Adrenergic Test #1 - Study notes for the first exam. Broken down into chapters. PDF

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Study notes for the first exam. Broken down into chapters....

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Pharm Test #1

Adrenergic Agonists and Antagonists Term: Agonist- Travel to opioid binding sites in CN bind to the receptors and produce an action Decrease patient’s pain level Antagonist- Travel to pain receptors and block them so they can not be activated.

Autonomic Nervous System Sympathetic Nervous System: Fight or Flight -Adrenergic agonists ·Norepinephrine(NE) -Adrenergic Antagonist ·Adrenergic Blocker

Parasympathetic Nervous System: Rest and Digest -Cholinergic agonists -Anticholinergic

Adrenergics: Sympathomimetics(mimics the SNS) -Adrenergic Agonists(Ms. Moore uses this one) -Two categories ·Catecholamines · Not  taken orally/ affects bioavailability/extensive 1st pass effect Ex. Dobutamine, Dopamine, Epinephrine, Norepinephrine, ·Noncatecholamines Ex. Albuterol, Pseudoephedrine

Term: Agonists Mimic neurotransmitter From Book: Body Tissue/ Organ Eye Lungs Heart Blood Vessels Gastrointestinal Bladder

Sympathetic fight or flight Response Dilates Pupil Dilates Bronchioles Increases H.R. Constricts B.V. Relaxes smooth muscle Relaxes Bladder Muscle

Parasympathetic Response Constricts Pupils Constrict Bronchioles Decreases H.R. Dilated B.V. Increases peristalsis Constricts Bladder Muscle

Uterus Salivary gland

Relaxes Uterine Muscle Increase Salivation

Term: Direct Acting- Stimulate the receptor(lock and key) Indirect Acting- Drug enhances release of more so epinephrine can get to more of the receptors Mixed Acting(a  little of both)- Stimulate the receptor/ Release more neurotransmitter

***KNOW FOR TEST:

Sympathetic Nervous System: Adrenergic Receptors -Alpha¹- Increase force of heart contraction/affects B  .V., E  yes, Bladder -Alpha²- Do not need to know. Does opposite of other receptors -Beta¹- Heart(and kidneys)- Increase H.R. & force contraction. (remember 1 heart)

-Beta²- Lungs(gut and reproductive)- Bronchodilation, GI uterine relaxation, (*remember- two lungs)

Glycogenolysis(Increase in Blood Sugar

Therapeutic Applications -Alpha¹ receptor agonist ·Nasal Decongestant, Hypotension -Alpha² receptor agonist ·HTN -Beta¹ receptor agonist ·Cardiac Arrest ·Heart failure ·Shock -Beta² receptor agonist ·Asthma ·Reduce preterm labor

Epinephrine=Adrenalin

*Given in Emergency Situation(ie. Can’t breathe (nonselective) MOA -Acts on Alpha and Beta receptors/ Vasoconstriction, Helps Stop Bleeding treats life-saving allergic reaction= anaphylaxis -Routes: Can come in all routes- Inhalation, topical, IV, Ophthalmos(eyes) -Half Life- Less than 5 min. That is why doctors often give two epipens because of half-life -Can give every 2-3 Min Contraindications: Hypertension/ tachycardia, palpitations, dysrhythmias, Dizziness, Tremors, Urinary retention.

Albuterol -Beta²- Adrenergic agonist MOA ·Treats bronchospasm: acute asthma ·Relaxes Bronchodilation(relaxing bronchial smooth muscle Contraindications: Tremors, restlessness, tachycardia, palpitations, N/V, Urinary retention Why does asthma make it hard to breathe? -Inflamed bronchial tube and constriction Nursing Implications: -Assess for allergies -Assess for history of hypertension, cardiac dysrhythmia, or/and cardiac diseases -Assess for renal function before treatment -Assess for narrow-angle glaucoma, diabetes -Perform baseline assessments of V.S. peripheral pulses, skin color, temp, cap refill *Make sure kidneys are functioning(so the drug can be excreted Glaucoma- From increased pressure in the eyes. - administering two adrenergic drugs together, may precipitate severe cardiac  effects such as tachycardia and hypertension. -Monitor IV site frequently/ cause extravasation Catecholamine- Destroyed by liver/ need I.V. ⇢NOT IN TISSUES Ex. Giving Chemo drugs(made to kill cells) if on hand can kill hand cells. ·Antidote: Phentolamine mesylate⇢antagonist -Toxicity S/S: CNS and cardiovascular stimulation ·Two drugs w/ same effect⇢double/triple⇢no longer side effect now adverse effect.

Adrenergic Antagonists: AKA Adrenergic Blocker:Sympatholytics -Block the SNS -Exert Action by: ·Interrupting/stopping the action of adrenergic drugs ·Reducing/interrupting available norepinephrine ·Preventing/blocking the action of cholinergic drugs Alpha ¹-Adrenergic Antagonists: Blood Vessels, Eye, Bladder, Prostate

Zosin -Selective f or Alpha 1 -Non Selective MOA: Promote Vasodilation ·Treats⇢HTN,BPH  , Extravasation, Raynauds *NOT frequently used contraindications: First Dose Phenomenon⇢ Severe/sudden drop in BP *Watch patient for dizziness/orthostatic hypotension Beta-Adrenergic Antagonists/Beta Blocker -olol, ilol,alol Selective-Atenolol(Tenormin) -Metoprolol(Lopressor) Nonselective-propranolol(inderal) MOA-

-Decrease HR, Decrease BP, Decrease contraction, Slow conduction(electricity In heart Indications: HTN, Angina, Heart failure, MI ***Taper off Medications- Catecholamines rebound effect/higher HR than baseline, BP cause MI Selective: Love Beta¹ Non-Selective: Love Beta¹ & Beta² Nursing Implications: -Assess for Allergies -Assess for history of COPD, cardiac dysrhythmias, CHF, heart block, bradycardia, Other cardiac problems -Assess for side effects *Don’t discontinue use suddenly -Change positions slowly to avoid postural hypotension -Avoid alcohol, caffeine, and hazardous activity(Take med awhile before starting any Major activity, to watch for major side effects) -May experience decreased activity tolerance when taking med @ first Alpha Blocker Toxicity⇢Activated Charcoal(given rarely anymore) -BP support symptoms/management Beta Blocker Toxicity⇢Atropine,pacemaker⇢to stimulate the heart

Education: Oral Med works w/in 45 min/ absorbed 1st then distributed...