Term
| What is the neurotransmitter for the Parasympathetic nervous system? |
|
Definition
|
|
Term
| what are the functions of the parasympathetic nervous system? |
|
Definition
pupils constrict (meiosis)
eyes focus for near vision
increase in gastric acid
emptying of bowels and bladder
contraction of small muscles in the bronchi
decrease in HR |
|
|
Term
| What does a direct acting cholinergic agonist agent do? |
|
Definition
| Acts directly at the cholinergic recepter site |
|
|
Term
| What does a indirect acting cholinergic agonist agent do? |
|
Definition
| Acts by making more of the neurotransmitter, acetylcholine, available at the receptor site. It inhibits cholinesterase and acetylcholinesterase. |
|
|
Term
|
Definition
| Transmission of synaptic impulses |
|
|
Term
|
Definition
| controls contractions of skeletal muscles |
|
|
Term
|
Definition
Causes bradycardia
eye-meiosis
bronchioconstriction and increase in bonchial secretions
eye contracts ciliary muscle to increase outflow of aqueous humor
GU-fosters voiding
vasodilation and hypotension
increases salivation
gastric motility and defecation
increased sweating
located on postsynaptic cells, muscles, and glands |
|
|
Term
| What two drugs are muscarnics? |
|
Definition
Pilocarpine (akarpine)
Bethanechol (urecholine) |
|
|
Term
| What is the enzyme that stops the action of acetylcholine? |
|
Definition
|
|
Term
| What is the action of bethanechol (urecholine)? |
|
Definition
contraction of detrusor muscle of bladder
relaxtion of urinary sphincter
esophageal motility
tone and motility of GI tract |
|
|
Term
| What is the therapuetic use of bethanechol (urecholine)? |
|
Definition
non-obstructive urinary retention
atony of bladder
GERD
gastric atony |
|
|
Term
| What are the side effects of bethanechol (urecholine)? |
|
Definition
CV-Bradycardia, hypotension
GI-abd. cramps, diarrhea
R-increased bronchial secretions, broncho/laryngospasm
exocrine-excessive salivation, sweating
eye-miosis |
|
|
Term
| therapeutic uses of Pilocarpine (akarpine)? |
|
Definition
open and closed angle glaucoma
xerostomia (dry mouth) |
|
|
Term
| side effects of Pilocarpine (akarpine)? |
|
Definition
CV-Bradycardia, hypotension
GI-abd. cramps, diarrhea
R-increased bronchial secretions, broncho/laryngospasm
exocrine-excessive salivation, sweating
eye-miosis |
|
|
Term
| contraindications for bethanechol (urecholine)? |
|
Definition
gastric ulcers, intestinal obstruction, urinary tract obstruction, asthma,
HYPERTHYROIDISM-TACHYCARDIA |
|
|
Term
| contraindications for Pilocarpine (akarpine)? |
|
Definition
|
|
Term
|
Definition
A pleasurable stimulation effect in brain
CNS stimulation
activates the hormone vasopressin which causes vasoconstriction |
|
|
Term
| therapeutic use of nicotine? |
|
Definition
|
|
Term
| side effects of nicotine? |
|
Definition
angina pectoris
tachycardia
HA
insomnia
nervousness |
|
|
Term
| contraindications for nicotine? |
|
Definition
post MI
life threatening arrhythmias
severe or worsening angina |
|
|
Term
| What is the action of neostigmine (prostigmin |
|
Definition
| It stimulates the skeletal muscle and acts as any other cholinergic agent. |
|
|
Term
| Therapeutic use of prostigmin |
|
Definition
myasthenia gravis
reverse neuromuscular blocking agents
treat anticholergic poisoning |
|
|
Term
| what is an adverse effect of Prostigmin? |
|
Definition
|
|
Term
|
Definition
| Atropine and mechanical ventilation with o2 when in cholinergic crisis |
|
|
Term
| What is the action of Echothiopate? |
|
Definition
|
|
Term
| therapeutic use of echothiopate? |
|
Definition
open and closed angle glaucoma
insecticeds |
|
|
Term
| Adverse effects of echothiopate? |
|
Definition
|
|
Term
| complications of echothiopate? |
|
Definition
|
|
Term
| antidote for echothiopate? |
|
Definition
| atropine, protopam, and diazepam |
|
|
Term
| what are the body actions of anticholinergic agents? |
|
Definition
increases HR
decreased GI secretions and motility
decrease bladder contraction and increased constriction of internal urinary sphincter
decreased airway resistance, bronchial dialation, decreased secretions
mydriasis
decreased saliva
decreased muscle regidity and tremors |
|
|
Term
| what are some contraindications for anticholinergic agents? |
|
Definition
hypersensitivity to sulfites
myasthenia gravis
MI |
|
|
Term
|
Definition
congentin-parkinsons
artain-parkinsons
robinul-peptic ulcer disease
bentyl-IBS
atropine-eye exams and preanestesia
detrol-overactive bladder
atroven-cures motion sickness
scopolamine-motion sickness, dry mouth |
|
|
Term
| Antidote to cholinergic antagonists? |
|
Definition
| physostigmin-it makes more acetylcholine available |
|
|
Term
| what is the therapeutic use of tubocurarine? |
|
Definition
to maintain controlled ventilation during surgery
electroconvulsive therapy to prevent bone fractures |
|
|
Term
| what are the contraindication of tubocurarine? |
|
Definition
myasthenia gravis
geriatric patients (impaired liver and renal system)
CV disease |
|
|
Term
| complications of tubocurarine? |
|
Definition
apnea
resp. paralysis
cv collapse
maligninant hyperthermia |
|
|
Term
| signs of malignant hyperthermia |
|
Definition
temp 105 or greater
vigorous muscle contraction
rigidity |
|
|
Term
| What should you not do if a pt is on tubocurarine? |
|
Definition
| say anything upsetting-they are still concious and can hear you |
|
|
Term
| What is the antidote for tubocurarine? |
|
Definition
neostigmine (prostigmin)
cholnesterase inhibitor |
|
|
Term
| therapeutic use of succinylcholine (anectine)? |
|
Definition
|
|
Term
| adverse effects of succinylcholine (anectine) |
|
Definition
| post op muscle pain in neck, back, and shouldurs. occurs 12-24 hrs after surgery and persists for days. |
|
|
Term
| contraindicatiosn for succinylcholine (anectine)? |
|
Definition
| pts at risk for hyperkalemia |
|
|
Term
| complications of succinylcholine (anectine)? |
|
Definition
malignant hyperthermia.
Also interacts with cholinesterase inhibitors |
|
|
Term
|
Definition
epinephrine(adrenalin)-All
allerest(phenylephrine)-A1
catapres (clondine)-A2
dopamine (intropin)-B1 |
|
|
Term
|
Definition
prazosin (minipress) A blocker
propranolol (inderal)-B blocker
metoprolol (lopressor, toprol XL) B1 blocker |
|
|
Term
| therapeutic use of epinephrine (adrenalin) |
|
Definition
|
|
Term
| adverse effects of epinephrine (adrenalin) |
|
Definition
many side effects due to nonselectivity action
tachycardia
hypertension |
|
|
Term
| contraindications of epinephrine (adrenalin) |
|
Definition
hypersensitivity to sulfites
closed angle glaucoma
labor
organic CV disease
CVA
HTN
diabetes (causes glycogenolysis) |
|
|
Term
| complications of epinephrine (adrenalin)? |
|
Definition
intracranial bleed due to hypertension
seizures
lethal arrhythmias
necrosis if infiltration occurs-antidote to infiltration-regitine |
|
|
Term
| How much is in each dose of epinephrine (adrenalin)? |
|
Definition
|
|
Term
| Nursing considerations for SQ epinephrine (adrenalin)? |
|
Definition
Aspirate
massage 10 seconds |
|
|
Term
| nursing consideratiosn for IV epinephrine (adrenalin)? |
|
Definition
use large veins
antidote-regitine
IV infusion pump
monitor VS frequently
Monitor urine output hourly |
|
|
Term
| Antidote for epinephrine (adrenalin) |
|
Definition
stop epi, cardiac and resp. support
prazosin (minipress) to treat hypertension |
|
|
Term
| Therepeutic use of Phenylephrine (allerest)? |
|
Definition
| Nasal congestion and shock |
|
|
Term
| adverse effects of Phenylephrine (allerest)? |
|
Definition
reflex bradycardia after increase in BP
hypertension |
|
|
Term
| Therapeutic use of clonidine (catapress)? |
|
Definition
| HTN, stimulation of A2 receptors inhibits the release of norepinephrine |
|
|
Term
| Therepeutic use of dopamine (intropin) |
|
Definition
shock
B1 and dopamine increas cardiac output and dilation of renal blood vessels. less of a risk or renal damage. |
|
|
Term
| nursing considerations for dopamine (intropin) |
|
Definition
close monitoring of IV titration
monitor UO hourly |
|
|
Term
| Action of Prazosin (minipress) |
|
Definition
dilation of blood vessels
decrease urinary sphincter
decrease resistance to urinary outflow |
|
|
Term
| therapeutic use of Prazosin (minipress) |
|
Definition
antihypertensive
benign prostatic hyperplasia (BPH) |
|
|
Term
| side effects of Prazosin (minipress) |
|
Definition
tachycardia
orthostatic hypotension
palpitations |
|
|
Term
| Drug interactions of Prazosin (minipress) |
|
Definition
| profound hypotension: beta blockers, calcium channel blockers, diuretics |
|
|
Term
| When should a person take minipress? (time of day) |
|
Definition
| at bedtime for the first 3 days to help prevent orthostatic hypotension |
|
|
Term
| therapeutic use of Propranolol (inderal)? |
|
Definition
antianaginal
cardioprotective
anti-arrhythmic
antihypertensive |
|
|
Term
| Adverse effects of propranolol (inderal)? |
|
Definition
rebound tachycardia from acute withdrawal
masks s/s of hypoglycemia
CHF
bradycardia
bronchioconstriction |
|
|
Term
| contraindications of propranolol (inderal)? |
|
Definition
history of CHF
History of asthma
diabetis
if asthmatic or diabetic-metoprolol is better choice |
|
|
Term
| how should you stop a betablocker? |
|
Definition
| never abruptly! taper off. |
|
|
Term
| nursing consideratiosn for beta blockers? |
|
Definition
report weight gain 2 lbs in 24 hours
HR <50 |
|
|
Term
| drug interactions of propranolol |
|
Definition
calcium channel blockers-bradycardia
insulin |
|
|
Term
| classification of Phenytoin (dilantin)? |
|
Definition
|
|
Term
| action of Phenytoin (dilantin) |
|
Definition
| decreases influx of sodium ions into the cell which helps decrease firing of neurons |
|
|
Term
| pharmocotherapeutics of Phenytoin (dilantin) |
|
Definition
| prevent and control all seizure but absence seizures |
|
|
Term
| what is status epileptius? |
|
Definition
| one seizure follows another without recovery of conciousness between events or return to baseline clinical sate, or lasts longer than 5 mins |
|
|
Term
| how do you treat status epileptious with Phenytoin (dilantin)? |
|
Definition
| give after benzodiazepine. use a seperate IV tubing for each medication. |
|
|
Term
| Off label uses of Phenytoin (dilantin) |
|
Definition
antiarrhythmic or andidysrhythmic
severe pre-eclampsia
trigeminal neuralgia |
|
|
Term
| how is Phenytoin (dilantin) absorbed? |
|
Definition
slowly. do not give with continous eneteral tube feedings. hold feedings for 1 hr before and after.
IM-slow absorption due to precipitates at the injection site within the muscle |
|
|
Term
| how should you change the dose on Phenytoin (dilantin)? |
|
Definition
| in small increments:titrate dose. Phenytoin (dilantin) has a narrow therapeutic index |
|
|
Term
| black box warning for Phenytoin (dilantin)? |
|
Definition
administer IV slowly to prevent sever hypotension and CV collapse
:direct IV not to exceed 50 mg over 1 min.
:intermittent infusion run over 1 hr
Increased risk of suicidal ideation and suicidality |
|
|
Term
| contraindications of Phenytoin (dilantin) |
|
Definition
| sinus bradycardia and heart blocks |
|
|
Term
| precautions of Phenytoin (dilantin)? |
|
Definition
do not stop abruptly- can precipitate status epilepticus
older adults more at risk for hypotension and cardiac arrhythmia when recieve IV |
|
|
Term
| Pregnancy category and effects of Phenytoin (dilantin)?` |
|
Definition
D-can cause hydantoin syndrome
-abnormal skull and face features
-underdeveloped nails
-growth deficienies
-mild developmental delays |
|
|
Term
| adverse effects of Phenytoin (dilantin)? |
|
Definition
ataxia and dizziness
nausea
gingival hyperplasia
hirsutism
impaired vit. D metabolism
Life threatening:
agranulocytosis
aplastic anemia
steven johnson syndrome |
|
|
Term
| drug to drug interactions of Phenytoin (dilantin) |
|
Definition
| phenytoin decrease effectivenss of oral contraceptives |
|
|
Term
| therapeutic use of Tegretol |
|
Definition
treat seizures and trigeminal neuralgia
off label-psychiatric disorders-ipolar, depression, schizoeffective, PTSD, alcohol, cocaine, and benzodiazepine withdrawal. |
|
|
Term
|
Definition
| decreases synaptic transmission in the CNS by affection sodium channels in neurons |
|
|
Term
| black box warnign of tegretol |
|
Definition
|
|
