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Noreepinephrine (Levophed)
- Acute situation
- Vaso pressor
- predominant Alpha1 adrenergic effects
- POTENT vasocontrisctor
- RX of shock states- impair cardiac performance, decreased organ and tissue pefusion
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Norepinephrine (Levophed) Antidote
- Phenatolamine (Regitine)
- alpha adrenergic blocker
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Albuterol (Ventolin)
Selection of which receptor
Selective B2
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Albuterol (Ventolin)
is what? administration? effects of high dosages.?
- Vasodialator
- oral, inhaler, neubulizer
- if high dosages it may have selectivity over beta1 receptor sites
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alpha 2 adrenergic agonist
- inhibits release of norepinephrine
- to lower BP
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Adrenergic agonist- two drugs
norepinephrine (Levophed) and Albuterol (Ventolin)
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adrenergic antagonist Blockers-
what do they do? (3), which is most common?, uses?, side effects?, contraindications/ precautions
- Turn off the SNS
- inhibit the effects of the adrenergics
- occupy receptor site or inhibit release of neurotransmitter
- Beta is most common
- used- hypertension, cardiac dysrhythmias, angina, and migraine
- side effects: hypotension, bradycardia, fatigue
- contraindications: hypotension, asthma, diabetes
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beta blockers to know- 2 drugs
which receptor are they selective for.?
what do they treat?
side effects.? adverse rxns?
- metropolol (lopressor)
- atenolol (tenormin)
- they are selective for beta 1 blocker
- they treat High BP, dysrhythmias, anginas
- side effects & adv rxns- hypotension, bradycardia, and fatigue
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Pt education Beta blockers (6)
- * tell patient to use from a seated position slowly
- *heart rate will be slow- report dizziness, unusual weakness, and difficulty in breathing
- *avoid alcohol, antihistamines, sedatives, and muscle relaxants
- * report sexual dysfunction or depression
- *do not leave medication abruptly
- *consult prescriber if you are going to use OTC medications for colds because they contain effedrin
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Alpha blockers- 1 medication
common? what do they cause?
- Not as common
- cause: orthostatic hypotension and reflex tachycardia
- med- terazosin (Hytrin)
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terazosin (Hytrin)
- *also used to treat symptoms of benign orthostatic hyperplasia
- *relaxes muscles of bladder and prostate allowing urine to flow
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Cholinergic Agonist
- Turn on PNS
- parasympathomimetics
- incresed secretions- everything is wetter
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Cholinergic agonist- direct acting
act on muscarinic receptors
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Cholinergic agonist- indirect acting
inhibit the release of cholineesterase- prevent the brakedown of acetylcholine
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Cholinergic agonist (2 drugs)
- metoclopramide (Reglan)
- Varenicline (Chantix)
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metoclopramide (Reglan)
- direct acting cholinergic agonist
- RX- GERD, nausea, gastroparesis
- speeds up gastric emptying
- can be used during pregnancy
- adverse rxn- terdue dyskenisia
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Varenicline (Chantix)
- acts on nicotinic receptors- partial binding
- prevents binding of nicotine- may help with withdrawal symptoms
- therapeutic effect-decreased desire to smoke
- start 1 week before quit day
- 12 week treatment, gradually increase dose in 1 week
- pregnancy category C- risk vs benefits
- side effects adv rxns- mood changes, mental status change, decreased alcohol tolerance, status johnson syndrome (skin slips off)
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cholinesterase inhibitor
- blocks brakes down of acetylcholine
- allows acetylcholine to accumulate in neuromuscular junction
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donepezil (Aricept)
- medication for alzheimers
- magic #12- number of patients it takes for one person to get benefit
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anticholinergics- definition, actions, uses, adverse rxns, contraindications
- definition- stops cholinergic effects
- ations- decreasing of secretions, decreased GI motility, dilation of pupil
- uses- preop (decreased secretions minimizes the risks of vomiting), antispasmodics, antidotes, bradycardia/ heart block, dilation of pupils (for eye exam), prevent or treat bronchospasms (for asthma)
- adverse rxns- blurred vison (pupil dialation), dry mouth , constipations, urinary retention (because of no secretions), "can't see can't pee can't spit, can't shit", palpitations or tchycardia, confusion/ excitement, fever flusing
- contraindication: asthma, COPD, angle closure glaucoma, GI/GU obstruction, cardiac dysrhythmias, hypertension
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anticholinergics- 4 meds
- end in ine
- atropine
- totterodine
- benztropine
- scopolamine
- anticholenergic syndrome or toxicity
- "Red as a beet (flushing), dray s above (no secretions), blind as a bat (dilated pupils), mad as a hater (psychosis) , hot as a hare (flushing), full as a flask (can't pee),
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