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Glossary of Pharmacology: The ANS and Antipasmodic Drug

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classification of
Bethanechol (Urecholine)
Parasympathomimetics (Cholinergics)
Mechanism of
Bethanechol (Urecholine)
a synthetic acetylcholine that acts to mimic the parasympathetic response through the Muscarinic Receptors.
Major side/Adverse Effects of
Bethanechol (Urecholine)
1. arrhythmias
2. burping
3. bladder urgency
4. abdominal cramps
5. headache
6. hypotension.
Nursing implication (dosage) for
Bethanechol (Urecholine)
Normal adult dose:
PO 10-50mg po bid-qid
SC 2.5-5mg tid or qid prn
Indications (usage) of
Bethanechol(Urecholine)
Treat unobstructed urinary retention and paralytic illus.
classification of
Neostigmine (Prostimin)
Parasympathomimetics (Cholinergics)
Mechanism of
Neostigmine (Prostimin)
Mimic the action of acetylcholine and thereby Activation of nicotinic neuromuscular receptor causes structural changes that allows potassium and sodium ions to alter their concentration- this stimulate skeletal muscle contraction.
Major side/Adverse Effects of
Neostigmine (Prostimin)
1. arrhythmias
2. burping
3. bladder urgency
4. abdominal cramps
5. headache
6. hypotension.
Indications (usage) of
Neostigmine (Prostimin)
Myasthenia gravis and help relieve urinary retension.
classification of
Atropine sulfate
Parasympatholytics (Anticholinergics)
Mechanism of
Atropine sulfate
act by blocking acetylcholine receptors mainly muscarinics. Crosses the BBB to become CNS stimulant.
Major side/Adverse Effects and Contraindications of
Atropine sulfate
Adverse effects: tachycardia associated larger dose.
Contraindications:
1. clients undergoing open heart surgery.
2. Glaucoma
3. BPH
Nursing implication (dosage)for
Atropine sulfate
oral 0.3 to 1.2 mg q 4-6 hours.
parenteral 0.4 to 0.6 mg q 4-6 hours.
Indications (usage) of
Atropine sulfate
1. Bradyarrhythmias
2. sinus bradycardiaand
3. relieves bronchospasm.
2. Treatment of GI disoders (such as IBS and spastic biliary tract disorders)
4. Parkinson's (decrease tremors)
5. preanesthetic agent.
Classification of
epinephrine (Adrenalin)
Sympathomimetics (Adrenergics)
Adrenergic Agonist
Mechanism of
epinephrine (Adrenalin)
Mimic the effect of sympathetic response. stimulates alpha and beta receptors of the heart, smooth muscles, bronchi and blood vessels.
Major Side/Adverse Effects of
epinephrine (Adrenalin)
1. Increase nervousness
2. restlessness
3. insomnia
4. tachycardia
5. increased blood pressure
6. sweating
7. tremors
8. nausea
9. Vomiting
10. pallor.
Implication Usage of
epinephrine (Adrenalin)
1. used in treatment of anaphylactic shock
2. also bronchodilates
3. use as adjunct with local anesthetics because it reduces circulation to site (less bleeding)and slows vascular absorption of local anesthetic (thereby prolongs duration of action).
Nursing Implication/ Dosage for
epinephrine (Adrenalin)
1. Not giving orally- will not achieve serum levels
2. Well absorbed following IM or SC
3. Rapid onset of action
a) 3 to 5 minutes after inhalations
b) 6 to 15 minutes after SC
c) In cardiac arrest dose may be repeated every 5-20 minutes.
Classification of
Propanolol (Inderol)
-Sympatholytics
(Adrenergic Blockers)
-Beta adrenergic blocking agent (beta blocker)
Mechanism of
Propanolol (Inderol)
Beta blockers compete with catecholamines at the receptor sites, this inhibiting the receptors.
Major Side/Adverse Effects of
Propanolol (Inderol)
Drowsiness, difficulty sleeping, weakness, anxiety, Nasal congestion, abdominal distress, dizziness, Bradycardia, Vomiting, Depression, Cold hands & feet, difficulty breathing.
Implication Usage of
Propanolol (Inderol)
1. Arrhythmias,
2. MI,
3. Angina pectoris,
4. Hypertension
Nursing Implication/ Dosage for
Propanolol (Inderol)
1. If apical pulse below 60. hold rx
2. cheek BP
3. Withdraw from Rx slowly
4. No OTC especially decongestants, cough or cold medicines.
5. mask signs of hypoglycemia
Neurotransmitter of the Sympathetic System
catacholamines:
1. Epinephrine
2. Norepinephnne
3. Dopamine
Receptors of the Sympathetic nervous system
Alpha(1&2) and Beta (1&2)Receptors
Where's alpha 1 receptors found?
Found primarily in the smooth muscle tissue of the peripheral blood vessels and in the sphincters of the gastrointestinal and genitourinary tracts.
Where's alpha 2 receptors found?
Located on the presynaptic neuron
What is (are) the action(s) of alpha 1 receptor when stimulated.
- When stimulated, Alpha1 receptor causes the smooth muscle to contract.
- Implication in relieving severe hypotension?
- Implication in relieving nasal congestion?
- Injection of alpha1 stimulant such as epinephrine (Adrenalin) with another drug (e.g. local anesthetic) causes local constriction of blood vessels in the area and prevent rapid diffusion of the drug away from the injection site.
What is (are) the action(s) of alpha 2 receptor when stimulated.
- Act as a "controllers" of neurotransmitter release by the presynaptic neuron.
- Sense the concentration of the neurotransmitter in the synaptic space, when its too much it stimulates the decrease of neurotransmitter from the presynaptic neuron.
Where's beta 1 receptors found?
Located in the muscles of the heart.
Located also in the fatty tissue
Where's beta 2 receptors found?
1. Located primary in the bronchial smooth muscle in the walls of blood vessels
2. located in skeletal muscle, the brain, and the heart.
What is (are) the action(s) of beta 1 receptor when stimulated.
1. It stimulates more forceful heart muscle contraction and more rapid heart rate. Indications for depress cardiac function
2. Stimulation of beta1 promotes the breakdown of stored fat to fatty acids, which the body can use as an energy source.
What is (are) the action(s) of beta 2 receptor when stimulated.
1. Stimulation of beta2 result in muscle relaxation, thereby increases the diameter of air channels and promoting improved gas exchange.
2. Implication in treatment of bronchial asthma or other condition marked by dyspnea.
What is the Neurotransmiter of parasympathetic (Cholinergic) nervous system.
acetylcholine
What are the two types of acetylcholine receptors
1. muscarinic receptor
2. nicotinic receptor
What can nicotinic neuromuscular receptor be stimulated by?
alkaloid nicotine
What can nicotinic neuromuscular receptor be blocked by?
curare derivatives
What can muscarinic receptors be blocked by?
1. atropine
2. belldona derivative
3. scopolamine.
Classification of
Adrenalin (Epinephrine)
Adrenergic Agonist
Primary action of
Adrenalin (Epinephrine)
Primary action: to stimulate the heart by increasing heart rate, force of contraction, and cardiac output.
Usage of
Adrenalin (Epinephrine)
1. For symptomatic treatment of bronchial asthma and COPD.
2. For symptomatic relief of acute hypersensitivity reactions. Emergency treatment of anaphylactic shock. Pulmonary congestion is also alleviated by the constriction of mucosal blood vessels.
3. use as adjunct with local anesthetics because it reduces circulation to site (less bleeding); slow vascular absorption of local anesthetic, prolongs duration of action and reducing the risk of anesthetic toxicity.
4. As a hemostatic agent to control superficial bleeding from arterioles and capillaries in the skin, mucous membrane, or other tissue.
5. In ocular surgery to control bleeding, induce mydriasis and conjunctivas decongestion, and decrease intraocular pressure.
6. to treat cardiac arrest o cardiac standstill.
Main SE of
Adrenalin (Epinephrine)
Increase nervousness, restlessness, insomnia, tachycardia, tremors, sweating, increased blood pressure, nausea, vomiting, pallor, dry mouth and throat, headaches, and flushing of the face and skin.
Classification of
Norepinephrine (Levophed)
norepinephrine is a direct-acting sympathomimetic amine identical to the catecholamine synthesized in the postganglionic nerve endings of the sympathetic nervous system.
effects of
Norepinephrine (Levophed)
1. constrict blood vessels of the skin and mucous membrane.
2. reduce blood flow to the kidney and other visceral organ.
3. increase the force of myocardial contraction, resulting in an increase in cardiac output.
4. Elevate both systolic and diastolic BP.
Usage of
Norepinephrine (Levophed)
1. selectively used to restore BP.
2. cardiac arrest
3. profound hypotension
Side Effects/ Adverse reactions of
Norepinephrine (Levophed)
1. Anxiety
2. Headache
3. Insomnia
4. Pallor
5. Dizziness
6. Pounding HR
7. Tremors
8. Hyperthyroid gland in the neck.
Classification of
Dopamine hydrochloride (Intropin)
Dopamine is a catecholamine that occurs as a precursor of norepinephrine. It acts both directly and indirectly by releasing norepinephrine.
effects of
Dopamine hydrochloride (Intropin)
Depends on the amount of drug administered.
1. Low dosages (0.5 to 2 ug/kg/min)
a) vasodilation on of the renal and mesenteric arteries.
b) increase urine and sodium excretion.
c) Helps present kidney failure secondary to shock.
2. low to moderate dosage (2 to 10 ug/kg/min)
a) increase cordiac output
b) Increase systolic and pulse pressure.
3. higher doses & dopamine (10 ug/kg/min)
a) increase peripheral resistance
b) Reduce urinary output
c) Vasoconstriction
Usage of
Dopamine hydrochloride (Intropin)
1. Use in treatment of circulatory shock and refractory heart failure
2. Used to correct homodynamic imbalances associated with shock syndrome caused by myocardial infarction, trauma, endotoxin septicemia, open heart surgery, renal failure, and chronic cardiac decompensation (as in CHF)
side effect/ Adverse reaction
Dopamine hydrochloride (Intropin)
1. headaches
2. Nausea
3. Vomiting
4. Angina
5. respiratory difficulties
6. decrease blood pressure

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