Lilley pharmacology and the nursing process

Lilley pharmacology and the nursing process Questions And Answers Eraboration Sympathetic system - fight or flight Norepinepherine Nerves that release NE are called adrenergic parasympathetic division - "rest-and-digest" division of ANS; conserves energy; increases digestion and absorption and relaxtion (ie, heart rate slows, glucose is stored, etc) Neurotransmitter that is released- acetylcholine Acetylcholine - the neurotransmitter released by neurons to activate muscles Cholinergic medications - Stimulate rest and digest response of the parasympathetic system cholinergic-blocking drugs - Drugs that block the action of acetylcholine and substances similar to acetylcholine at receptor sites in the synapse. Acts similar to an adrenergic med Adrenergic medication - Stimulate fight or flight reaction of the sympathetic system adrenergic receptors - receptor sites for the sympathetic neurotransmitters norepinephrine and epinephrine alpha 1&2 beta 1&2 Alpha 1 receptors - vasoCONSTRICTION - increase BP Beta 1 receptors - increase heart rate Beta 1 - increases HR, inotrophy (forced contraction of heart) increases electrical impulse in heart Beta 2 receptors - Relax the smooth muscle in bronchi, uterus, peripheral arterial blood vessels Adrenergic Agonists - Drugs that stimulate and mimic the actions of the sympathetic nervous system. Also called sympathomimetics. Adrenergic Blockers - block adrenergic receptors to suppress fight or flight response; lower HR and BP, can cause wheezes; given to resolve hypertension and tachycardia; may need to institute fall precautions Cholinergic Drug Effects - Cardiovascular effects Decreased heart rate Vasodilation Respiratory effects Bronchial constriction, narrowed airways Adrenergic Drugs: Indications - All used to treat hypertension Glaucoma Management of severe heart failure (HF) when used with cardiac glycosides and diuretics Decongestant Beta-adrenergic agonists - cause a sympathetic response (use with caution in pregnant, elderly, clients with: renal dysfunction, hyperthyroidism, prostatic hypertrophy, hypertension, and Glaucoma) Do NOT take any over the counter drugs without consulting physician Stimulation of the heart (beta 1) and lungs (beta 2). Bronchial, GI, and uterine smooth muscle relaxation. Cardiac stimulation Indications: asthma and allergic reaction Adrenergic Blockers - drugs that block the effects of adrenergic neurotransmitters. Have opposite effect of adrenergic drugs. Alpha adrenergic indications - Hypertension Vascular issues to improve circulation BPH Prostate issues Beta-adrenergic blockers - 1. Olol medications 2. Reduce blood pressure by decreasing cardiac output 3. Indernal (Propranolol) non-selective beta blocker 4. Tenormin (atenolol) selective beta blocker 5. Lopressor (metoprolol) selective beta blocker 6. Avoid epinephrine with non-selective beta blockers Used for A-fib Be careful giving to patients with respiratory problems Cholinergic Actions - Increase GI secretions and motility Increase urinary tract function Pupillary constriction Cholinergic Indications - Urinary retention Treatment of Alzheimer's disease by delaying the deterioration Antidote to skeletal ms blockers Antidote to anticholinergic drug poisoning cholinergic-blocking drugs - Drugs that block the action of acetylcholine and substances similar to acetylcholine at receptor sites in the synapse. cholinergic-blocking indications - Antispasmodic for GI system Asthma and copd Urinary incontinence (more control) Parkinson's disease Antiemetic (helps with nausea) Bradycardia (increase HR) cholinergic-blocking actions - Increase heart rate Decrease secretions and bronchodilation Reduce salivary and GI secretions Inhibit urinary peristalsis and the voiding of urine CNS depressant effect- drowsiness and sedation Alpha Adrenergic Blockers - Relax certain muslces and help small blood vessels remain open. They work by keeping the hormone norepinephrine from tightening the muscles in the walls of smaller arteries and veins. Blocking that effect causes the vessels to remain open and relaxed. This imporves blood flow and lowers BP.