Term
|
Definition
Generally end in
-ide -one
Promote excretion of H20 and electrolytes |
|
|
Term
|
Definition
Thiazides
Loop
Potassium Sparing |
|
|
Term
Thiazide
Mechanism of Action |
|
Definition
Inhibits Na Cl transporter in distal tubule
- less electrolyte loss |
|
|
Term
Thiazide
Therapeutic Effects |
|
Definition
-Excretion of Na+, Cl-, K+ and H20
-Treat edema
-SULFA derivative |
|
|
Term
|
Definition
-Hypokalemia
-HA, dizziness, worsening of insulin resistance |
|
|
Term
|
Definition
Hydrodiuril
(hydrochlorothiazide)
-most common
-also used to stop Ca based renal stones
-may be used in DI |
|
|
Term
Thiazide
Nursing Considerations |
|
Definition
-Avoid if SULFA allergy
-Monitor CBG
-Monitor I&O
-Orthostatic hypotension common
-Avoid NSAIDs
-Monitor digoxin levels closely |
|
|
Term
Loop Diuretics
Mechanism of Action |
|
Definition
| Inhibit Na+ Cl- resorption in loop of Henle H2O follows Na+ Cl- |
|
|
Term
Loop Diuretics
Therapeutic Effects |
|
Definition
-Potent diuresis resulting in substantial fluid loss
-treats edema associated w/ CHF and hepatic/renal disease |
|
|
Term
Loop Diuretics
Adverse Effects
|
|
Definition
-Hypokalemia
-Metabolic alkalosis
-Dehydration (hypovolemia) leading to hypotension
-Dose related hearing loss (ototoxicity) |
|
|
Term
|
Definition
|
|
Term
Loop Diruetics
Nursing Considerations |
|
Definition
-Monitor I&O, BP and Electrolytes
-Monitor effects of Lanoxin (digoxin) and Lithium
- Assess for
- dehydration
- hypotension
- Arrhythmias
- Blood glucose control
- Tinnitus
- •Increased w/ cisplatin and / or aminoglycoside use
|
|
|
Term
Loop Diuretics
Short Acting |
|
Definition
Bumex (bumetanide)
-Lasts only 40 minutes
-40 times more potent thatn Lasix |
|
|
Term
Loop Diuretics
Important Actions |
|
Definition
| If on repeated loop diuretics put the pt on a tele monitor |
|
|
Term
Potassium Sparing Diuretics
Mechanism of Action |
|
Definition
Urinary excretion of Na+/ H2O but decreased excretion of K+
-Sever hyperkalemia can occur |
|
|
Term
Potassium Sparing Diuretics
Therapeutic Effects |
|
Definition
-Diuresis
-Decreased K+ excretion
-Have weaker diuretic and anti-HTN effects
-not used much for BP mgmt
-Seen more commonly in combination therapies to balance K loss with thiazides
|
|
|
Term
|
Most neuropharmacologic drugs act by altering?
|
|
Definition
|
Synaptic Transmission because they are more selective, because synapses differ from one another, but all axon are the same.
|
|
|
Term
|
Drugs that activate receptors are called?
|
|
Definition
|
|
Term
| Drugs that prevent receptor activation are called? |
|
Definition
|
|
Term
|
The autonomic nervous system is divided into the….
|
|
Definition
| Parasympathetic and sympathetic nervous systems |
|
|
Term
|
The autonomic nervous system has three primary functions…
|
|
Definition
|
1.) regulation of the heart
2.) regulation of secretory glands
3.) regulation of smooth muscle
|
|
|
Term
| The PNS uses which 3 neurotransmitters? |
|
Definition
|
1.) acetylcholine
2.) norepinepherine
3.) epinepherine
|
|
|
Term
|
The receptors of the PNS are divided into….
|
|
Definition
|
Cholinergic and Adrenergic
|
|
|
Term
|
Cholinergic receptors are activated by?
|
|
Definition
|
|
Term
|
Adrenergic receptors are activated by?
|
|
Definition
|
Epinepherine and norepinepherine
|
|
|
Term
|
The cholinergic receptors (activated by acetylcholine) are divided further divided into 3 receptor subtypes called?
|
|
Definition
|
1.) Nicotinic N (Neuronal) receptors
2.) Nicotinic M (Muscle) receptors
3.) Muscarinic- This is the biggie!
|
|
|
Term
|
Nicotinic N receptors control what?
|
|
Definition
|
Promote ganglionic transmission at all ganglia of the sympathetic and parasympathetic nervous systems and promotes the release of epinepherine from the adrenal medulla.
|
|
|
Term
|
Nicotinic M receptors control what?
|
|
Definition
|
The contraction of skeletal muscle.
|
|
|
Term
|
Muscarinic receptors control what?
|
|
Definition
|
•Increased glandular secretion
•Contraction of smooth muscle in the bronchi and GI tract
•Slowing of the HR
•Contraction of sphincter muscle of the iris (causes iris constriction)
•Contraction of ciliary muscle (focuses on near vision)
•Dilation of blood vessels
•Voiding of bladder
|
|
|
Term
|
Adrenergic receptors are divided into 5 subtypes called?
|
|
Definition
|
• Alpha 1
• Alpha 2
• Beta 1
• Beta 2
•Dopamine too!
|
|
|
Term
|
•Activation of Alpha 1 receptors causes?
|
|
Definition
|
•Mydriasis (dilation of pupil)
•Artery constriction
•Vein constriction
•Ejaculation
•Prostate contraction
•Bladder muscle contraction
|
|
|
Term
|
Activation of Alpha 2 receptors causes?
|
|
Definition
|
Inhibits transmitter release
|
|
|
Term
|
Activation of Beta 1 receptors causes?
|
|
Definition
|
•Increased HR
•Increased force of contraction
•Increased AV conduction velocity
•Renin release
•ACTS MOSTLY ON HEART!
|
|
|
Term
|
Activation of Beta 2 receptors causes?
|
|
Definition
|
•Arteriole (heart, lung, skeletal muscle) dilation
•Bronchial dilation (Think beta 2 (2 lungs))
•Uterine relaxation
•Liver glycogenesis
•Skeletal muscle contraction
•glycogenesis
|
|
|
Term
|
Beta 2 receptors can only be activated by which neurotransmitter?
|
|
Definition
|
•Epinepherine.
•This makes sense because the actions caused by activating beta 2 are good for “Fight or Flight”
|
|
|
Term
|
Epinepherine can activate which receptors?
|
|
Definition
|
All alpha and beta receptors. But not dopamine
|
|
|
Term
|
Norepinepherine can activate which receptor subtypes?
|
|
Definition
|
•Alpha 1
•Alpha 2
•Beta 1
|
|
|
Term
|
Dopamine can activate which receptor subtypes?
|
|
Definition
|
•Dopamine
•Alpha 1
•Beta 1
•*Dopamine can only activate Dopamine*
|
|
|
Term
|
Bethanechol is what kind of drug?
|
|
Definition
|
|
Term
|
Bethanechol causes what actions?
|
|
Definition
|
•Bradycardia
•Increased sweating, salivation, bronchial secretions, and gastric acid
•Promotes contraction of lung and GI tract
•Bladder emptying
•Vessel dilation
•Miosis
•Accomadation for near vision
|
|
|
Term
|
Bethanechol is mainly used for?
|
|
Definition
|
•Urinary retention (that isn’t caused by an obstruction)
•Has been used on an investigational basis to treat gastroesophageal reflux and other disorders associated with GI paralysis (but not with an obstruction).
|
|
|
Term
|
Why should you not use bethanechol with urinary retention or GI paralysis that is caused by an obstruction?
|
|
Definition
|
Because Bethanechol promotes contraction of these muscles and can cause damage if an obstruction is present.
|
|
|
Term
|
Adverse effects of bethanechol are?
|
|
Definition
|
•Hypotension (caused by vasodilation)
•Bradycardia
•Excessive salivation
•Increased secretion of gastric acid
•Abdominal cramps
•diarrhea
|
|
|
Term
|
Bethanechol is contraindicated for pateints with?
|
|
Definition
|
•Low BP •Low CO
•Gastric ulcers (because of the increase of gastric secretions)
•Intestinal obstruction •Pts recovering from recent bowel surgery
•Urinary tract obstruction •Bladder wall weakness
•Asthma •And hyperthyroid patients
|
|
|
Term
|
Why is bethanechol contraindicated in patients with hyperthyroidism?
|
|
Definition
|
Because it can cause dysrhythmias.
|
|
|
Term
|
What kind of drug is atropine?
|
|
Definition
|
|
Term
|
Atropine causes what to happen?
|
|
Definition
|
•Increase HR
•Decrease secretion from salivary, bronchial, sweat glands, and the acid secreting cells of the stomach
•Relaxes the bronchi •Decreases urinary bladder tone
•Decreased GI motility and tone •Mydriasis- Pupil dilation
•Focuses lens on far vision •CNS excitation
|
|
|
Term
|
Toxic doses of Atropine causes what side effects?
|
|
Definition
|
•Hallucinations •Delerium
•Coma •Respiratory arrest
•Death
|
|
|
Term
|
Treatment of what diseases is not recommended because higher doses are needed to treat these?
|
|
Definition
|
•Asthma and Peptic ulcer disease. The increased dosage to treat these can cause serious side effects.
|
|
|
Term
|
Atropine can be used for what?
|
|
Definition
|
•Increase HR so can be used as a preanesthetic med
•Can cause mydraisis and paralysis of cilliary muscle which can be used in eye exams and occular surgery
•Increase HR in bradycardia
•Can decrease GI tone and motility in hyperactive bowel issues like mild dysentry or diverticulitis
•*Can reverse all signs of muscarinic poisioning*
•Can be used to treat biliary colic
|
|
|
Term
|
What are the adverse effects of Atropine?
|
|
Definition
|
•Dry mouth •Blurred vision •Photophobia
•Increased Intraoccular pressure •Constipation
•Urinary hesitansy and retention •Tachycardia
•Anhidrosis (absence of sweat) •Asthma exacerbation
|
|
|
Term
|
Atropine is contraindicated for patients with?
|
|
Definition
•Glaucoma •Over the age of 40
•Intestinal atony •Asthma
•Pre-existing tachycardia
|
|
|
Term
|
Atropine has drug-drug interactions with?
|
|
Definition
•Antihistamines
•Phenothiazine
•Antipsychotics
•Tricyclic antidepressants
|
|
|
Term
|
Anticholinergic drugs should be used to treat what condition?
|
|
Definition
|
Overactive bladder. The main concern with using these drugs is dry mouth!
|
|
|
Term
|
How can you reduce the side effects of anticholinergic drugs?
|
|
Definition
|
•Long acting formulations
•Using drugs that don’t cross the BBB
•Using drugs that are selective for muscarinic receptors in the bladder (for overactive bladder)
|
|
|
Term
|
Adrenergic agonists are divided into 2 categories called?
|
|
Definition
|
Catecholamines Noncatecholamines
|
|
|
Term
|
What are the differences between catecholamines and noncatecholamines?
|
|
Definition
|
Catecholamines cannot be taken orally, have a brief duration of action, and cannot act in the CNS!
|
|
|
Term
|
•Norepinepherine, dopamine, and dobutamine can only be given by?
|
|
Definition
|
Continuous infusion because of their rapid inactivation by MAO and COMT
|
|
|
