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Adrenergics
stimulates the sympathetic nervous system (sympathomimetics)
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Adrenergic Blockers
block the sympathetic nervous system (sympatholytic)
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Cholinergics
stimulate the parasympathetic nervous system (parasympathomimetics)
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Anticholinergics
block the parasympathetic nervous system (parasympatholytic)
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Sympathetic Neurotransmitter
Norepinephrine
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Sympathetic Receptors
Alpha1, Alpha2, Beta1, Beta2
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Parasympathetic Neurotransmitter
acetycholine
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Parasympathetic Receptors
Nicotinic or muscarinic receptors
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Sympathetic Receptor Sites
heart, bronchiole walls, GI tract, urinary bladder, ciliary muscle of the eye
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Non-selective
excites all receptors approximately equally - more side effect
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Selective Drugs
excites specific receptor sites (fewer side effects)
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Direct Acting Adrenergic
stimulates adrenergic receptors
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Indirect-Acting Adrenergic Drugs
stimulate release of norepinephrine at nerve endings
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Uses of epinephrine
treat allergic reations, anaphylaxis, bronchospasm, cardiac arrest, orthostatic hypotenstion
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Contraindications of epinephrine
- cardiac dysrhythmias
- glaucoma (can exacerbate IOP)
- prolonged used: drug resistance
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Side and Adverse effects of epinephrine
- Side:
- -anorexia
- -nausea/vomiting
- -tremors
- -insomnia
- -pallor
- Adverse:
- -cardiac dysrhythmias
- -palpitations
- -tachycardia
- -dyspnea
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Routes of Administration for Epinephrine
- IV
- Injection
- Nebulizer
- Instilled (w/ saline)
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Nursing Assessments and Teachings for Epinephrine
- Urine output (retention)
- Check blood glucose (can increase)
- Take w/ food (but very rarely PO)
- No cold/diet pills (can be potentiating)
- Use of nasal sprays - for inflamed/congested nasal tissue
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Uses of Albuterol
bronchospasm, asthma, bronchitis, COPD
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Contraindications for Albuterol
cardiac disease, hypertension, hyperthyroidism
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Side/Adverse Effects of Albuterol
Side: tremor, dizziness, nervousness, restlessness
Adverse: palpitations, reflex tachycardia, dysrhythmias
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Non-Selective Beta Adrenergic Blockers
- Proprenolol
- More side-effects - NEVER for COPD/asthma
- (Beta1 and Beta2)
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Selective Beta Adrenergic Blockers
Atenolol (Beta2)
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Uses of Atenolol
treat angina, cardiac dysrhythmias, hypertension, heart failure
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Contraindications for Atenolol
bradycardia, heart block, overt heart failure
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Side/Adverse Effects of Atenolol
Side: bradycardia, dizziness, fainting, impotence
Adverse: significant bradycardia, dysrhythmias, masking of hypoglycemia
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Nursing Implications of Beta Adrenergic Blockers
- Vital Signs
- Assess respirations/bronchospasm (selective vs nonselective)
- Must tapper (possible rebound tachycardia)
- Hypoglycemia (may need to decrease insulin dose)
- Orthostatic hypotension
- Impotence/Decreased libido
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