■ NUR 210 — PHARMACOLOGY EXAM 2 BABY STUDY GUIDE ■
Unit 4: ANS Drugs (Adrenergic + Cholinergic) | Unit 5: Neuro Drugs (Parkinson's, Alzheimer's, Myasthenia Gravis, Muscle
Spasms)
■ HOW TO READ THIS GUIDE
■ Each drug gets its own section broken down super simply — like a friend explaining it to you!
■ Memory tricks are in YELLOW boxes — say them out loud to make them stick!
■ Red boxes = danger! These are the things that can HURT or KILL patients.
■ Blue boxes = what to TEACH the patient.
■ = the most tested thing in that section — do NOT skip it!
■ This guide covers EVERY drug on your teacher's med list — nothing left out!
■ AUTONOMIC NERVOUS SYSTEM (ANS) OVERVIEW — Understand This First!
■ MEMORY TRICK:
"SNS = FIGHT or FLIGHT | PNS = REST and DIGEST"
These two systems are OPPOSITES. Everything one does, the other UNDOES. ■ SNS (Sympathetic) = FIGHT or FLIGHT: → Heart
beats FASTER, BP goes UP, bronchi OPEN, pupils DILATE, bladder RELAXES → Think: You see a bear → your body gets READY
TO RUN! ■ PNS (Parasympathetic) = REST and DIGEST: → Heart beats SLOWER, BP goes DOWN, bronchi CONSTRICT, pupils
CONSTRICT, bladder CONTRACTS → Think: You just ate a big meal → your body DIGESTS and RESTS! ■ Adrenergic drugs = act
like SNS (fight or flight) ■ Cholinergic drugs = act like PNS (rest and digest)
Body Part SNS Response (Fight/Flight) Adrenergic Effect PNS Response (Rest/Digest) Cholinergic Effect
Heart ❤■ FASTER (↑ HR, ↑ contractility) ❤■ SLOWER (↓ HR)
Blood Vessels ■ CONSTRICT (↑ BP) ■ DILATE (↓ BP)
Bronchi/Lungs ■ OPEN/DILATE (bronchodilation) ■ CONSTRICT + more secretions
Eyes (pupils) ■■ DILATE (mydriasis) ■■ CONSTRICT (miosis)
GI Tract ■ SLOW DOWN (↓ motility) ■ SPEED UP (↑ motility, peristalsis)
Bladder ■ RELAX (retain urine) ■ CONTRACT (urinate)
Salivary Glands ■ DRY MOUTH (↓ saliva) ■ WET MOUTH (↑ saliva)
Skin/Sweat ■■ SWEAT (diaphoresis) —
Blood Glucose ■ INCREASES (glycogenolysis) —
■ MEMORY TRICK:
"RECEPTOR TRICK: B1 = 1 HEART | B2 = 2 LUNGS"
Beta 1 receptor = 1 heart → mainly affects the HEART (↑HR, ↑contractility) Beta 2 receptor = 2 lungs → mainly affects the LUNGS
(bronchodilation) Alpha 1 receptor → blood vessels (vasoconstriction, ↑BP), pupils (dilate), bladder (sphincter contracts) Drugs A-M =
SELECTIVE beta-1 blockers (safer for COPD/asthma) → atenolol, metoprolol Drugs N-Z = NON-SELECTIVE beta blockers (block
BOTH beta-1 AND beta-2) → propranolol ■ NON-SELECTIVE beta blockers in COPD/asthma = DANGEROUS (causes
bronchoconstriction)!
■ UNIT 4: ADRENERGIC AGONISTS — "Copy the Fight or Flight Response!"
, ■ ADRENERGIC AGONISTS — What Do They Do?
They STIMULATE the sympathetic nervous system (SNS).
They mimic norepinephrine and epinephrine — the body's own "emergency" chemicals.
Think: "These drugs make your body think it is in an EMERGENCY!"
→ Heart goes FASTER, BP goes UP, bronchi OPEN, bladder RELAXES, pupils DILATE
Also called: SYMPATHOMIMETICS (they mimic the sympathetic nervous system)
■ Receptors they act on: Alpha-1, Beta-1, Beta-2 (or just some of these)
■ EPINEPHRINE (Adrenaline) Adrenergic Agonist — Nonselective (α1, β1, β2)
■ USES (When do we give it?): ■ CONTRAINDICATIONS:
• ■ #1 use: ANAPHYLAXIS (severe allergic reaction — • TACHYCARDIA (already fast — giving epi makes it WORSE)
life-threatening emergency!) • GLAUCOMA (increases intraocular pressure)
• Bronchospasm, status asthmaticus (severe asthma attack) • Labor (can inhibit contractions)
• Cardiogenic shock, cardiac arrest • CAUTION: Hypertension, prostatic hypertrophy, DIABETES
• Local anesthetic (to prolong effect) MELLITUS
■■ HOW IT WORKS (Action): ■ DRUG INTERACTIONS:
• NON-SELECTIVE: stimulates Alpha-1, Beta-1, AND Beta-2 • MAOIs + TCAs → INTENSIFY and PROLONG epinephrine
receptors effect (dangerous hypertension)
• Alpha-1 → VASOCONSTRICTION → ↑ blood pressure • Beta blockers → BLOCK the effect of epinephrine
• Beta-1 → ↑ HEART RATE and ↑ contractility • Digoxin → INCREASES risk of DYSRHYTHMIA
• Beta-2 → BRONCHODILATION (opens up the airways) • ■ Lab: INCREASES blood glucose — warn diabetic patients!
■■ SIDE EFFECTS/ADVERSE REACTIONS: ■ NURSING INTERVENTIONS:
• Tachycardia, palpitations, cardiac DYSRHYTHMIAS • Monitor BP, HR, and urine output closely
• HYPERTENSION • IV: give slowly (1 mg/minute) unless cardiac arrest — put on
• HYPERGLYCEMIA (Beta-2 activates liver glycogenolysis → ↑ cardiac monitor
blood sugar) • Monitor IV site for INFILTRATION (vasoconstriction can cause
• Headache, dizziness, anxiety, agitation, insomnia tissue death!)
• Sweating, GI disturbances • Monitor blood glucose in DIABETIC patients
• ■ Monitor diabetic patients' blood sugar closely! • Report: hypertension, irregular heart rate, tachycardia
■ PATIENT TEACHING — EPINEPHRINE / EPIPEN (from PowerPoint)
✔ Have your EpiPen with you AT ALL TIMES — everywhere you go!
✔ Use at the FIRST SIGN of allergic reaction — do not wait to see if it gets worse
✔ Inject into the OUTER THIGH (subcutaneously) — hold in place 5-10 seconds, then MASSAGE the site
✔ Do NOT refrigerate EpiPen — store in a cool, dark place
✔ Inspect contents before use — do NOT use if solution is PINK or BROWN (discolored)
✔ Report to provider if you use EpiPen MORE THAN TWICE a week
✔ AVOID cold medications and diet pills — they increase blood pressure
✔ Avoid adrenergic medications while BREASTFEEDING
✔ Nasal spray version: use only 3-5 days (rebound congestion after that!)
■ MEMORY TRICK:
"EPI = EMERGENCY PILL. Think 3 things: ↑HR, ↑BP, OPEN AIRWAYS!"
Alpha-1 = Arteries squeeze (↑BP) Beta-1 = Beat Faster (↑HR) Beta-2 = Breathe Better (bronchodilation) ■ EpiPen teaching: OUTER
THIGH | HOLD 5-10 sec | MASSAGE after | STORE cool dark place ■ CI: tachycardia, glaucoma, labor ■ RAISES blood sugar —
watch diabetics! ■ DIGOXIN + EPI = dysrhythmia risk ■ MAOIs + EPI = dangerously intense response
■ UNIT 4: ADRENERGIC BLOCKERS (Beta Blockers) — "Block the Fight or Flight!"
Unit 4: ANS Drugs (Adrenergic + Cholinergic) | Unit 5: Neuro Drugs (Parkinson's, Alzheimer's, Myasthenia Gravis, Muscle
Spasms)
■ HOW TO READ THIS GUIDE
■ Each drug gets its own section broken down super simply — like a friend explaining it to you!
■ Memory tricks are in YELLOW boxes — say them out loud to make them stick!
■ Red boxes = danger! These are the things that can HURT or KILL patients.
■ Blue boxes = what to TEACH the patient.
■ = the most tested thing in that section — do NOT skip it!
■ This guide covers EVERY drug on your teacher's med list — nothing left out!
■ AUTONOMIC NERVOUS SYSTEM (ANS) OVERVIEW — Understand This First!
■ MEMORY TRICK:
"SNS = FIGHT or FLIGHT | PNS = REST and DIGEST"
These two systems are OPPOSITES. Everything one does, the other UNDOES. ■ SNS (Sympathetic) = FIGHT or FLIGHT: → Heart
beats FASTER, BP goes UP, bronchi OPEN, pupils DILATE, bladder RELAXES → Think: You see a bear → your body gets READY
TO RUN! ■ PNS (Parasympathetic) = REST and DIGEST: → Heart beats SLOWER, BP goes DOWN, bronchi CONSTRICT, pupils
CONSTRICT, bladder CONTRACTS → Think: You just ate a big meal → your body DIGESTS and RESTS! ■ Adrenergic drugs = act
like SNS (fight or flight) ■ Cholinergic drugs = act like PNS (rest and digest)
Body Part SNS Response (Fight/Flight) Adrenergic Effect PNS Response (Rest/Digest) Cholinergic Effect
Heart ❤■ FASTER (↑ HR, ↑ contractility) ❤■ SLOWER (↓ HR)
Blood Vessels ■ CONSTRICT (↑ BP) ■ DILATE (↓ BP)
Bronchi/Lungs ■ OPEN/DILATE (bronchodilation) ■ CONSTRICT + more secretions
Eyes (pupils) ■■ DILATE (mydriasis) ■■ CONSTRICT (miosis)
GI Tract ■ SLOW DOWN (↓ motility) ■ SPEED UP (↑ motility, peristalsis)
Bladder ■ RELAX (retain urine) ■ CONTRACT (urinate)
Salivary Glands ■ DRY MOUTH (↓ saliva) ■ WET MOUTH (↑ saliva)
Skin/Sweat ■■ SWEAT (diaphoresis) —
Blood Glucose ■ INCREASES (glycogenolysis) —
■ MEMORY TRICK:
"RECEPTOR TRICK: B1 = 1 HEART | B2 = 2 LUNGS"
Beta 1 receptor = 1 heart → mainly affects the HEART (↑HR, ↑contractility) Beta 2 receptor = 2 lungs → mainly affects the LUNGS
(bronchodilation) Alpha 1 receptor → blood vessels (vasoconstriction, ↑BP), pupils (dilate), bladder (sphincter contracts) Drugs A-M =
SELECTIVE beta-1 blockers (safer for COPD/asthma) → atenolol, metoprolol Drugs N-Z = NON-SELECTIVE beta blockers (block
BOTH beta-1 AND beta-2) → propranolol ■ NON-SELECTIVE beta blockers in COPD/asthma = DANGEROUS (causes
bronchoconstriction)!
■ UNIT 4: ADRENERGIC AGONISTS — "Copy the Fight or Flight Response!"
, ■ ADRENERGIC AGONISTS — What Do They Do?
They STIMULATE the sympathetic nervous system (SNS).
They mimic norepinephrine and epinephrine — the body's own "emergency" chemicals.
Think: "These drugs make your body think it is in an EMERGENCY!"
→ Heart goes FASTER, BP goes UP, bronchi OPEN, bladder RELAXES, pupils DILATE
Also called: SYMPATHOMIMETICS (they mimic the sympathetic nervous system)
■ Receptors they act on: Alpha-1, Beta-1, Beta-2 (or just some of these)
■ EPINEPHRINE (Adrenaline) Adrenergic Agonist — Nonselective (α1, β1, β2)
■ USES (When do we give it?): ■ CONTRAINDICATIONS:
• ■ #1 use: ANAPHYLAXIS (severe allergic reaction — • TACHYCARDIA (already fast — giving epi makes it WORSE)
life-threatening emergency!) • GLAUCOMA (increases intraocular pressure)
• Bronchospasm, status asthmaticus (severe asthma attack) • Labor (can inhibit contractions)
• Cardiogenic shock, cardiac arrest • CAUTION: Hypertension, prostatic hypertrophy, DIABETES
• Local anesthetic (to prolong effect) MELLITUS
■■ HOW IT WORKS (Action): ■ DRUG INTERACTIONS:
• NON-SELECTIVE: stimulates Alpha-1, Beta-1, AND Beta-2 • MAOIs + TCAs → INTENSIFY and PROLONG epinephrine
receptors effect (dangerous hypertension)
• Alpha-1 → VASOCONSTRICTION → ↑ blood pressure • Beta blockers → BLOCK the effect of epinephrine
• Beta-1 → ↑ HEART RATE and ↑ contractility • Digoxin → INCREASES risk of DYSRHYTHMIA
• Beta-2 → BRONCHODILATION (opens up the airways) • ■ Lab: INCREASES blood glucose — warn diabetic patients!
■■ SIDE EFFECTS/ADVERSE REACTIONS: ■ NURSING INTERVENTIONS:
• Tachycardia, palpitations, cardiac DYSRHYTHMIAS • Monitor BP, HR, and urine output closely
• HYPERTENSION • IV: give slowly (1 mg/minute) unless cardiac arrest — put on
• HYPERGLYCEMIA (Beta-2 activates liver glycogenolysis → ↑ cardiac monitor
blood sugar) • Monitor IV site for INFILTRATION (vasoconstriction can cause
• Headache, dizziness, anxiety, agitation, insomnia tissue death!)
• Sweating, GI disturbances • Monitor blood glucose in DIABETIC patients
• ■ Monitor diabetic patients' blood sugar closely! • Report: hypertension, irregular heart rate, tachycardia
■ PATIENT TEACHING — EPINEPHRINE / EPIPEN (from PowerPoint)
✔ Have your EpiPen with you AT ALL TIMES — everywhere you go!
✔ Use at the FIRST SIGN of allergic reaction — do not wait to see if it gets worse
✔ Inject into the OUTER THIGH (subcutaneously) — hold in place 5-10 seconds, then MASSAGE the site
✔ Do NOT refrigerate EpiPen — store in a cool, dark place
✔ Inspect contents before use — do NOT use if solution is PINK or BROWN (discolored)
✔ Report to provider if you use EpiPen MORE THAN TWICE a week
✔ AVOID cold medications and diet pills — they increase blood pressure
✔ Avoid adrenergic medications while BREASTFEEDING
✔ Nasal spray version: use only 3-5 days (rebound congestion after that!)
■ MEMORY TRICK:
"EPI = EMERGENCY PILL. Think 3 things: ↑HR, ↑BP, OPEN AIRWAYS!"
Alpha-1 = Arteries squeeze (↑BP) Beta-1 = Beat Faster (↑HR) Beta-2 = Breathe Better (bronchodilation) ■ EpiPen teaching: OUTER
THIGH | HOLD 5-10 sec | MASSAGE after | STORE cool dark place ■ CI: tachycardia, glaucoma, labor ■ RAISES blood sugar —
watch diabetics! ■ DIGOXIN + EPI = dysrhythmia risk ■ MAOIs + EPI = dangerously intense response
■ UNIT 4: ADRENERGIC BLOCKERS (Beta Blockers) — "Block the Fight or Flight!"
