cholenergic/ adrenergic

  1. Noreepinephrine (Levophed)
    • Acute situation
    • Vaso pressor
    • predominant Alpha1 adrenergic effects
    • POTENT vasocontrisctor
    • RX of shock states- impair cardiac performance, decreased organ and tissue pefusion
  2. Norepinephrine (Levophed) Antidote
    • Phenatolamine (Regitine) 
    • alpha adrenergic blocker
  3. Albuterol (Ventolin)
    Selection of which receptor
    Selective B2
  4. Albuterol (Ventolin)
    is what? administration? effects of high dosages.?
    • Vasodialator
    • oral, inhaler, neubulizer
    • if high dosages it may have selectivity over beta1 receptor sites
  5. alpha 2 adrenergic agonist
    • inhibits release of norepinephrine
    • to lower BP
  6. Adrenergic agonist- two drugs
    norepinephrine (Levophed) and Albuterol (Ventolin)
  7. 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
  8. 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
  9. 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
  10. Alpha blockers- 1 medication
    common? what do they cause?
    • Not as common 
    • cause: orthostatic hypotension and reflex tachycardia
    • med- terazosin (Hytrin)
  11. terazosin (Hytrin)
    • *also used to treat symptoms of benign orthostatic hyperplasia
    • *relaxes muscles of bladder and prostate allowing urine to flow
  12. Cholinergic Agonist
    • Turn on PNS
    • parasympathomimetics
    • incresed secretions- everything is wetter
  13. Cholinergic agonist- direct acting
    act on muscarinic receptors
  14. Cholinergic agonist- indirect acting
    inhibit the release of cholineesterase- prevent the brakedown of acetylcholine
  15. Cholinergic agonist (2 drugs)
    • metoclopramide (Reglan)
    • Varenicline (Chantix)
  16. metoclopramide (Reglan)
    • direct acting cholinergic agonist
    • RX- GERD, nausea, gastroparesis
    • speeds up gastric emptying
    • can be used during pregnancy
    • adverse rxn- terdue dyskenisia
  17. 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)
  18. cholinesterase inhibitor
    • blocks brakes down of acetylcholine
    • allows acetylcholine to accumulate in neuromuscular junction
  19. donepezil (Aricept)
    • medication for alzheimers
    • magic #12- number of patients it takes for one person to get benefit
  20. 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
  21. 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),
Card Set
cholenergic/ adrenergic
ch 15 and 16