PHARM 2 EXAM 1 STUDY GUIDE!
CHAPTER 15:
How to adrenergic agonist drugs differ from adrenergic antagonist drugs?
• ADRENERGIC AGONIST medications will help aid the sympathetic nervous system response
o Mobilizes the FIGHT or FLIGHT RESPONSE!
▪ Increased HR, increased BP, urinary retention, decreased peristalsis, diaphoresis,
dry mouth, dry eyes, glycolysis
o ACTIONS: bronchodilation, vasoconstriction, pupil dilation, low urine output
• ADRENERGIC ANTAGONIST medications will create effects that are opposing the sympathetic
nervous system (parasympathetic nervous system)
o Like REST and DIGEST
▪ Decreased HR, decreased BP, increased urinary output, increased peristalsis,
increased hunger
o ACTIONS: bronchoconstriction, vasodilation, pupil constriction, urine output
~ the effect of the drug will depend on which adrenergic receptor acts on!
• ALPHA 1: heart constriction at the periphery (vasoconstriction, which increased blood pressure)
• ALPHA 2: lung constriction (bronchoconstriction, typically seen in rest and digest)
• BETA 1: heart dilation (central dilation of the heart, decreasing the contractility via decreasing
impulses, resulting in decreased HR)
• BETA 2; lung dilation (bronchodilation, typically an effect of the SNS; method if action used for
SABA, CORTICOSTERIODS, & LABA for those with COPD and asthma)
KNOW TABLE 16.1
EPINEPHRINE:
Class: Adrenergic Agonist
Action: Binds to beta ½, alpha 1 to mobilize the effect of SNS
Indication: Anaphylactic shock (drops the blood pressure, drops the heart rate), cardiac arrest,
allergic reactions, congestion
Expected reaction: Bronchodilation, increased HR, increased BP
,Side effects: (Adrenergic effect) High sugar levels, headache, dizziness, weakness, n/v, restlessness,
tremors, nausea
Adverse effects: dysrhythmias! (pt that are on epinephrine need to be on a cardiac monitor), did the
medication work? (increased heart rate, increased BP)
Nursing Considerations:
• MONITOR patients for tachycardia, dysrhythmias
• MONITOR patient glucose levels
Patient education:
• EDUCATE patient how/when to use EpiPen and ADVISE pt to only take medication that has
adrenergic effects too
• ADVISE pt to report any abnormal signs that are related to the heart
• EDUCATE patient to call 911 after EpiPen admin to make sure there is no rebound effect
ATENOLOL:
Class: Adrenergic Antagonist (Beta-Blocker)
Action: Inhibition of B1 receptor --- decreases the HR and BP, by causing vasodilation and slowing down
AV and SA node, suppression of the RAAS system (increased urine output)
• B1 = increases heart contraction
• B2 = bronchodilation
Indication: Hypertension, prophylaxis and treatment for MI**, angina, heart failure
Expected reaction: decreased heart rate, decreased blood pressure, increased urination, increased bowel
movement, n/v/d, peristalsis
Side effects: bronchoconstriction, increased urine output, bradycardia, hypotension, dizzy, weak,
fatigue
• SIDE EFFECTS THAT ARE RELATED TO DECREASED HEART RATE!
o Hypotension, fatigue, drowsiness, erectile dysfunction
Adverse effects: bronchospasm (do not give to pt with COPD --- reduced airflow), dysrhythmias, chest
pain, heart failure, renal failure
Nursing considerations:
• ASSESS patient urine output --- check electrolyte balance
• MONITOR pt vital signs (BP, HR)
o EDUCATE patients on how to take blood pressure and what the normal blood pressure is
• MONITOR pt for ORTHO HYPOTENSION --- change to BP can cause ORTHO HYPO
• ASSESS pt blood pressure before administration of ATENOLOL
, o Do NOT admin to patient who is naturally hypotensive
• Pt at risk for falls
Patient education:
• EDUCATE patient to take their time when getting up
o Do not get up fast, get up slowly
• Not safe for pregnant women
• Therapeutic effect does not occur until 2-3 weeks after
• Do not take if hypotensive
• Do not stop medication abruptly
• Do not take with NSAIDS
~ adverse effect: notify the doctor and they will prescribe a different one
CHAPTER 16:
Differentiate the action of cholinergic from anticholinergics.
• All CHOLINERGIC medications will work with MUSCARINIC (smooth) and NICOTINIC
(skeletal)
• CHOLINERGIC MEDICATION: increases “REST & DIGEST” functions of the body
o S/Sx: Pupil constriction, increased salivation, decreased BP & HR, urination, n/v/d
• CHOLINERGIC ANTAGONIST: these medications will induce effects that are like “FIGHT or
FLIGHT” responses
o S/Sx: pupiil dilation, decreased salivation, decreased peristalsis, increased BP & HR,
hyperglycemia, tachypnea, decreased urination
BETHANECHOL:
Class: Cholinergic Agonist (Aids the effect of the PNS, increases the effect of REST and DIGEST)
Action: Binds to muscarinic receptors to initiate bladder contraction and cause bronchoconstriction
Indication: Urinary retention
Expected reaction: Increased urination for patients that are experiencing urinary retention
Side effects: Hypotension, urinary frequency and urgency, increased salivation, peristalsis, n/v/d,
headache
Adverse effects: Bronchospasms, tachycardia, HYPOTENSION!
Nursing considerations:
CHAPTER 15:
How to adrenergic agonist drugs differ from adrenergic antagonist drugs?
• ADRENERGIC AGONIST medications will help aid the sympathetic nervous system response
o Mobilizes the FIGHT or FLIGHT RESPONSE!
▪ Increased HR, increased BP, urinary retention, decreased peristalsis, diaphoresis,
dry mouth, dry eyes, glycolysis
o ACTIONS: bronchodilation, vasoconstriction, pupil dilation, low urine output
• ADRENERGIC ANTAGONIST medications will create effects that are opposing the sympathetic
nervous system (parasympathetic nervous system)
o Like REST and DIGEST
▪ Decreased HR, decreased BP, increased urinary output, increased peristalsis,
increased hunger
o ACTIONS: bronchoconstriction, vasodilation, pupil constriction, urine output
~ the effect of the drug will depend on which adrenergic receptor acts on!
• ALPHA 1: heart constriction at the periphery (vasoconstriction, which increased blood pressure)
• ALPHA 2: lung constriction (bronchoconstriction, typically seen in rest and digest)
• BETA 1: heart dilation (central dilation of the heart, decreasing the contractility via decreasing
impulses, resulting in decreased HR)
• BETA 2; lung dilation (bronchodilation, typically an effect of the SNS; method if action used for
SABA, CORTICOSTERIODS, & LABA for those with COPD and asthma)
KNOW TABLE 16.1
EPINEPHRINE:
Class: Adrenergic Agonist
Action: Binds to beta ½, alpha 1 to mobilize the effect of SNS
Indication: Anaphylactic shock (drops the blood pressure, drops the heart rate), cardiac arrest,
allergic reactions, congestion
Expected reaction: Bronchodilation, increased HR, increased BP
,Side effects: (Adrenergic effect) High sugar levels, headache, dizziness, weakness, n/v, restlessness,
tremors, nausea
Adverse effects: dysrhythmias! (pt that are on epinephrine need to be on a cardiac monitor), did the
medication work? (increased heart rate, increased BP)
Nursing Considerations:
• MONITOR patients for tachycardia, dysrhythmias
• MONITOR patient glucose levels
Patient education:
• EDUCATE patient how/when to use EpiPen and ADVISE pt to only take medication that has
adrenergic effects too
• ADVISE pt to report any abnormal signs that are related to the heart
• EDUCATE patient to call 911 after EpiPen admin to make sure there is no rebound effect
ATENOLOL:
Class: Adrenergic Antagonist (Beta-Blocker)
Action: Inhibition of B1 receptor --- decreases the HR and BP, by causing vasodilation and slowing down
AV and SA node, suppression of the RAAS system (increased urine output)
• B1 = increases heart contraction
• B2 = bronchodilation
Indication: Hypertension, prophylaxis and treatment for MI**, angina, heart failure
Expected reaction: decreased heart rate, decreased blood pressure, increased urination, increased bowel
movement, n/v/d, peristalsis
Side effects: bronchoconstriction, increased urine output, bradycardia, hypotension, dizzy, weak,
fatigue
• SIDE EFFECTS THAT ARE RELATED TO DECREASED HEART RATE!
o Hypotension, fatigue, drowsiness, erectile dysfunction
Adverse effects: bronchospasm (do not give to pt with COPD --- reduced airflow), dysrhythmias, chest
pain, heart failure, renal failure
Nursing considerations:
• ASSESS patient urine output --- check electrolyte balance
• MONITOR pt vital signs (BP, HR)
o EDUCATE patients on how to take blood pressure and what the normal blood pressure is
• MONITOR pt for ORTHO HYPOTENSION --- change to BP can cause ORTHO HYPO
• ASSESS pt blood pressure before administration of ATENOLOL
, o Do NOT admin to patient who is naturally hypotensive
• Pt at risk for falls
Patient education:
• EDUCATE patient to take their time when getting up
o Do not get up fast, get up slowly
• Not safe for pregnant women
• Therapeutic effect does not occur until 2-3 weeks after
• Do not take if hypotensive
• Do not stop medication abruptly
• Do not take with NSAIDS
~ adverse effect: notify the doctor and they will prescribe a different one
CHAPTER 16:
Differentiate the action of cholinergic from anticholinergics.
• All CHOLINERGIC medications will work with MUSCARINIC (smooth) and NICOTINIC
(skeletal)
• CHOLINERGIC MEDICATION: increases “REST & DIGEST” functions of the body
o S/Sx: Pupil constriction, increased salivation, decreased BP & HR, urination, n/v/d
• CHOLINERGIC ANTAGONIST: these medications will induce effects that are like “FIGHT or
FLIGHT” responses
o S/Sx: pupiil dilation, decreased salivation, decreased peristalsis, increased BP & HR,
hyperglycemia, tachypnea, decreased urination
BETHANECHOL:
Class: Cholinergic Agonist (Aids the effect of the PNS, increases the effect of REST and DIGEST)
Action: Binds to muscarinic receptors to initiate bladder contraction and cause bronchoconstriction
Indication: Urinary retention
Expected reaction: Increased urination for patients that are experiencing urinary retention
Side effects: Hypotension, urinary frequency and urgency, increased salivation, peristalsis, n/v/d,
headache
Adverse effects: Bronchospasms, tachycardia, HYPOTENSION!
Nursing considerations:
