N220 Pharmacology Study Guide
Exam 3
1) Know the difference between a beta and alpha adrenergic drugs.
● Alpha Adrenergic Drugs
○ Predominant response is vasoconstriction and CNS stimulation
○ Alpha 1
■ Receptors located on the postsynaptic effector cells
■ The tissue, muscle, or organ that the nerve stimulates
○ Alpha 2
■ Receptors located on the presynaptic nerve terminals
■ Control the release of neurotransmitters
● Beta Adrenergic Drugs
○ Response is bronchial, gastrointestinal, uterine smooth muscle relaxation
○ Glycogenolysis
○ Cardiac Stimulation
○ Beta 1
■ Heart
○ Beta 2
■ Smooth muscle fibers of bronchioles, arterioles, visceral organs
2) Know about epinephrine.
● Lab Work (Route, Onset of Action, Peak Plasma Concentration, Elimination
Half-life, Duration of Action)
○ Subcut, 5-10 minutes, 20 minutes, variable, unknown
○ IV, less than 2 min, Rapid, Less than 5 min, 5-30 min
● Acts directly on both the alpha and beta adrenergic receptors of tissues innervated
by the SNS
● Considered prototypical non selective adrenergic agonist
● Used in emergency situations and is one of the primary vasoactive drugs used in
many advanced cardiac life support protocols
● Low doses
○ stimulates mostly beta 1 adrenergic receptors, increasing the force of
contraction and heart rate.
○ Used to treat acute asthma and anaphylactic shock because of significant
bronchodilatory effects (Beta 2 in lungs)
● High Doses(IV Drip)
○ stimulated mostly alpha receptors causing vasoconstriction which elevates
blood pressure
● For IV two strengths
○ 1:1000 (1mg/ml)
, ○ 1:10000 (.1mg/ml)f=
3) Know the effects of beta 1 and 2 and alpha 1 drugs.
● Beta 1
○ Heart
○ Cardiac Stimulation
● Beta 2
○ Bronchodilation
● Alpha Drugs
○ Vasoconstriction of blood vessels
4) Be able to recognize beta blocker drugs and know the nursing
considerations.
● List of Beta Blockers
○ Carvedilol-Coreg, Coreg CR
○ Labetalol-Normodyne, Trandate
○ Nadolol-Corgard
○ Penbutolol-Levatol
○ Pindolol-Visken
○ Propranolol-Inderal
○ Sotalol-Betapace
○ Timolol-Blocadren, Timoptic
● Nursing Considerations(Indications)
○ Angina(Chest pain)
○ MI(Myocardial Infarction-heart attack)
○ Cardiac Dysrythmias(irregular heart rhythms)
○ Hypertension(high blood pressure)
○ Heart Failure(heart does not pump as well as it should)
5) Know about the client teaching for alpha and beta agonist and antagonist.
● Agonists (Adrenergic Drugs)
○ Medications are to be used only as prescribed with regard to amount,
timing and spacing of doses
○ Advise patient to immediately report any complaints of chest pain,
palpitations, headaches, or seizures
○ Lung disease patients need to avoid anything that may exacerbate their
respiratory system. Example: Smoking
○ Salmeterol
■ Not to be used for relief of acute symptoms
■ 1 puff twice daily 12 hours apart
■ recheck orders and directions
○ If another type of inhaler is used (Such as corticosteroids)
, ■ Use bronchodilator first with a 5 minute waiting period prior to
taking the second drug
○ Ophthalmic forms
■ Expiration Date
■ Clear Solution
■ Do not allow eyedropper to touch eye
■ conjunctival sac not onto the cornea
○ Oral midodrine
■ As prescribed
■ Usually ordered to be given with forcing fluids before the patient
gets out of bed in the morning.
■ In the morning because that is when patients with orthostatic
intolerance are usually more symptomatic.
■ Avoid taking this med after 6 pm if possible to prevent insomnia
and possible supine hypertension
● Antagonists
○ Avoid caffeine
○ medical alert bracelet or necklace identifying the specific medical
diagnoses provide list of all medication
○ Encourage intake of water to minimize dry mouth
○ Alpha Blockers
■ Change positions slowly to prevent postural hypotension or
syncope
○ Tamsulosin
■ Caution with elderly and while driving
■ Benign prostatic hyperplasia BPH
■ inform all health care providers including dentist
■ Especially before surgery
○ Things to avoid to avoid vasodilation
■ Alcohol
■ excessive exercise
■ exposure to hot climates
■ saunas, hot tubs, heated showers or baths
○ Contact prescriber if patient has
■ Dizziness
■ Fainting
■ Lightheadedness
■ systolic blood pressure is lower than 100 mm hg
■ pulse rate lower than 60 beats per min
■ increase of 2 pounds in 24 hours 5 pounds in 1 week
○ Must be weaned off slowly could lead to rebound hypertension or chest
pain
6) Know everything about bethanechol chloride.
Exam 3
1) Know the difference between a beta and alpha adrenergic drugs.
● Alpha Adrenergic Drugs
○ Predominant response is vasoconstriction and CNS stimulation
○ Alpha 1
■ Receptors located on the postsynaptic effector cells
■ The tissue, muscle, or organ that the nerve stimulates
○ Alpha 2
■ Receptors located on the presynaptic nerve terminals
■ Control the release of neurotransmitters
● Beta Adrenergic Drugs
○ Response is bronchial, gastrointestinal, uterine smooth muscle relaxation
○ Glycogenolysis
○ Cardiac Stimulation
○ Beta 1
■ Heart
○ Beta 2
■ Smooth muscle fibers of bronchioles, arterioles, visceral organs
2) Know about epinephrine.
● Lab Work (Route, Onset of Action, Peak Plasma Concentration, Elimination
Half-life, Duration of Action)
○ Subcut, 5-10 minutes, 20 minutes, variable, unknown
○ IV, less than 2 min, Rapid, Less than 5 min, 5-30 min
● Acts directly on both the alpha and beta adrenergic receptors of tissues innervated
by the SNS
● Considered prototypical non selective adrenergic agonist
● Used in emergency situations and is one of the primary vasoactive drugs used in
many advanced cardiac life support protocols
● Low doses
○ stimulates mostly beta 1 adrenergic receptors, increasing the force of
contraction and heart rate.
○ Used to treat acute asthma and anaphylactic shock because of significant
bronchodilatory effects (Beta 2 in lungs)
● High Doses(IV Drip)
○ stimulated mostly alpha receptors causing vasoconstriction which elevates
blood pressure
● For IV two strengths
○ 1:1000 (1mg/ml)
, ○ 1:10000 (.1mg/ml)f=
3) Know the effects of beta 1 and 2 and alpha 1 drugs.
● Beta 1
○ Heart
○ Cardiac Stimulation
● Beta 2
○ Bronchodilation
● Alpha Drugs
○ Vasoconstriction of blood vessels
4) Be able to recognize beta blocker drugs and know the nursing
considerations.
● List of Beta Blockers
○ Carvedilol-Coreg, Coreg CR
○ Labetalol-Normodyne, Trandate
○ Nadolol-Corgard
○ Penbutolol-Levatol
○ Pindolol-Visken
○ Propranolol-Inderal
○ Sotalol-Betapace
○ Timolol-Blocadren, Timoptic
● Nursing Considerations(Indications)
○ Angina(Chest pain)
○ MI(Myocardial Infarction-heart attack)
○ Cardiac Dysrythmias(irregular heart rhythms)
○ Hypertension(high blood pressure)
○ Heart Failure(heart does not pump as well as it should)
5) Know about the client teaching for alpha and beta agonist and antagonist.
● Agonists (Adrenergic Drugs)
○ Medications are to be used only as prescribed with regard to amount,
timing and spacing of doses
○ Advise patient to immediately report any complaints of chest pain,
palpitations, headaches, or seizures
○ Lung disease patients need to avoid anything that may exacerbate their
respiratory system. Example: Smoking
○ Salmeterol
■ Not to be used for relief of acute symptoms
■ 1 puff twice daily 12 hours apart
■ recheck orders and directions
○ If another type of inhaler is used (Such as corticosteroids)
, ■ Use bronchodilator first with a 5 minute waiting period prior to
taking the second drug
○ Ophthalmic forms
■ Expiration Date
■ Clear Solution
■ Do not allow eyedropper to touch eye
■ conjunctival sac not onto the cornea
○ Oral midodrine
■ As prescribed
■ Usually ordered to be given with forcing fluids before the patient
gets out of bed in the morning.
■ In the morning because that is when patients with orthostatic
intolerance are usually more symptomatic.
■ Avoid taking this med after 6 pm if possible to prevent insomnia
and possible supine hypertension
● Antagonists
○ Avoid caffeine
○ medical alert bracelet or necklace identifying the specific medical
diagnoses provide list of all medication
○ Encourage intake of water to minimize dry mouth
○ Alpha Blockers
■ Change positions slowly to prevent postural hypotension or
syncope
○ Tamsulosin
■ Caution with elderly and while driving
■ Benign prostatic hyperplasia BPH
■ inform all health care providers including dentist
■ Especially before surgery
○ Things to avoid to avoid vasodilation
■ Alcohol
■ excessive exercise
■ exposure to hot climates
■ saunas, hot tubs, heated showers or baths
○ Contact prescriber if patient has
■ Dizziness
■ Fainting
■ Lightheadedness
■ systolic blood pressure is lower than 100 mm hg
■ pulse rate lower than 60 beats per min
■ increase of 2 pounds in 24 hours 5 pounds in 1 week
○ Must be weaned off slowly could lead to rebound hypertension or chest
pain
6) Know everything about bethanechol chloride.
