NUR 2407 Exam 1 Review

NUR 2407 Exam 1 Review Exam 1 Review - ANS drugs o Sympathetic system  Actions  Dilate pupils  can cause blurred vision  No effect on tear glands  Weak stimulating for saliva  dry mouth  Increased heart rate  constricts arterioles  increased BP and CO  Dilates bronchi  increased space for air  Inhibit stomach motility, secretion, pancreas, adrenals, and intestinal motility  constipation  Urine retention  may need catheter  Stimulates ejaculation  Increased blood glucose  Neurotransmitters  Norepinephrine  Epinephrine  Dopamine  Serotonin  Receptor organ cells  Alpha 1  increases force of heart contraction, vasoconstriction, mydriasis (dilation of pupils),  Alpha 2  inhibits release of norepi, dilates blood vessels, produces hypotension  Beta 1  impacts heart, increases BP  Beta 2  impacts lungs, GI, urine, increased glucose, increased blood flow  Medication Types  Adrenergic agonists (direct, indirect, or mixed acting) o Epinephrine or norepinephrine (direct- stimulate receptor)  Often used in emergencies to treat anaphylaxis- increases CO, promotes vasoconstriction, and produces bronchodilation. o Amphetamine (indirect- stimulates release of norepi and inhibit reuptake)  For ADHD and narcolepsy  SE- can cause insomnia, restlessness, tremors, irritability, and weight loss.  High potential for abuse o Pseudoephedrine (mixed)  For nasal congestion due to common cold o Albuterol (selective for beta-2 receptors)  For asthma/bronchospasm- relaxation of bronchial smooth muscle and bronchodilation o Dextroamphetamine (Adderall)  For ADHD and narcolepsy when amphetamine like drugs are ineffective  SE- blurred vision, dry mouth, unpleasant taste, anorexia, impotence, changes in libido  Serious SE- palpitations, tachycardia, increased BP, sudden death, MI, cardiomyopathy, Steven-Johnson syndrome  C2 controlled substance- potential for abuse 2  Appetite suppressant  Take in the morning due to possible insomnia  Non-catecholimine sympathomimetic amine with CNS stimulant activity o Sumatriptan  For migraine control  Vascoconstrictor--- do not use in people who have hx of stroke, heart disease o Ephedrine  To treat hyportensive states, bronchospasm, and asthma  Adrenergic antagonists o Alpha Blocker  Prozosin (selective alpha 1 blocker)  For hypertension  SE- dizzy, fatigue, nausea, wkns, palpitations  Causes sodium and water retention causing edema, so they are often taken with a diuretic o Beta-adrenergic antagonists  Beta Blocker  decreased HR and BP follows  Selective Beta 1 blockers o Metoprolol  To treat hypertension, angina, HF, and acute MI o Atenolol  For hypertension, angina, and prophylaxis and treatment of acute MI  SE- drowsy, HoTN, diarrhea, cool extremities, depression.  AR- bradycardia, dyspnea  LT- cronchospasm,  Interactions- increased absorption with atropine and other anticholinergics--- decreased with NSAIDS o Acebutolol  Non-selective beta blockers o Propranolol o Pindolol o Sotalol o Parasympathetic system  Actions  Constricts pupils  Stimulate tear glands  Inhibits heart, dilates arterioles  decreased HR  Constricts bronchi  Stimulates stomach secretions, pancreas, intentional motility,  Urinary urgency  Stimulates erection  Neuro transmitter  Acetylcholine  Receptor organs  Nicotinic- affect skeletal muscles 3  Muscarinic- stimulate smooth muscle and slow HR  Cholinergic agonists (direct (act on receptors) and indirect (inhibit action of cholinesterase/acetylcholinesterase))  Direct acting- primarily selective to muscarinic receptors but are nonspecific because the muscarinic receptors are located in smooth muscle of GI and GU tract, glands, heart. o Bethanechol chloride- to treat urinary retention and neurogenic bladder o Metoclopramide hydrochloride- treats gastroparesis, nausea, and GERD  Indirect- inhibits the action of cholinesterase, which breaks down acetylcholine into choline and acetic acid. o Reversible  For Myasthenia gravis, Alzheimer’s  Used to treat Glaucoma, and strengthen pts with myasthenia gravis  Physostigmine- antidote for atropine to reverse anticholinergic toxicity  Cholinergic antagonists  Major actions- decrease GI motility, decrease salivation, dilate pupils, increased HR  GI or cholinergic blockers o Atropine sulfate  Pre-op med used to reduce salivation, increased HT for bradycardia, and dilate pupils for ocular diagnostic exams  Can be used as an antidote for muscarinic receptors  SE- dry mouth, diminished GI motility, blurred vision and sensitivity to light, dizziness, nausea, tachycardia o Scopolamine  For motion sickness, as a prophylaxis for nausea/vomiting from surgery.  Transdermal patch.  SE- dry mouth, dizziness, somnolence, urinary retention, agitation, visual impairment, confusion, pharyngitis  Anti-parkinson’s meds o Benztropine  Muscarinic antagonist  To decreased involuntary symptoms of Parkinson’s medications or drug induced Parkinson’s  Don’t consume alcohol with this  SE- constipation, urinary retention, weakness, dry mouth, blurred vision (dilated pupils) - Central and Peripheral Nervous system drugs o Stimulates  Amphetamines and caffeine- stimulate the cerebral cortex  Long term use can cause dependence and tolerance  Stimulate the release of norepi and dopamine and inhibit reuptake of these transmitters  SE .....Continued.....