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CNS
brain and spinal cord
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PNS
somatic and autonomic nervous system
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What are the two parts of the autonomic nervous system
sympathetic and parasympathetic
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sympathetic is?
1. fight or flight
2. rest and digest
fight or flight
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parasympathetic is?
1. fight or flight
2. rest and digest
rest and digest
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sympathomimetric drugs
- (adrenergics)
- sitmulate the sympathetic nervous system
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adrenergic antagonists or blockers
inhibit sympathetic nervous system
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parasympathomimetic drugs
- (cholinergics)
- stimulate the parasympathetic nervous system
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anticholinergics or cholinergic blockers
inhibit parasympathitic nervous system
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MOA: adrenergic drugs (sympathomimetric)
work like naturally produced neurotransmitters: epinephrine and norepinephrine
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Actions: adrenergic drugs (sympathomimetrics)
- relax smooth muscle of bronchi
- constrict blood vessels
- decrease gastric motility
- increase HR
- increase glucose use
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Uses: adrenergic drugs (sympathomimetric)
- hypotension
- control of superficial bleeding
- asthma
- cardiac arrest
- anaphylactic shock
- heart block
- arrhythmias
- nasal congestion
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Adverse reactions: adrenergic drugs (sympathomimetric)
- carediac arrhythmias
- h/a
- insomnia
- nervousness
- anorexia
- increased BP
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Class? dopamine (Inotropin)
adrenergic drug
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What should I know about giving dopamine (Inotropin) IV?
- must be used for precise infusion
- dedicated line: do not mix with other drugs
- titrade rate of flow based on B/P
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What vital sign should be monitored every 15 min when administering dopamine (Inotropin)?
BP
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What should I know about elderly clients and adrenergic drugs?
They are especially susceptable to cardiac arrhythmias
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nursing interventions for anorexia
- know food preferences
- several small meals better tolerated
- avoid spicy, caffeinated and gas-forming foods
- provide good oral care
- provide pleasant environment for meals
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nursing interventions for insomnia
- avoid caffeinated products
- back rub
- warm milk
- hs snack
- may need sleeping aid
- avoid interruptions & bright lights when rendering care during the night
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What are the four groups of adrenergic blockers?
- 1. alpha adrenergic blockers
- 2. beta adrenergic blockers
- 3. antiadrenergics
- 4. alph/beta adrenergic blockers
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uses: alpha adrenergic blockers
- peripheral vasodilators
- adrenal gland tumor
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phentolamine (Regitine) is what kind of adrenergic blocker?
alpha
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Adverse reactions: alpha adrenergic blockers
- cardiac arrhythmias
- hypotension
- tachycardia
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MOA: beta adrenergic blockers
block beta receptors of the heart, decreasing HR & B/P
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Uses: beta adrenergic blockers
- hypertension
- arrhythmias
- migraines
- glaucoma
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atenolol (Tenormin) or timolol (Timoptic) are examples of what kind of adrenergic blocker?
beta
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adverse reactions: beta adrenergic blockers
- bradycardia
- hyperglycemia
- heart failure
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contraindications: beta adrenergic blocker
other cardiac depressants (ex: digoxin)
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What vitals should be monitored when administering beta adrenergic blockers?
- B/P while standing, sitting, and lying down
- apical HR before administration
- monitor for orthostatic hypotension
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MOA: antiadrenergic drugs
- decrease activity of the sympathetic nervous system
- may be central or peripherally acting
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uses: antiadrenergic drugs
hypertension and cardiac arrhythmias
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cental acting clonidine (Catapress) is an example of which adrenergic blocker?
antiadrenergic
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Adverse reactions: antiadrenergic drugs
- dry mouth
- drowsiness
- anorexia
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MOA: alpha/beta adrenergic blockers
- block receptors of alpha and beta receptors
- result in peripheral vasodilation
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uses: alpha/beta adrenergic blockers
hypertension
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labetolol (Normodyne) is what kind of adrenergic blocker
alpha/beta
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adverse reaction: alpha/beta adrenergic blockers
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MOA: cholinergics
- mimic parasympathetic system: like acetylcholine and acetylcholinestrerase
- conserves energy, slows HR, digestion, and elimination
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uses: cholinergics
- glaucoma
- myasthenia gravis
- urinary retention
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pilocarpine (Isoptocarpine) is a cholinergic used for what?
glaucoma
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pyridostigmine (Mestinon) is a cholinergic used for what?
myasthenia gravis
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bethanocol (Urecholine) is a cholinergic used for what?
urinary retention
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adverse effects: cholinergics
- nausea,
- diarrhea
- abdominal cramping
- salivation
- flushing of skin
- cardiac arrhythmias
- muscle weakness
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what is the antidote for cholinergics?
atropine
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nursing intervention for glaucoma pts recieving cholinergics
- assist pts to carry out ADLs
- instill drops in lower conjuctival sac
- do not touch tip of dropper
- monitor for fall risk
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nursing interventions for myasthenia gravis pts recieving cholinergics
- complete neuro assessment
- monitor for overdose/underdose
- encourage medical alert tag
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What might be signs of an overdose for a myasthenia gravis pt recieving cholinergics?
- rigidity
- smasms
- salication
- clenching of jaw
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what might be signs of underdose of myasthenia gravis pt recieving cholinergics?
- fatigability of muscles
- drooping eyelids
- difficulty breathing
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what should be closely monitored for any pt on cholinergics?
- intake and output
- risk for urinary retention
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MOA: cholinergic blockers
- vlock the action of acetylcholine
- affects eyes, lungs, heart, GI tract, bladder
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affect of cholinergic blockers:
CNS
eye
lungs
heart
GI
bladder
- CNS: dowsiness, dreamless sleep
- eye: dilation of pupil, inability to accomodate
- lungs: dry secretions, bronchodilation
- heart: increased HR
- GI: decrease gastric motility
- bladder: contact detrusor muscle
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uses: cholinergic blockers
- pylorospasm
- peptic ulcer
- ureteral colic
- vagal-induced bradycardia
- parkinsonism
- reduce secretion pre-op
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adverse reactions: cholinergic blockers
- dry mouth
- blurred vision
- photophobia
- constipation
- drowsiness
- dysuria
- palpitations
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contraindications: cholinergic blockers
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what should be kept in mind when administering cholinergic blockers in the summer
monitor for heat prostration (fever, tachycardia, flushing, warm, dry skin, confusion
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nursing intervention for pt with heart block taking cholinergic blockers
- place pt on heart monitor
- monitor for change in HR or rhythm
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nursing interventions for pt pre-op recieving cholinergic blockers
- have pt void before giving
- warn of dry mouth and NPO status
- side rails up for safety
- administer on time
- >60 b/o side effects
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nursing intervention for managing altered mucous membranes for pts recieving cholinergic blockers
- good oral care
- sips of water
- hard candy
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nusing interventions for managing risk of injury
- assist with abulation
- make sure room is free form obstacles
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nursing intervention for managing constipation
- encoiurage fluis
- added fiber
- exercise
- stool softener
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