Term
| sympathetic nervous system |
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Definition
- adrenergic receptors
- epinephrine
- norepinephrine
- inc. BP; inc. bld flow to the brain, heart, and skeletal muscles
- dec. bld flow to visceral & the skin
- "fight or flight"
- alpha- blood vessels (when stimulated we see vasocontriction)
- beta 1- primarily heart (inc. in rate, contraction, &d conduction)
- beta 2- primarily in lungs & bld vessels (bronchodilatio and perepheral vasodilation)
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Term
| parasympathetic nervous system |
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Definition
- cholonergic receptors
- resting time for CNS
- dilation of bld vessels and dec. hrt rate
- inc. in secreation of digestive enzyme
- constriction of the smooth muscles of the bronchi
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Term
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Definition
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mimic the SNS
wisespread action
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used in emergencies: cardiac arrest, hypotension, bronchospasm, anaphylaxis, heart failure, bleeding, some OB emergencies
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adverse effects- arrhythmias, HTN, palpitations, anginas, nervousness
(all things that you would think might happen if we stimulate the hrt too much)
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interactions- TCAs, MAOIs
use extreme care with calculations of meds (mcg/kg)
monitor VS, ECG (critical care), u/o, CO
allergies, carry epi pen at all times
tolerance can develop
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Term
epinephrine HCL
(Adrenalin) |
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Definition
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Prototype adrenergic drug
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Used in emergencies with anaphylactic reactions, cardiac emergencies, part of the ACLS protocol
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Term
norepinephrine
(Levophed) |
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Definition
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Adrenergic drug that primarily stimulates alpha
“last ditch effort”
“leave ‘em dead Levophed”
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Increases BP
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Causes peripheral vasoconstriction
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NI: tips of toes and fingers become purple from extreme vasoconstriction
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Term
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Definition
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Low doses= good renal profusion
Med. Doses= inc. cardiac output
High doeses= inc. BP (critical care unit)
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Very common drug used to inc. BP in the critical care unit
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In doses higher than 20mcg/kg, the beta receptors are stimulated, but the alpha stimulation may overcome its actions
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NI: results are dependent on the amt of the dose given
Monitor BP closely
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Term
phenylephrine
(Neo-Synephrine) |
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Definition
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Adrenergic drug
Affects alpha receptor
IV
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Potent vasoconstrictor
Nasal decongestant
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Term
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Definition
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Adrenergic drug
Beta stimulator
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Bronchodilator
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Term
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Definition
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Adrenergic drug
Beta stimulator
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Used in shock
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Term
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Definition
Blocks SNS- whole or part
↓BP, ↑ renal profusion
Suppresses pathological response to activity, stress |
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Term
phentolamine mesylate
(Regitine) |
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Definition
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blocks alpha 1 receptor sites
prototype
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Use:
HTN (tumor in adrenal glands)
BPH
Reynaud’s – vasospastic disorder causing discoloration of the fingers/toes, stress & cold are triggers (cause vasodilation so we get better flow into fingers)
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Adverse effects:
Tachycardia
Hypotension (vasodilation, ↓BP)
Dilation of GU smooth muscle
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NI:
Monitor VS
Supine w/ IV Regitine
Change positions slowly
Taper doses
Give w/ food
Take at same time every day
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Term
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Definition
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blocks alpha 1 receptor sites
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Use:
BPH- Benign Prostatic Hyperplasia (enlarged prostate- shrinks tumor to make urinating easier by dilating GU smooth muscle)
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Adverse effects:
Tachycardia
Hypotension (vasodilation, ↓BP)
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NI:
Monitor VS
Change positions slowly
Taper doses
Give w/ food
Take at same time every day
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Term
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Definition
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blocks alpha 1 receptor sites
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Use:
HTN
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Adverse effects:
Tachycardia
Hypotension (vasodilation, ↓BP)
Dilation of GU smooth muscle
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NI:
Monitor VS
Supine w/ IV Regitine
Change positions slowly
Taper doses
Give w/ food
Take at same time every day
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Term
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Definition
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Prototype, nonselective
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Use:
Prevention of migranes
Angina (chest pain)
Post MI
Dysrhythmias
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NI:
Monitor VS, esp. HR
Watch for symptoms of hypoglycemia (w/ DM)
Change position slowly
Taper dose
Avoid hot tubs, hot showers, saunas (vasodilation)
Interact w/ ETOH
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Term
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Definition
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Cardioselective
Very common beta blocker
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Use:
Angina (chest pain)
Post MI
Dysrhythmias
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NI:
Monitor VS, esp. HR
Watch for symptoms of hypoglycemia (w/ DM)
Change position slowly
Taper dose
Avoid hot tubs, hot showers, saunas (vasodilation)
Interact w/ ETOH
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Term
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Definition
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Beta and alpha blockers
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Use:
Angina (chest pain)
Post MI
Dysrhythmias
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NI:
Monitor VS, esp. HR
Watch for symptoms of hypoglycemia (w/ DM)
Change position slowly
Taper dose
Avoid hot tubs, hot showers, saunas (vasodilation)
Interact w/ ETOH
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Term
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Definition
decrease HR
decreast contraction and conduction |
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Term
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Definition
| bronchoconstriction of the smooth muscles of the pulmonary system |
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Term
| cardioselective beta blockers |
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Definition
| allow pts with respiratory disorders to take beta blockers |
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Term
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Definition
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Prototype
Parasympathetic drug
Direct acting cholinergic drug
Action: (mimic parasympathetic system)
↓ HR
↑GI muscle tone
↑ bladder tone
relaxes sphincters
↑ resp secretions
constricts pupils
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Use:
Glaucoma
GI reflux
Neurogenic bladder
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Adverse effects:
Bradycardia
Hypotension
HA
Restlessness
Coma
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NI:
Monitor HR, resp rate
Watch for GI problems
Can exacerbate peptic ulcers
Atropine sulfate- antidote
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Contraindicated: CAD, MI, heart block, intestinal obstruction, resp disorder
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Term
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Definition
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Parasympathetic drug
Direct acting cholinergic drug
Action: (mimic parasympathetic system)
↓ HR
↑GI muscle tone
↑ bladder tone
relaxes sphincters
↑ resp secretions
constricts pupils
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Use:
Urinary retention
Glaucoma
GI reflux
Neurogenic bladder
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Adverse effects:
Bradycardia
Hypotension
HA
Restlessness
Coma
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NI:
Monitor HR, resp rate
Watch for GI problems
Can exacerbate peptic ulcers
Atropine sulfate- antidote
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Contraindicated: CAD, MI, heart block, intestinal obstruction, resp disorder
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Term
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Definition
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Indirect acting cholinergics
Inhibit action of acetylcholinesterase (enzyme that breaks down acetylcholine and improves neuro transmission in the brain) and prolongs the effects of acetylcholine
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Use:
Myasthenia gravis (autoimmune neuromuscular disorder)
Urinary retention
Glaucoma
Bladder distention
Paralytic ileus
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Adverse effects:
Hypotension
Bradycardia
Intestinal spasm
Resp arrest
Vasodilation
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NI:
Watch for signs of neuro toxicity
Monitor resp rate
Assess for abdominal cramping
Measure U/O
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Caution:
Bradycardia
Parkinson’s
Intestinal/bladder obstructions
Resp disorders
Ulcerative colitis
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Term
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Definition
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Indirect acting cholinergics
Inhibit action of acetylcholinesterase (enzyme that breaks down acetylcholine and improves neuro transmission in the brain) and prolongs the effects of acetylcholine
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Use:
Myasthenia gravis (autoimmune neuromuscular disorder)
Used to diagnose MG
Glaucoma
Bladder distention
Paralytic ileus
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Adverse effects:
Hypotension
Bradycardia
Intestinal spasm
Resp arrest
Vasodilation
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NI:
Watch for signs of neuro toxicity
Monitor resp rate
Assess for abdominal cramping
Measure U/O
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Caution:
Bradycardia
Parkinson’s
Intestinal/bladder obstructions
Resp disorders
Ulcerative colitis
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Term
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Definition
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Indirect acting cholinergics
Inhibit action of acetylcholinesterase (enzyme that breaks down acetylcholine and improves neuro transmission in the brain) and prolongs the effects of acetylcholine
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Use:
Alzheimers (doesn’t cure, slows progression)
Myasthenia gravis (autoimmune neuromuscular disorder)
Glaucoma
Bladder distention
Paralytic ileus
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Adverse effects:
Hypotension
Bradycardia
Intestinal spasm
Resp arrest
Vasodilation
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NI:
Watch for signs of neuro toxicity
Monitor resp rate
Assess for abdominal cramping
Measure U/O
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Caution:
Bradycardia
Parkinson’s
Intestinal/bladder obstructions
Resp disorders
Ulcerative colitis
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Term
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Definition
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Prototype
Anticholinergic drug
Blocks parasympathetic nerve impulses by competing w/ acetylcholine for sites on muscarinic receptors
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Use:
Gi disorders that have ↑motility
Bradycardia
Relieve spastic bladder
↓ saliva
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Adverse effects:
Dry mouth (used to be used at preop med to dry mouth out)
Constipation
Tachycardia
Difficult urination
Blurred vision
Confusion
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NI:
Monitor pulse (HR), BP UO
Encourage fluids (causes decrease in secretions)
Provide ice chips
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Caution: glaucoma, hrt dz, paralytic ileus
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Term
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Definition
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Anticholinergic drug
Blocks parasympathetic nerve impulses by competing w/ acetylcholine for sites on muscarinic receptors
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Use:
Gi disorders that have ↑motility
Bradycardia
Relieve spastic bladder
↓ saliva
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Adverse effects:
Dry mouth
Constipation
Tachycardia
Difficult urination
Blurred vision
Confusion
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NI:
Monitor pulse (HR), BP UO
Encourage fluids (causes decrease in secretions)
Provide ice chips
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Caution: glaucoma, hrt dz, paralytic ileus
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Term
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Definition
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Anticholinergic drug
Blocks parasympathetic nerve impulses by competing w/ acetylcholine for sites on muscarinic receptors
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Use:
Gi disorders that have ↑motility
Bradycardia
Relieve spastic bladder
↓ saliva
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Adverse effects:
Dry mouth
Constipation
Tachycardia
Difficult urination
Blurred vision
Confusion
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NI:
Monitor pulse (HR), BP UO
Encourage fluids (causes decrease in secretions)
Provide ice chips
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Caution: glaucoma, hrt dz, paralytic ileus
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