Adrenergic Meds
The neurotransmitters and receptors are
epinephrine/ norepinephrine: Alpha 1, alpha 2 and beta1, beta2
p. 171
Neurotransmitters and receptors are
acetylcholine: nicotinic (stimulate smooth muscle and slow heart rate), muscarinic (affects skeletal muscles) p. 185
The nurse is preparing to administer ear drops to baby. The nurse knows to position the ear lobe in this way.
Pull down and back
This class of drugs should not be taken by patients taking nitroglycerine for heart conditions.
PDE-5 Inhibitors
End in -afil
Useful primarily as a preoperative medication to decrease salivary secretions, as an agent to increase heart rate, as an antidote for cholinergic agonists overdose.
Atropine
Describe the effects of Alpha 1 and alpha 2 stimulation
vasoconstriction, increases BP, increases cardiac contractility, mydriasis (pupil dilation), bladder relaxes (can’t urinate), prostate constriction
Alpha 2 receptor stimulation
vasodilation due to reduced norepinephrine and BP decreases, decreased GI tone and motility
p.174
Scopolamine, an anticholinergic, should be applied at what time and where?
patch behind ear 4 h before antiemetic is needed
p. 193
A patient is prescribed 2 different eye medications. How long should they wait before instilling the second medication?
5 minutes
p. 588
T/F A nurse informs a pregnant woman that it is safe for her to prepare her husbands finasteride prescription.
No. It is preferred that women of childbearing age do not handle the 5 alpha reductase inhibitors due to teratogenic effects on fetus. She must wash her hands thoroughly with soap and water if she does.
Give an indication for Benztropine
Parkinsonism
p. 192
Describe the effects of Beta 1 and beta 2 stimulation
increased heart contraction and increased HR, increased renin secretion, increased angiotensin (stimulation of RAAS), increased blood pressure
Beta 2 receptor stimulation
decreased GI tone and motility, bronchodilation, relaxation of uterine smooth muscle, activation of glycogenolysis, increase blood sugar
p. 174
Give 2 types of cholinergic agonists and how they work.
Indirect- act on a specific receptor but are nonspecific (muscarinic)
Indirect- inhibit the action of the enzyme cholinesterase, forms a chemical complex that allows acetylcholine to persist and attach to the receptor
To prevent systemic absorption, patient's may apply pressure to this are...
nasolacrimal duct
p. 579
Name one thing that a patient taking 5 alpha reductase inhibitors should notify their HCP of immediately
changes in breasts
p.718
A patient is having bronchospasms, which selective beta 2 agonist will you be ready to administer?
Albuterol
p.174
Why can beta blockers be contraindicated in some respiratory conditions?
nonselective stimulate beta 2 as well and can cause bronchoconstriction, bronchospasms etc
p.179
What effects do cholinergic agonists cause in the body?
stimulates bladder & GI tone, miosis, and increase neuromuscular transmission, decreased heart rate and BP and increased salivary, GI, and bronchial secretions
p. 185
Anticholinergics are contraindicated for patients with this condition.
glaucoma
This class of medications interact with grapefruit
PDE-5
ending -afils
p. 717
This class of drugs can be used for HTN as well as BPH.
Alpha adrenergic blockers
ending -zosin
p. 181 they block alpha 1
T/F also called the flight or fight response
part2: what do we call the cholinergic effects?
true
part2: rest and digest
Give contraindication for anticholinergics
glaucoma.
p. 193 lightning bolt
T/F Contact lenses are allowed to be worn immediately after diagnostic staining of the eye.
False
p. 580 contacts can be worn after at least an hour
These 4 classifications of drugs may be used for BPH treatment.
•Alpha-adrenergic antagonists
•5-Alpha-reductase inhibitors
•Anticholinergics
•Phosphodiesterase-5 inhibitors
p. 717
This is a beta 2 agonist used for bronchodilation. It is a rescue drug
Albuterol
p. 176