Surgical anethesia causes urinary retention and abdominal distention.

So... giving this drug will stimulate the detrusor muscle of the bladder to contract, promoting urination and will simulate GI peristalsis

Mechanical obstruction of either GI or urinary tract becuase it can lead to rupture

§  CV: bradycardia→hypotension

§  GI: increased salivation, increase HCL secretions (ulcers), abdominal cramping

§   GU: never given for obstructions

§  Bronchoconstriction

non-depolarizing Neuromuscular blocker

Blocks ACh stimulation of nicotinic receptors on skeletal muscle

Absorption: IV admin

Distribution: throughout body

Metabolism: hepatic

Excretion: kidneys

- relaxation of skeletal muscles, causing a state known as flaccid paraylsis

- Competitively blocks ACh

- Respiratory paralysis, not unconsciousness (Curare poison arrows in the Amazon jungle

• Intubation, ventilator control
• surgery adjunct, especially ortho and abdominal
• Electroconvulsive therapy

• Slow return of respiratory muscle function
• Hypotension r/t no muscular tone
• causes release of histamine, a potent bronchoconstrictor
• NO CNS effects--remain awake

• Pronlonged apnea
• Treatment: AChE inhibitor

• neuromuscular blocker but does not inhibit ACh at the skeletal muscles, it stimulates it using up the ACh and remaining depolarized
• Very short acting paralysis

• Most significant is malignant hyperthermia in which severe muscle contraction takes place, generated heat, temp rises
• Arrythmies r/t K release by muscles

• Cannot move, but still can hear and feel
• Needs sedation and PAIN meds
• Can't breathe on their own
• High risk for skin breakdown
• Pts try to move to "shake it away" but it does not hasten reversal and increases risk of joint injury
• Face has tendency to recover faster

• 4 electronic stimuli to the thumb
• If no response: too much on board
• if 1-2 twitches: OK
• If 4 twitches: need more medication!!!

• Vascular smooth muscle, pupils, heart
• vasoconstriction: systemic (increases BP) and local (slows systemic absorption, nasal decongestants)
• Pupil dilation
• GI and GU sphincter relaxations
• uterine conraction
• stimulate ejaculation
• increased glycogen breakdown in liver

• Stimulation of heart: increased rate, conduction, force, automaticity
• Renin release by kidneys

• Lungs, liver, uterus
• dilation of bronchioles, decreased respiratory resistance
• relaxation of uterine smooth muscle
• dilation of blood vessels in skeletal muscle, brain, heart
• increased glycogen breakdown in liver

• Absorption: inactivated by gastric acid, must be given parenterally
• Distribution: fast metabolism, effect is mostly local
• Metabolism: rapid with enzymes in blood stream

• Respiratory: SC or MDI for acute asthma
• Treatment for anaphylaxis: EPI Pen
• CV ( improve BP)
• Surgically: local hemostasis
• Anesthetically: localize meds to maintain better pain control and hemostasis
• Eye: mydriasis, control bleeding

• Get all of the SNS effects
• severe HBP with danger of stroke or CVA
• anxiety and nervousness, muscle tremor
• Dysrhythmias, pallor, weakness, N/V

• HBP or other significant CV compromise
• Closed angle glaucoma
• Diabetes
• Cautino in pregnancy

• HBP with danger of stroke
• Tachycardia with danger of MI
• Pulmonary edema
• Treatment: rapid-acting vasodilators (nitroprusside)

§  Antagonizes histamine (decreases sneezing, rhinorrhea, nasal and ocular pruritus, ocular tearing and redness)

§  Significant CNS depressant and anticholinergic properties

§  Suppression of cough

§  Prevention of motion sickness

§  Absorption: Oral (40-60% reaches systemic due to first-pass) and IM admin

§  Distribution: widely distributed

§  Metabolism: liver

§  Relief of allergic symptoms caused by histamine (includes anaphylaxis)

§  CNS: drowsiness

§  CV: hypotension

§  GI: anorexia, dry mouth

§  CNS: drowsiness

§  CV: hypotension

§  GI: anorexia, dry mouth

§  Increase cardiac output

§  Increase BP

§  Improve renal blood flow

§  Absorption: admin IV only via central line

§  Distribution: widely distributed but does not cross the blood-brain barrier

§  Metabolism: metabolized in liver, kidneys, and plasma

§  Adjunt to improve: BP, cardiac output, urine output in treatment of shock unresponsive to fluid replacement

§  T ½ is 2 minutes

§  Need hemodynamic monitoring

§  Alter dose based on parameters

§  Stroke

§  Tissue sloughs off down to the bone

§  Stimulates NE production

§  Alpha and beta receptor activation

§  Positive inotrope and chronotrope

§  Absorption: not destroyed in stomach so can use oral form

§  Bronchodilation

§  Nasal decongestant

§  Severe HBP with danger of stroke or CVA

§  Anxiety and nervousness, muscle tremor

§  Dysrhythmias, pallor, weakness, N/V 

§  Do not take with MAO inhibitors (psych med)

§  HBP or other significant CV compromise

§  Closed angle glaucoma

§  Diabetes

§  Caution in pregnancy

§  Can cause MI and CVA

§  Can spike HTN

§  Problem as in most OTC cold meds

§  FDA pulled ephedra from OTC herbal market, but keep sneaking back

·         Found in many “new and fantastic” diet pills

§  Baseball has banned ephedra products r/t sudden death of young players

o   Two types of MAO inhibitors and function

§  MAO A is necessary to metabolize norepi and serotonin

§  MAO B metabolizes dopamine