Pharmacology Exam 3
Terms
undefined, object
copy deck
- Adrenergic agents' action
- Stimulate the Sympathetic Nervous System (SNS).
- Adrenergic receptors
-
Blood vessels
- alpha 1 constriction, beta 2 dilation
Cardiac muscle
- Positive inotropic effect - beta 1 increased contractility
- AV Node - Positive chronotropic effect - beta 1 increased heart rate
Bladder
- alpha 1 constriction
Uterus
- beta 2 relaxation
Bronchial muslces
- beta 2 dilation
GI System
- decreased motility - Catecholamines
-
- Norepinephring, epinephrine, dopamine
- Produced by SNS
- Stored in the nerve ends
- Nerve stimulated = Catecholmine released into synaptic cleft
- Causes organ to respond
- Stopped by enzymes or reuptake of neurotransmitter - Drug effects of the beta 2 specific drugs
-
- bronchodilation
- long term matintenence treatment of asthma
- prevention of bronchospasm - Sudafed/Afrin action
- Decongestant
- Therapeutic used of Adrenergic Agents
-
- Anorexiant
- Bronchodilator
- Glaucoma
- Mydriasis
- Ophthalmics
- Vasoactives/Pressors/Inotropes - Stress Hormone
- Epinephrine
- Neurotransmitters of the Sympathetic Nervous System
-
- Norepinephrine
- Epinephrine
- Dopamine - Adrenergic-blocker agents
-
- Work primarily on SNS
- antagonists
- sypatholytics
- Alpha and Beta blockers
- Block stimulation of SNS receptors - Dobutrex
-
- Beta 1 selective
- Increases cardiac output
- Increases stroke volume, contractility
- Used for CHF
- Increased blood flow = increases O2 to body parts
- IV only - Inotropic, Chronotropic, Dromotropic Effects
-
- Inotropic - increase the force of myocardial contratction
- Chronotropic - increase the rate at which the heart beats
- Dromotropic - accelerate conduction - Tenormin
-
- prevention of furture MI's
- hypertension
- angina - Cholingergic agent actions
-
- act on the PSNS
- direct acting - stimulate receptor
- indirect acting - prevent Ach breakdown - Anticholingeric Side Effects
-
- dry mouth
- urinary retention
- blurred vision
- constipation
- arrythmias - Bee Sting Kits
- ??
- Serevent
-
- new beta 2 agonist
- long-term maintenence treatment of asthma
- prevention of bronchospasm
- not for asthma attacks - Ergostat
-
- constricts blood vessels in brain
- treatment for Migrains
- contraindicated - peripheral vascular disease, coronary artery disease, hypertension, pregnancy. - Minipress
-
- alpha blocker
- orthostatic hypotension associated
- treat - hypertension, bph (increased prostate size) - Lopressor
-
- Adrenergic Beta blocker
- popular for post-MI patients
- shown increase in survival rates of post-MI patients - Urecholine
-
- direct acting cholinergic agent
- smooth muscle of the bladder
- used for post-partum or post-surgical urine retention
- Oral - Aricept
-
- cholinergic agent
- increase leved of Ach by blocking breakdown, indirect acting
- used to treat Alzheimers - Elderly patients taking Anticholinergics
- - more suseptible to the side effects
- Anticholinergic side effects
-
- dry mouth
- urinary retention
- blurred vision
- constipation
- arrythmias - Cardiac Glycosides
-
- help heart perform its duties
- restores heart to normal sinus rhythm
- Digoxin - Apical Pulse/Cardiac Glycosides
- Must take the apical pulse before giving a Cardiac Glycoside. If it is less than 60, hold the dose, contact MD.
- Digibind
- Given to stop effects of Cardiac Glycosides in a case of toxicity/overdose.
- Normal Heart Contractions
- ??
- Lidocaine
-
- class Ib antidysrhythmic agent
- drug of choice for Ventricular Dysrhythmias
- IV
- Adverse Effects: CNS toxicities, decreasees HR, BP and respirations.
- Monitor vitals carefully - Health teaching for Digoxin
-
- take at the same time each day
- never double up or skip doses
- don't change brands
- watch for side effects
- high potassium foods - Predisposition to digitalis toxicity
-
- bradycardia, any dysrhythmias, anorexia
- N + V, headache, fatigue, confusion
- visual disturbances - Therapeutic Digoxin Levels
- 0.5 - 2.0
- Potassium levels effect on digitalis activity
- low potassium levels increase toxicity
- Adverse effects of Quinidine
- - cause prolonged QT interval on EKG, means the heart is too slow.
- Condarone
-
- class III anytidysrhythmic
- inhibit repolarization
- indicated for life-threatening ventricular tach. or ventricular fib. when resistant to other drug therapy. - Calan
-
- prevents recurrence of PSVT
- class IV antidysrhythmic - Categories of antidysrhythmics
-
- class Ia and Ib - Membrane stabilizing
- class II - beta blockers
- class III - inhibit repolarization
- class IV - calcium channel blockers (CCB's) - Ejection fraction
- amount of blood ejected with each contraction compared with the total amount of blood in the ventricle before contraction. Should be at least 65% ejected.
- SA Node
-
- pacemaker of the heart
- causes atrium to contract - Bundle of His
-
- located in the ventricular septum
- important in sending impulses to the heart - Drug of choice for ventricular dysrhythmias
- Lidocaine
- Adrenelin - most common route
- Parenterally
- Anticholinergic agent actions
-
- blocks or inhibit Ach
- blocks PSNS, allows SNS to dominate. - Congestive Heart Failure
-
- Heart is unable to pump, increased blood in the ventricle = back-up of blood = increased pressure = pulmonary congestion.
- Left ventricle back-up into the lungs = dyspnea, SOB, gurgline, cough
- Right ventricle back-up into the venae cavae = edema in lower extremities, hepatic congestion = abdominal pain, acities.