1. What are the two types of nervous systems?
    • Central nervous system
    • Peripheral nervous system
  2. What is int he central nervous system?
    • Brain
    • Spinal Cord
  3. What is in the peripheral nervous system?
    • Afferent nerons (to the brain)
    • Efferent neurons (away from the brain)
    • Autonomic nervous system (parasympathetic branch and sympathetic branch)
  4. What are the two divisions of the autonomic nervous system?
    • Parasympathetic branch
    • Sympathetic branch
  5. What are afferent neurons?
    To the brain
  6. What are efferent neurons?
    away from the brain
  7. What is the purpose of the autonomic nervous system?
    To regulate involuntary vital functions
  8. How does the sympathetic nervous system effect the body?
    • Fight or flight
    • accelerates heart rate
    • constricts blood vessels
    • relaxes bronchial smooth muscle
  9. How does the parasympathetic nervous system effect the body?
    • Feed or breed
    • slows heart rate
    • increases intestinal peristalsis
    • increases gladn activity
  10. What is norepinephrin?
    • It is a neurotransmitter for sympathetic system.
    • It stimulates beta 1, beta 2 and alpha receptors.
  11. What is a Beta 1 receptor?
    • Located in cardiac muscle
    • Increases heart rate and ventricular contractility
  12. What is a Beta 2 receptor?
    • Located in bronchial smooth muscle
    • Relaxes smooth muscle in the airway
  13. What is an Alpha receptor?
    • Located in arteriole walls
    • Causes vasoconstriction
  14. What is Acetylcholine?
    • It is a neurotransmitter for the parasympathic system
    • Stimulates cholinergic receptors
  15. What is a cholinergic receptor?
    • Located in heart, airway walls, various other places
    • When stimulated, decreases heart rate and causes bronchoconstriction
  16. What is sympathomimetic drug?
    • Chemical that causes stimulation of the sympathetic nervous system
    • Also called Adrenergic agonist
  17. What is Sympatholytic drug?
    • Chemical that blocks a sympathic response
    • Also called a beta blocker
  18. What is a cholinergic drug?
    Chemical that causes stimulation of the parasympathetic response
  19. What is an anticholinergic drug?
    • Chemical that blocks a parasympathetic response
    • Also called parasympatholytic
  20. What are effects of anticholinergic drugs?
    • Bronchodilation
    • Drying of secreations
    • Treatment of bradycardia
  21. What are some examples of anticholinergic or parasympatholytic drugs?
    • Atropine
    • Atrovent (ipratropium bromide)
    • Spiriva (tiotrpium bronide)
  22. What are effects of sympathomimetic drugs?
    • Bronchodilation
    • Increase cardiac contractility
    • Increase heart rate
  23. What are some examples of sympathomimetic or adrenergic agonist drugs?
    • Epinephreine
    • Albuterol
    • Dopamine
    • Salmeterol
    • Dobutamine
  24. What are indications of sympathomimetic bronchodilators?
    Relieve bronchoconstriciton of obstructive airway disease where it has been shown to improve airflow
  25. What is mode of action of sympathomimetic bronchodilators?
    • Stimulate beta 2 receptors
    • cause relaxation of smooth muscles in airway wall
    • can improve mucociliary clearance
  26. Epinepherine
    • Powerful alpha and beta effects
    • Nebulized, IV drip, IM or ETT
    • Short acting
    • Powerful cardiac effect
    • Drug choice for cardiac arrest
  27. Epinephrine dosage
    • SVN: 1% solution 0.25 mL - 0.5 mL qid
    • MDI: 0.22 mg/puff prn
  28. Albuterol sulfate
    • name brands: Proventil, Ventolin, ProAir
    • Beta 2 preferential
    • Little cardiac effect
    • Nebulizer, MDI, PO
    • Effects up to 6hrs
  29. Albuterol dosage
    • MDI: 90 mcg/puff, 2 puffs tid, qid or as needed
    • SVN: 0.5% solution, 2.5mg tid, qid or as needed
  30. Pirbuterol
    • Name brand: Maxair Autohaler
    • MDI
    • Short onset
    • Beta 2 preferential, little beta 1 effect
    • Effects last about 5hrs
  31. Pirbuterol dosage
    • MDI: 200 mcg/puff
    • 2 puffs q4-6
  32. Levalbuterol
    • Beta 2 selective, no beta 1
    • Short onset
    • Effects last 5-8 hrs
  33. Levalbuterol dosage
    • MDI: 45 mcg/puff, 2 puffs q4-6 hr or as needed
    • SVN: 0.31mg, 0.63 mg, 1.25 mg dose tid or as needed
  34. Salmeterol
    • Name brand: Serevent
    • Long acting
    • Effects last up to 12hrs
    • Beta 2 preferential, little beta 1 effects
  35. Formoterol
    • Name brand: Foradil, Preformist
    • Long acting
    • Effects last about 12hrs
  36. Arforoterol Tartrate
    • Name brand: Brovona
    • Long action
    • Effects last about 12hrs
    • Selective beta 2, little beta 1 effects
  37. Racemic epinephrine
    • Short onset
    • Effects last about 2hrs
    • Alpha and beta effects
  38. Indacterol
    • Brand name: Arcapta
    • long acting beta 2 adrenergic agonist bronchodilator
    • FDA approved for COPD
    • used as DPI
  39. What are some side effects of sympathomimetics?
    • Tachycardia
    • Tremor
    • Nervousness
    • Headache
    • Insomnia
    • Nausea
  40. What do anticholinergic drugs do?
    • Block parasympathetic action and dilates the airways
    • Also called parasympatholytic
  41. Anticholinergic drug indications
    relieve bronchoconstriciton associated with COPD
  42. What are some examples of anticholinergic or parasymaptholytic drugs?
    • Ipratropium bromide (Atrovent)
    • Tiotropium bromide (Spiriva)
    • Atropine sulfate
  43. ipratropium bromide
    • Name brand: atrovent
    • Powerful bronchodilator in COPD
    • Effects last 4-6 hrs
  44. tiotropium bromide
    • Name brand: Spriiva
    • Long acting
    • Effects last about 24hrs
  45. Aclidinium bromide
    • Name brand: Tudorza Pressair
    • Long acting anticholinergic bronchodilator
  46. Atropine sulfate
    • no longer used
    • early anticholinergic
  47. What are side effects to anticholinergic drugs?
    • Dry mouth and upper airway
    • Urinary retention
    • Mucocilary slowing
    • Inhibition of tear formation
    • Worsening of glaucoma
  48. What are combination drugs?
    • Combivent (albuterol sulfate and ipratropium bromide)
    • Duoneb (albuterol sulfate and ipratropium bromide)
  49. What falls under drug information?
    • Clinical pharmacology
    • Indications and usage
    • Contraindications
    • Drug interactions
    • Adverse reactions
    • Dosage and administration
  50. Drug administration
    Method by which the drug is made avalibe to the body
  51. What are routes of administration?
    • Enternal-oral
    • Parenteral-injectable
    • Transdermal-absorbed through the skin
    • Inhilation-inhaled aerosol
    • Topical-n the skin or mucous membranes
  52. Outline the movement of the drug through the body
    • Absorption
    • Distribution
    • Metabolism
    • Elimination
  53. What is the difference between loading dose and subsequent dose?
    • Loading dose is the initial dose to create desired level of concentration
    • Subsequent dose maintain concentration
  54. What is the first-pass effect?
    orally delivered drug enter bloodstream from stomach, follows portal vein directly to liver where metabolism takes place
  55. Half-life
    tire required to decrease amount of drug in the body by one half, through elimination
  56. Maintenance dose
    Subsequent dosing equal to the rate of elimination to maintain a steady level of drug in the body
  57. Structure-activity relation
    Relationship between a drug's chemical structure and its clinical effect
  58. Drug receptors
    Proteins whos shape or electrical charge match a drug's chemical shape or charge
  59. Therapeutic range
    • Blood concentration range, within which a drug has a therpeutic effect
    • Concentrations above this range can be toxic
  60. Agonist
    A drug that binds to a corresponding receptor and produces a clinical effect
  61. Antagonist
    • Drug that can bind to a corresponding receptor, but produces no clinical effect
    • Blocks the agonist
  62. Potentiation
    One drug has no effect but increases the effect of another drug
  63. Synergism
    Two drugs hae the same effect, but by different mechanisms or actions
  64. Additivity
    Two drugs both act on the same receptors and their combined effect is additive
  65. What must every drug order include?
    • Drug name
    • Dose
    • Route
    • Requency
    • Dr. signature
Card Set
bronchodilators and drug interactions