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Fight-or-flight hormones released by the adrenal glands in response to stress; they are part of the sympathetic nervous system
Sympathetic NS activates:
Pupil dilation, increased sweating, increased heart rate and increased blood pressure.
Mimic the effects of SNS neurotransmitters norepinephrine, epinephrine & dopamine.
Alpha One adrenergic receptors:
Are located on smooth muscles, such as blood vessels and result in vasoconstriction and CNS stimulation.
Beta one adrenergic receptors:
Primarily located in the heart, and increase the heart rate and force of contraction, as well as increasing the conduction of nerve impulses.
Beta two adrenergic receptors:
Known as Bonchi & Babies.
Located in smooth muscle fibers fo the bronchioles, arterioles and visceral organs.
Relaxation: Bronchodilation and uterus contractions
Vasoconstrict nasal mucosa, decreasing blood flow, thereby decreasing congestion.
A1 adrenergic receptor rescue drug:
Used for shock & hypotension, causing systemic vasoconstriciton.
Treat hypertension by causing both arterial and venous dilation, reducing peripheral vascular resistance and bp.
Benign Prostatic Hypertrophy:
Alpha blockers effect receptors on prostrate gland, decreasing bladder resistance to urinary outflow.
Also quickly reverses vasoconstrictive effects of extravasated vasopressors: norepinephrine or epinephrine.
____ ( ___ ) is an Alpha blocker that causes vasodilation to decrease blood pressure & urinary obstruction w/BPH.
Alpha blocker ; vasodilation to decrease blood pressure & urinary obstruction w/BPH
An agent that alters the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscular contractions. Positively inotropic agents increase the strength of muscular contraction.
Beta 1 receptors are located primarily on the _____; Beta-blockers selective for these receptors are called ______ beta-blockers.
Smooth muscles; blood vessels:
Beta 2 receptors are located primarily on ____ ____ of bronchioles and ____ ____.
Cardioselective B-Blockers, such as metoprolol & acebutolol, block the action of ____ on the B1 receptor; cardiac effects w/out constriction of bronchi.
Adrenergic ____ _____: Assess for COPD, hypotnesion, cardiac dysrhythmias, bradycardia, and heart failure.
Patients taking ____ ____ need to check apical pulse for one minute and blood pressure.
Indirect acting; enzyme:
___ ___ cholinergic agonists inhibit the ____ cholinesterase which breaks down acetylcholine.
Cholinergic drugs ____ the intestine and bladder, resulting in ____ gastric secretions, gastrointestinal motility & urinary frequency.
Acetylcholine, carbachol, pilocarpine:
___, ___, & ____ are used in glaucoma and intraocular surgery to reduce pressure.
____ (urecholine) treats atony and neurogenic bladder, by increasing the tone and motility of bladder and GI tract.
____ & ____ are indirect acting cholinergic agents that cause skeletal muscle contractions, such as those associated with myasthenia gravis.
____ ____ is a neuromuscular disorder that causes weakness of the voluntary (skeletal) muscles.
Circulatory collapse; shock:
Cholinergic toxicity causes ___ ___ , hypotension, bloddy diarrhea, ____, & cardiac arrest.
Drugs that block/inhibit the actions of ____ in the PSNS are called ____ blocking agents.
____ (cogentin) is a synthetic cholinergic ____ drug that treats parkinsonins.
____ is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
____ is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.
PSNS; decreased; relaxation:
Blockage of the ____ results in ____secretions, ____ of smooth muscle, and decreased GI motility.
____ prevents motion sickness, as well as correcting imbalances of acetylcholine and norepinephrine in high centers of the brain.
____ (Ditropan) treats incontenence due to over active bladder, as well as reflex neurogenic bladder (spinal cord injury).
Some cardiac glycosides have a ___ ___ effect, in that they increase the force and velocity of myocardial contractions, without an increase in oxygen consumption.
Negative chronotropic; reduce:
Some cardiac glycosides have a ___ ___ effect in that they ___ the heart rate.
Some cardiac glycosides have a ____ ____ effect in that they decrease automaticity at SA node as well as decreasing nodal conduction.
Increased; decrease; increase:
Side effects of cardiac glycosides include ____ stroke volume, ____ in BP and ____ in coronary circulation.
____(lanoxin) levels must be monitored, as well as ___ levels; also has a very narrow therapeutic window.
____ inhibitors work by inhibiting the enzyme_____, which results in a positive inotropic response (vasodilation).
Amrinone; milrinone :
___ and ___ are phosphodiesterase inhibitors with positive inotropic effects useful for the treatment of ventricular dysfunction after cardiac surgery.
____ ____ are used in the short term management of heart failure, when pt hasn't responded to digoxin, diuretics or vasodilators.
<60 or >120:
When giving positive inotropic agents, hold does and notify prescriber is apical pulse is between _____.
Signs and symptoms of Inotropic toxicity is blurred vision or seeing ___ or ___ halos around objects.
____ ____ involve changes to the automaticity or conductivity of the heart cells.
Electrolyte imbalances; acidosis:
Cardiac Dystythmias can be caused by ____ ____, decreased O2 delivery, structural damage, ____ or adverse effects of drugs.
Lidocaine, tocainide, mexiletine, phenytoin
Class 1b antidysrhythmic drugs include ___, ___, ___, & ____.
Flecainide (Tambocar); Propafenone (Rythmol):
____ (___) and ____ (____) are Class 1c antidysrhythmic drugs, which are used for severe ventricular dysrhythmias.
Atenolol, esmolol, petaprolol, propranolol:
___, ___, ___, & ____ are all class II beta blockers, which reduce or block sympathetic NS stimulation
Amiodarone, bretyliu, sotalol, ibutilide:
____, ___, ___, & ___ are all Class III are potassium channel blocking antidysrhythmic drugs.
____ (___) is an unclassified antidysrhythmic drug that slows conduction through the AV node.
Paroxysmal supraventricular tachycardia:
Adenosine (adenocard) is a rescue drug used to convert ____ ____ _____ to sinus rhythm. Short half life-10 sec; iv push.
____ is used to treat dysrhymias, by slowing the calcium from leaving the cell, which slows conduction and heart rate.
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