952
Durham-Humphrey amendment
126
What legislation:
Was the first law directed towards controlling addiction
1914
Harrison Narcotic Law
127
What legislation:
Provided regulation regarding the manufacture and distribution of certain drugs
1914
Harrison Narcotic Law
128
What legislation:
Regulated distribution of narcotics and categorized narcotics
1970
Comprehensive Drug Abuse Prevention and Control Act
129
What legislation:
Established the DEA
1970
Comprehensive Drug Abuse Prevention and Control Act
130
What legislation:
Established 5 categories (schedules)
1970
Comprehensive Drug Abuse Prevention and Control Act
131
What is schedule 1
132
What is schedule 2
133
What is schedule 3
134
What is schedule 4
135
What is schedule 5
136
MEDS:
Schedule 1
Heroin
LSD
weed
137
MEDS:
Schedule 2
Opioid analgesic
Morphine
Meperidine (Demerol)
138
MEDS:
Schedule 3
Tylenol with codine
Ketamine
Anabolic steroids
139
MEDS:
Schedule 4
Xanax
valium
Ativan
Ambien
tramadol
pentazocine
anticonvulsants
Muscle relaxers
Sedatives
140
MEDS:
Schedule 5
Antidiarrheal
Antitussives with small amounts of narcotics (codeine)
141
Nursing Implications for scheduled meds
The count: inventory must match
The record: narcotic sheet
Co-signing all discarded and wasted meds: another RN
All controlled substances locked
- narcotics double locked
142
Myths associated with pain
Pain increases as we age
Pain is a psych issue made up in the pts head
Taking an opioid will lead to addiction
Addiction is the most serious adverse effect
143
Major complication arising from morphine administration
Light headedness
Dizziness
Confused
Sedation
Hypotension
N/V
Constipation
Respiratory depression
Fall risk
144
What is PQRST
Provoking factor-cause
Quality- feels like
Radiate/relief- does it move? Any relief?
Severity- scale 1-10
Timing- how long? Constant? Intermittent?
145
Best practice for analgesic dosing:
Morphine
-Assess pain
-Re-assess frequently
-PRN- best if dosed routinely around the clock to ensure constant blood levels of analgesia (joint decision between pt and RN)
146
Best practice for analgesic dosing:
Codine
Assess respiratory function
147
When would you not give codine
When a pt needs to cough to clear airway because it depress cough reflex
148
Education for a pt who is fearful that they will become addicted to pain meds
Educate pt that their chances of becoming addicted if they take the pain med as prescribed are slim to none
149
How is the nervous system divided
Central nervous system (CNS)
Peripheral nervous system (PNS)
150
What system deals with the nerves of the brain and spinal cord
CNS
151
What system deals with the nerves OUTSIDE of the brain and spinal cord
PNS
152
How is the PNS subdivided
Afferent
Efferent
153
What are Afferent neurons
Carry impulses from the periphery to the CNS
154
What are efferent neurons
Carry impulses from the CNS to the periphery
155
How are efferent neurons divided
Somatic
Autonomic
156
Describe somatic
Voluntary
Skeletal muscle control
innervates skeletal muscles and controls voluntary movements
157
Describe autonomic (ANS)
Involuntary
Automatic
controls involuntary activity in smooth muscle, secretory glands and the visceral organs of the body (heart, stomach, kidneys, fallopian tubes)
158
How is the autonomic (ANS) divided
SNS
PSNS
159
What is the main function of the autonomic (ANS)
maintain constant internal environment
respond to stress
repair body tissues
Involuntary control of smooth muscle, heart, exocrine
glands (Glands that produce secretions for the surface of
an organ. Ex. Sweat glands, salivary glands)
160
Adrenergic refers to what
SNS
161
Cholinergic refers to what
PSNS
162
What are neurotransmitters
transmitters of nerve impulses
chemicals that transmit signals from a neuron to a target cell (across a synapse)
163
neurotransmitters bind with what
receptors on an effector organ/tissue to bring about an action of respective NS
164
What is an effector organ
an organ or cell that carries out a response from a nerve impulse
165
Are neurotransmitters exogenous or endogenous
Endogenous
chemicals that originate inside the body
166
The primary neurotransmitters in the SNS
norepinephrine (NE)
epinephrine (Epi)
167
The primary neurotransmitters in the PSNS
acetylcholine (ACh)
168
Most common NT of SNS
Norepinephrine
169
Mainly made in adrenal medulla
(made from norepi)
Epinephrine
170
Both NT & hormone
Epinephrine
Norepinephrine
171
Acts more like a hormone
(although sm. amounts made in nerve)
Epinephrine
172
Mostly made inside nerve axons
Norepinephrine
173
Synthesized from dopamine and released into blood as hormone
Norepinephrine
174
Acts mostly on alpha receptors
Norepinephrine
175
Acts on both alpha and beta receptors
Epinephrine
176
Only released during times of stress
Epinephrine
177
continually released into circulation at low levels as hormone
Norepinephrine
178
used for treating:
low BP assoc w/ septic shock
ER tx of allergic reactions
eye surgery to maintain dilation
Epinephrine
179
Most prevalent NT in body
Acetylcholine
180
NT Dominated by the PSNS
Acetylcholine
181
NT Crucial for arousal, learning, memory and motor function
Acetylcholine
182
Binds to muscarinic receptors
parasymp response
Acetylcholine
183
acts as an excitatory NT in skeletal muscle
Acetylcholine
184
Names for adrenergic drugs
adrenergic neurotransmitter (NE)= Norepinephrine
sympathomimetics
adrenergic agonists
alpha or beta adrenergic agonists
adrenergic
185
Names for Cholinergic drugs
Cholinergic neurotransmitters= Acetylcholine
parasympathomimetics
cholinomimetic
cholinergic agonists
cholinergic
186
What receptor does Acetylcholine attach to to bring about a PSNS response
muscarinic
187
What receptor does Acetylcholine attach to to bring about excitatory muscle contraction
Nicotinic
188
Direct acting drugs do what
directly stimulate receptor
189
Indirect acting drugs do what
stimulate neurotransmitter to be released and attach to receptor site
190
Adrenergic Receptors: action
Alpha 1 receptors
Vasoconstriction
191
Adrenergic Receptors: action
Alpha 2 receptors
Stop norepinephrine
192
Adrenergic Receptors: action
Beta 1 receptors
Tachycardia
193
Adrenergic Receptors: action
Beta 2 receptors
bronchodilation
194
alpha 2 agonist do what
lower blood pressure
Because the function of the alpha 2 receptor is
to stop NE (a vasoconstrictor).
So, in alpha 2 receptors, you would want an agonist to
promote the function of vasodilation which in
turn will then lower blood pressure.
195
Adrenergic Agonist Drugs:
Are absorbed how?
Rapidly after injection
196
In ER situations Adrenergic Agonist Drugs are given how
IV for rapid onset
197
Adrenergic Agonist Drugs can not be given by what route
PO
198
Adrenergic Agonist Drugs duration
Short
199
Can Adrenergic Agonist Drugs pass the BBB
No
200
Adrenergic Agonist Drugs lose effectiveness if given with what type of drug
Adrenergic Antagonists
201
Adrenergic Agonist Drugs cause increased risk of HTN if given with what meds
meds that increase HTN including OTC and herbal therapies (caffeine)
202
Nursing implications for Adrenergic Agonist Drugs
establish baseline status
(pulse, BP, lung sounds, RR, urine output, lab tests)
Monitor pt response closely
203
Nonselective adrenergic agonist
Epinephrine
204
Beta 2 agonist
Albuterol
205
Alpha 2 adrenergic agonist
Clonidine
206
What does it mean if a drug is nonselective
All receptors can be activated
207
Epinephrine Pharmacotherapeutics
Shock
Cardiac emergencies
Asthma
Used for tx low BP assoc w/ septic shock, ER tx of allergic reactions, & also used during eye surgery to maintain dilation
208
Epinephrine stimulate which adrenergic receptors
ALL
209
Epinephrine causes what
increased BP
increased HR & force of contraction
hyperglycemia
bronchodilation
vasoconstriction of arterioles in the skin mucosa and most viscera
210
Adverse effects of epinephrine
nervousness
restlessness
tremors
insomnia
angina
arrhythmias
HTN
tachycardia
211
Classification of epinephrine
nonselective adrenergic agonist
212
Trade name for norepinephrine
Levophed
213
Classification of norepinephrine
adrenergic agonist
With predominate alpha agonist effects
214
Pharmacotherapeutics of norepinephrine
Severe hypotension
215
Pharmacodynamics of norepinephrine
Has predominate alpha agonist effects and results in potent peripheral arterial vasoconstriction.
Results in increased BP (more than it increases HR, contraction or CO) Causes reduced renal blood flow (which limits long term use)
216
Pt teaching for adrenergic agonists
If you are receiving IV adrenergic drugs to stimulate
your heart or raise BP:
frequent cardiac monitoring,
HR, BP, urine output are necessary.
217
Pt teaching for diabetic pts taking adrenergic agonists
monitor your glucose levels carefully because adrenergic medication may elevate them
218
Adverse effects of adrenergic agonists
diminished renal perfusion and decreased
urine output
decreased liver perfusion with subsequent liver damage due to vasopressor action
cardiac dysrhythmias due to beta1 activity
Hyperglycemia, hypokalemia due to beta1 activity
Severe hypertension and reflex bradycardia
Limb ischemia due to profound vasoconstriction
219
Beta-Adrenergic Antagonists do what
Prevent stimulation of SNS by inhibiting catecholamines (epi & norepi)
220
How are Beta-Adrenergic Antagonists grouped
according to their selectiveness
(selective or nonselective)
221
Nonselective Beta-Adrenergic Antagonists affect what
Beta 1 receptor sites (mainly in heart)
Beta 2 receptor sites (bronchi, blood vessels, uterus)
[(blocks) Bronchodilation]
222
Selective Beta-Adrenergic Antagonists affect what
Specific receptor site
Primarily affect beta 1
Tachycardia, inotropy (increased force of contraction)
223
Beta-Adrenergic Antagonists end in what
-lol
224
Beta-Adrenergic Antagonists Pharmacotherapeutics
Angina
MI
HTN
Heart failure
Dysrhythmias
225
Beta adrenergic antagonists action
Antagonizes (blocks) beta receptor sites
226
Selective Beta adrenergic antagonists what happens with higher doses
cardioselectivity is diminished
May block beta 2 receptors
227
Beta adrenergic antagonists cause what
Decreased
HR
Force of contractions
Rate of a-v conduction
Side effects
Lethargy
CHF
Decreased BP
Depression
228
metoprolol is a what
Selective beta 1 adrenergic antagonists
229
metoprolol Pharmacotherapeutics
Treatment of arrhythmias, HTN, chronic angina, controlled HF.
230
metoprolol does what
Decreases HR & contractility, slows conduction, suppresses automaticity, and decreases cardiac output.
May block beta 2 receptors in high doses
231
metoprolol contraindications
Abrupt cessation of med will cause an exacerbation of angina. MI may occur
232
Maximizing therapeutic effects of Beta adrenergic antagonists
Do not abruptly stop medication
233
Minimizing adverse effects of Beta adrenergic antagonists
Prior to dose: check the apical and peripheral
pulses.
– Monitor blood pressure, cardiac rhythm
234
Teaching for diabetic pts taking Beta adrenergic antagonists
Check blood sugar because Beta adrenergic antagonists can mask signs of hypoglycemia
235
Indirect acting cholinergic agonists drug
Neostigmine
236
Cholinergic antagonist
Atropine
237
When Acetylcholine attaches to a receptor, that receptor is always a what
A cholinergic receptor
Either muscarinic or nicotinic
238
2 types of cholinergic receptors
Muscarinic
Nicotinic
239
What are muscarinic receptors
Stimulated by Ach & muscarine (alkaloid substance from mushrooms)
bethanechol chloride
Vasodilation & perfusion of organs.
240
What are nicotinic receptors
Stimulated by nicotine (plant alkaloid) but will
respond to ACh
241
Nicotinic-N (neuronal-type) receptor stimulation results in what
the release of Epinephrine
242
Nicotinic-M stimulation results in what
muscle contraction
243
What NS dominates, maintains homeostasis/internal environment
parasympathetic
244
Which NS dilates pupils
SNS
245
Which NS causes tears to flow
PSNS
246
Which NS constricts pupils
PSNS
247
Which NS thickens saliva
SNS
248
Which NS increases HR
SNS
249
Which NS increases watery saliva
PSNS
250
Which NS constricts bronchioles and increases secretions
PSNS
251
Which NS dilates the coronary artery
SNS
252
Which NS dilates the trachea and bronchioles
SNS
253
Which NS slows HR
PSNS
254
Which NS causes the coronary artery to constrict
PSNS
255
Which NS causes the GI to produce more secretions
PSNS
256
Which NS increases GI motility
PSNS
257
Which NS produces sweat
SNS
258
Which NS constricts blood vessels in the skin and mucous membranes
SNS
259
Which NS decreases GI tone and mobility
SNS
260
Which NS causes ejaculation in men
SNS
261
Which NF contracts the lower colon
PSNS
262
Which NS contracts the bladder and ureters
PSNS
263
Which NF stimulates erection in men
PSNS
264
Which NS contracts sphincters
SNS
265
Which NS relaxes the uterus and bladder
SNS
266
Neurotransmitters transmit signals from ___ to ____
Neurons to target cells
267
What is the most prevalent NT in the body
ACh
268
Which NT is dominated by the PSNS
ACh
269
Which NT is crucial for arousal, learning, memory, and motor function
ACh
270
Which NT transmits parasympathetic signals to end organs
ACh
271
Which NT will act as excitatory NT in skeletal muscle (nicotinic)
ACh
272
What are the muscarinic receptors
M1-M5
273
What do muscarinic receptors do
vasodilation and perfusion of organs
decrease BP
274
Which receptors are stimulated by nicotine but will respond to ACh
Nicotinic
275
What are the 2 nicotinic receptors
Nicotinic-N (neuronal type)
Nicotinic-M (muscle type)
276
Nicotinic-N stimulation results in what
The release of epinephrine
277
Nicotinic-M stimulation results in what
Skeletal muscle contraction
278
What do Adrenergic Agonists do
Stimulate all adrenergic receptors
Increase:
BP
HR
Inotropy
Hyperglycemia
Bronchodilation
Vasoconstriction of arterioles in skin
To low BP in association with septic shock
Asthma
Cardiac emergencies
ER tx of anaphylactic shock
Eye surgery to maintain dilation
279
What is the sub classification of epinephrine
Nonselective adrenergic agonists
280
What is the sub classification of norepinephrine
Adrenergic agonist with predominant alpha agonist effects
281
What does norepinephrine do
Helps with severe hypotension
Predominant alpha agonist effects result in potent peripheral arteriole vasoconstriction
Results in:
Increase BP
Can cause reduced renal blood flow
282
What is metoprolol sub classification
Beta adrenergic antagonist (Beta Blocker)
Selective to Beta 1
283
What does metoprolol do
Antagonizes beta receptor sites
Cardioselectivity is diminished with higher doses and will cause activity at Beta 2 receptors
- causing lung constriction
Tx:
Arrhythmias
HTN
Chronic angina
Controlled HF
Decreases HR and contractility
Slows conduction
Suppresses
Automaticity
Decreases cardiac output
284
What is propranolol
Adrenergic antagonist
285
Is propranolol selective or nonselective
Nonselective
286
What does propranolol do
Antagonizes beta receptor sites
287
What is neostigmine
indirect acting Cholinergic agonist
288
What is the sub classification of neostigmine
Indirect acting cholinergic agonist
289
What is bethanechol chloride
Direct acting cholinergic agonist
290
What does bethanecol chloride do
TX:
Urinary retention- increase muscle tone in bladder to allow for bladder emptying
Helps you pee
291
What is atropine
Cholinergic antagonist
292
What does atropine do
Helps clear secretions
specifically targets muscarinic cholinergic receptors
Antidote for overdose of cholinergic agonist:
Strong inhibitor of cholinergic receptors
-Brings pt back to baseline
Increases HR
Decrease secretions
Enlarged pupils
Contracts bladder and GI
Decrease GI motility
Drowsiness
293
What happens when you stimulate cholinergic receptors in the eye
Pupils constrict
294
What happens when you stimulate cholinergic receptors in the GI
Increase secretions
Increase motility
Lower colon contracts
295
What happens when you stimulate cholinergic receptors in the GU
Ureters and bladder contract
Increased urine output
Erection in men
296
What causes cholinergic crisis
Too much cholinergic stimulation (agonists)
297
What is an issue in cholinergic crisis
Respiratory compromise
298
S/S of cholinergic crisis
Muscle weakness - prolonged contraction
Slows breathing
Other parasympathetic effects
299
What is the antidote for cholinergic agonists
Atropine
300
What are excessive effects of atropine
Mad as a hatter- confusion/ delirium
Blind as a bat- pupils constrict
Red as a beet- flushed face, tachycardia
Dry as a bone- decreased secretions, thirsty
301
How do small doses of atropine effect the body
Bradycardia
Decreased secretions
- gets rid of death rattle, but can cause mucus plug
302
How do high doses of atropine effect the body
Tachycardia
303
Beta adrenergic antagonist inhibit what
Catecholamines
304
How are beta adrenergic antagonists grouped
By their selectiveness
305
Adverse side effects of metoprolol
Common:
bradycardia
Hypotension
Depression
Serious:
Bronchoconstriction
Bronchospasm
306
Common side effects of any cholinergic antagonist
Dry mouth
Constipation
Urinary retention
Blurred vision
307
Cholinergic antagonist prototype
Atropine
308
What herbal/ OTC medications increase the effectiveness of atropine
Senna (herbal laxative)
Aloe
309
What do you assess for in Geri’s taking atropine
Cholinergic antagonists
Increased temp - Due to suppression of perspiration and heat loss
Nervousness
Weakness
Confusion
Excitement
310
What do you assess for in kids taking cholinergic antagonists
Increased temp
Hyperpyrexia
Due to suppression of perspiration and heat loss
311
Atropine teaching
Avoid high temps
Drink water frequently
Rinse mouth frequently
Hard candy- dry mouth
Void before taking medication
Visit ophthalmologist regularly
Notify HCP- for fever or severe weakness
