NURS 5334 Module 4 Correctly answered updated 2022

NURS 5334 Module 4 Correctly answered updated 2022What are the mechanisms by which neuropharmacologic agents act? ... Transmitter synthesis is the first step in transmission. What are the other 4 steps? ... True or false. Neuropharmacologic drugs have high selectivity. True. Neuropharmacologic drugs have high selectivity because the nervous system uses many different receptor types. What are 3 functions of the ANS? 1. Regulate the heart 2. regulate the secretory glands (salivary, gastric, sweat, and bronchial) 3. Regulate the smooth muscles (bronchi, blood vessels, urogenital system, and GI tract) What are the regulatory functions of the PNS? 1. Slowing HR 2. Increasing gastric secretions 3. Emptying the bladder 4. Emptying the bowel 5. Focusing the eyes for near vision 6. Constricting the pupils 7. Contracting bronchial smooth muscles What are the functions of the SNS? 1. Regulation of the CV system 2. Regulation of body temp 3. Implementation of the "fight-or-flight" response How does the SNS regulate the CV system? 1. Maintaining blood flow to the brain 2. Redistributing blood 3. Compensating for lost blood How does the SNS regulate body temp? 1. Regulates blood flow to the skin 2. Promotes secretion of sweat 3. Induces piloerection What are the effects of the "fight-or-flight" response? 1. Increased HR and BP 2. Shunting of blood away from the skin and viscera 3. Dilation of the bronchi 4. Pupil dilation 5. Mobilization of stored energy What is the baroreceptor reflex? -Receptors near heart monitor BP changes and send info to brain -Brain activates ANS to restore BP to normal -When BP falls, baroreceptor reflex causes vasoconstriction and increases cardiac output -When BP rises, baroreceptor reflex causes vasodilation and reduces cardiac output Where is acetylcholine employed? Most junctions of the PNS Where is norepinephrine released? By most postganglionic neurons Where is epinephrine released? Adrenal medulla What are cholinergic receptors mediated by? Acetylcholine What are cholinergic receptor subtypes? Nicotinic and muscarinic What are the functions of nicotinic receptors? -Ganglionic transmission at all ganglia of the SNS and PNS -Promotes release of epi from the adrenal medulla What are the functions of muscarinic receptors? -Increased glandular secretions (pulmonary, gastric, intestinal, and sweat) -Contraction of smooth muscles in bronchial and GI tract -Slowing of HR -Contraction of sphincter muscles of iris (miosis) -Contraction of ciliary muscle of the eye (near vision) -Dilation of blood vessels -Voiding of urinary bladder What are adrenergic receptors mediated by? epi and NE What are adrenergic receptor subtypes? -Alpha 1 -Alpha 2 -Beta 1 -Beta 2 -Dopamine What are the functions of alpha 1 receptors? -Vasoconstriction -Ejaculation -Contraction of bladder neck and prostate What are the functions of alpha 2 receptors? -Minimal clinical significance -Located in presynaptic junction What are the functions of beta 1 receptors? Heart: -Increased HR -Increased force of contraction -Increased velocity of conduction in atrioventricular (AV) node Kidney: -Renin release What are the functions of beta 2 receptors? -Bronchial dilation -Relaxation of uterine muscle -Vasodilation -Glycogenolysis What are the functions of dopamine receptors? Dilation of renal blood vessels Which receptors are activated by epi? All alpha and beta; does not activate dopamine receptors Which receptors are activated by NE? Alpha 1, alpha 2, beta 1; does not activate beta 2 of dopamine receptors Which receptors are activated by dopamine? Alpha 1, beta 1, and dopamine receptors What do muscarinic agonists do? Mimic the effects of Ach at muscarinic receptors What do muscarininc antagonists do? Selectively block the effects of Ach (and other muscarinic) agonists at muscarinic receptors What are the therapeutic uses of Bethanechol? -Urinary retention -Investigational GI uses What are the actions of Bethanechol on smooth muscles? -Lungs: constriction of bronchi -GI: increased tone and motility -Bladder: contraction of detrusor muscle and relaxation of trigone and sphincter What are the actions of Bethanechol on exocrine glands? -Increased sweating -Increased salivation -Increased bronchial secretions -Increased secretion of gastric acid What are the actions of Bethanechol on the eyes? -Miosis -Contraction of ciliary muscle What are the adverse effects of Bethanechol? -CV system: hypotension -GI system: increased tone and motility -Exacerbation of asthma -Dysrhythmias in pts w/ hyperthyroidism What are Cevimeline, pilocarpine, and acetylcholine used for? -Cevimeline: derivative of ach used mainly for xerostomia, keratoconjunctivitis sicca, and dry eye -Pilocarpine: used mainly for topical therapy of glaucoma -Acetylcholine: used for rapid miosis (pupil constriction) in cataract surgery What are the pharmacologic effects of atropine? Cholinergic receptor blockade: -Heart: increased HR -Exocrine glands: decreased secretions -Smooth muscles: relaxes bronchi, decreases tone of urinary bladder detrusor, and decreases tone and motility of the GI tract -Eyes: mydriasis and cycloplegia -CNS: mild excitation to hallucinations and delirium What are the therapeutic uses of atropine? -Preanesthetic medications -D/O of the eye -Bradycardia -Intestinal hypertonicity and hypermotility -Muscarinic agonist poisoning -PUD -Asthma -Biliary colic What are the side effects of atropine? -Xerostomia (dry mouth) -Blurred vision/photophobia -Elevation of intraocular pressure -Urinary retention -Constipation -Anhidrosis -Tachycardia -Asthma What are the therapeutic uses of scopolamine? -Motion sickness -Production of cycloplegia (paralysis of ciliary muscle) -Mydriasis for ophthalmic procedures -Pre-anesthetic sedation -Obstetric amnesia What are the side effects of scopolamine? ... What are the therapeutic uses of ipratropium bromide? -Asthma -COPD -Rhinitis caused by allergies or common cold What are the side effects of ipratropium bromide? Not associated w/ typical antimuscarinic side effects What are mydriatic cycloplegics? -Atropine -Homatropine -Scopolamine -Cyclopentolate -Tropicamide Used to produce mydriasis and cycloplegia in ophthalmic procedures What causes muscarinic poisoning? -Ingestion of certain mushrooms -Direct-acting muscarinic agonists -Cholinesterase inhibitors What are the symptoms of muscarinic poisoning? -Profuse salivation -Lacrimation (tearing) -Visual disturbances -Bronchospasm -Diarrhea -bradycardia -Hypotension w/ possible CV collapse What is the treatment for muscarinic poisoning? Atropine and supportive therapy Which receptors are activated by epinephrine? alpha 1 & 2, beta 1 & 2 What are the therapeutic uses for epinephrine? -Delayed absorption of local anesthetics -Control superficial bleeding -Elevate BP -Overcome AV heart block -Restore cardiac function -Bronchodilation -Treating anaphylactic shock What are the adverse effects of epinephrine? -HTN crisis -Dysrhythmias -Angina pectoris -Necrosis following extravasation -Hyperglycemia What are the drug interactions of epinephrine? -MAOIs -TCAs -General anesthetics -Alpha-adrenergic antagonists -Beta-adrenergic antagonists Which receptors are activated by norepinephrine? alpha 1 & 2, beta 2 What are the therapeutic uses for norepinephrine? -Hypotensive states -Cardiac arrest What are the adverse effects of norepinephrine? Identical to epi minus the hyperglycemia Which receptors are activated by isoproterenol? beta 1 & 2 What are the therapeutic uses for isoproterenol? -AV heart block -Cardiac arrest -Increase cardiac output during shock