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Chapter 13- Drugs Affecting Adrenergic Function
Terms in this set (24)
Adrenergic Agonists (Stimulators)
Those that stimulate the sympathetic receptors
Adrenergic Antagonists (Blockers)
Those that block the sympathetic receptors
What is the prototype nonselective adrenergic agonist?
What is the prototype alpha-1 adrenergic agonist?
What is the prototype alpha-2 adrenergic agonist?
What is the prototype beta-adrenergic agonist?
What is the prototype beta-1 agonist?
What are the two branches of the autonomic nervous system?
CNS and PNS
What is the CNS composed of?
The brain and spinal cord
What is the PNS composed of?
Includes efferent and afferent division. Efferent carries signals AWAY from the brain and spinal cord to the periphery. Afferent carries neurons from the periphery to the CNS.
What does the sympathetic nervous system do?
Fight or flight. Increases HR, dilates pupils, mobilize our energy and redirects blood flow from non-essential organs to our skeletal muscles.
Also sweat produced, ejaculation in males, ureters and bladder relax, sphincter contracts
What happens in the parasympathetic system?
Heart rate slows
GI motility increases
Ureters and bladder contract
Penile erection stimulated in males
What are the neurotransmitters in the ANS?
Acetylcholine (ACh), norepinephrine (NE) and epinephrine (Epi)
Primarily responsible for vasoconstriction of coronary arteries and veins and decrease smooth muscl motility in the GI tract.
Responsible for shutting off the release of NE.
Responsible for increasing cardiac output by increasing the speed of conduction, increasing the force of contraction and increasing the heart rate.
Have short duration of action (need to be administered in a continuous fashion, i.e by IV)
Can not be given orally
Do not cross the blood-brain barrier
Stimulates all adrenergic receptors
Treats shock (supplied on crash cart)
Major contraindications: hypersensitivity, during active labor, general anesthesia
Most common adverse effects: Fatigue, sleep distrubances, tremor, weakness, dizziness
Most serious adverse effect: Cardiovascular stimulation
Maximizing therapeutic effects: monitor cardiovascular status closely
Most important patient education: use of inhalers and nebulizers
Potential severe adverse effects include: heart attack, stoke, paranoid psychosis, vomiting, fever, palpitations, convulsions, and coma.
Used in management of shock. During shock states it is increases blood flow to the heart and brain
Can be used to replace the first or second dose of epi in management of pulseless ventricular tachycardia or ventricular fibrillation
Used parenterally for treatment of vascular failure in shock, shock-like states, or drug-induced hypotension
Most commonly used topically for relief of nasal and nasopharyngeal mucosal congestion and dilation of the pupil for ophthalmologic procedures
Alpha 1 adrenergic agonist and vasopressor (constricts blood vessels, raises blood pressure)
Important drug to drug interactions: possible life-threatening interaction with MAOI inhibitors
Important patient education: stress safety related to blurred vision
Parenteral vasopressor agent used for blood pressure support during surgery.
Treatment of hypertension.
Alpha-2 adrenergic agonists
Decreases heart rate, decreases blood pressure, decreases vasoconstriction, and decreases renal vascular resistance
Most common current "off label" use is for withdrawal from alcohol, methadone or opiates
Frequently administered transdermally but can orally or parenterally
Used to treat the hypotension resulting from shock because it can stimulate alpha and beta receptors to increase cardiac output, BP and renal perfusion
Correct hypovolemia before administering
Important drug-drug interactions: MAOIs
Maximizing therapeutic effects: use infusion pump, titrate drug until desired effect is obtained
Minimizing adverse effects: monitor BP, urinary output, cardiac output, and pulmonary wedge pressure throughout therapy
Most important patient education: reassure patient that close monitoring will be maintained.
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