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Marian pharm exam 3
midterm
| Question | Answer |
|---|---|
| Adrenergics precautions | Cardiac patients, Diabetic (blood glucose elevates), galucoma (increase intraocular pressure) |
| What do Adrenergic drugs stimulate? | beta 2 adrenergic recepotrs in the smooth muscle of the bronchi and bronchioles |
| Adrenergic effects? | tachycardia, hypertension, cardiac arrhythmias, restlessness, agitation, insomnia |
| Some adrenergic work on beta 1 receptors as resulting in what stimulation? | cardiac |
| Adrenergics are used for treatment of? | asthma |
| Bronchodilators can relax what? | smooth muscle in bronchi and bronchioles |
| Bronchodilators are often used with drugs to relieve what in the airways? | Inflammation |
| Name the three drugs associated with Bronchodilators? | adrengeric, Xanthines, and Anticholinergics |
| Name some Chronic obstructive pulmonary diseases | chronic bronchitis, chronis emphysema, irritants, increased dyspnea, and decreased in activity tolerance |
| Asthma step 1: The symptoms happen how often? | Sx 2 days a week or less or 2 nights a month or less |
| In step I asthma, daily meds given? True or False | False False |
| What treatment is given for Step 1 asthma? | short acting beta 2 inhaler for symptom relief |
| If an inhaler is used more than twice a week for a step 1 asthma pt, what should the nurse/doctor consider? | Asthma step 2 |
| Asthma step 4 is considered? | severe |
| treatment for step 4 asthma is | Long term-high dose corticosteroid inhaler plus a long acting beta2 agonist tablet or inhaler or a long acting theophylline plus corticosteroid oral |
| For step 4 asthma, what is a short acting beta2 agonist inhaler for symptom relief? | albuterol (Proventil), levalbuterol (Xopenex) |
| What is the name of two drugs that can be used for Step 4 asthma that are long acting beta2 agonist inhalers? | formoterol (Foradil), salmeterol (seravent) |
| Adrenergics important drugs | Epinephrine (Adrenalin) Albuterol (Proventil)-fast acting/short acting Salmetrol (Serevent disk)-long acting Metaproterenol (Alupent) tioltropium (Spiriva)- long acting-once a day dosing Fluticasone/salmeterol (Advair)-24 hour duration |
| What are the nursing interventions with adrenergic and xanthines they you must monitor on a pt? | pulse, BP, respirations, serum levels |
| With the drug theophylline, what does the nurse need to monitor? | serum levels |
| When Atrovent is given with other inhalers, give it first or last? If atrovent is given with corticosteroid do you give the atrovent inhaler first or last? | first last |
| What kind of symptoms would the pt be experiencing with adreergic and xanthines? | nervousness and shaky are common |
| Mechanism of action is unknown for this drug? | Xanthines |
| What is the action of Xanthines? | cause bronchodilation |
| Is Xanthines considered a first or second line agent? | second line |
| What are the adverse effects of Xanthines? | restlessness can cause convulsions, tachycardia, gastric mucosa irritation, N/V/pain, diuretic |
| What is a precaution of Xanthines? | cardiac patients |
| What are the important drugs with Xanthines? | Theophylline (Theo-dur)extended release Aminophylline (Phyllocontin) IV |
| What is the therapeutic level for Xanthines? | 10-20 mcg/ml |
| What is the toxicity for Xanthines? | arrythmia and seizures |
| What is Xanthines contraindicated with? | acute gastritis and peptic ulcer disease |
| Mimics the action of the sympathetic nervous system | Adrenergic drugs |
| What is the action of an Adrenergic drug? | wide spread action |
| Explain sympathetic | speeds up the heart and slows down the gut |
| Explain paraympethic | slows down the heart and speeds up the gut |
| What drugs fall under sympathetic? | Adrengeric,anticholinergic, epinephrine and catecholamine |
| What drugs fall under paraympethic? | Anti-adrengeric, cholinergic, |
| For Adrenergic, Beta2 is primarily in the lungs and blood vessels | bronchodilator, peripheral vasodilation |
| In Adrenergic, Alpha is primarily in the blood vessels | activation results in vasoconstriction |
| In Adrenergic, Beta1 is primarily in the heart | increases the heart, increases contraction and increases conduction |
| Adrenergic Drugs are used in what kind of situations? | Emergency situations |
| What are Adrenergic Drugs used for? | Cardiac arrest to stimulate the heart Hypotension Bronchospasm Anaphylaxis Heart failure Bleeding |
| What is the protype for Adrenergic? | Epinephrine hydrochloride (Adrenalin) |
| What are the ways Epinephrine can be given? | Sq, IM, IV (works imediately), IO- Intraosteosis, Indotrachial |
| What happens to the pupils, blood sugar,mouth and the gut in sympathetic response? | Fight or Flight~ Dilation of the pupils, more blood sugar because the liver increases, gut slows down so you dont poop yourself, mouth is dry |
| What are the precautions of Adrenergic Drugs? | tachyarrhythmia, hypertension, and angina |
| What are the adverse effects of Adrenergic Drugs? | nervousness, tachycardia, hypertension, N&V, angina, wgt. loss, stroke, rebound nasal congestion |
| With the adverse effects for Adrenergic drugs, what is most important to watch? | Blood pressure |
| What are the interactions with Adrenergic drugs< | cocaine, TCA&MAOI, antidepressants, beta blockers |
| What is the drug of choice for Anaphylactic shock? | Epinephrine hydrochloride (Andrenalin) |
| What does Epinephrine hydrochloride (Adrenalin) do? | prototype, emergency drug, drug of choice for anaphylactic shock, stimualtes the heart, OTC preparations |
| Nursing Implication for Adrenergics | Monitor VS, take over the counter drugs as directed, tolerance can result, some anxiety, nervousness, restlessness is expected, carry injection of epi with you for sever allergies, epi is an advanced cardiac life support drug |
| Adrenergic Drugs: Phenylephrine (neo-synephrine) what do they do? | vasoconstriction, nasal decongestant, alpha activity |
| Adrenergic drugs: Isoproterenol (Isuprel) what do they do? | beta-stimulates heart, bronchodilator |
| Adrenergic drugs: Pseudoephedrine (Sudafed) what do they do? | Nasal decongestion (3 day limit) |
| What kind of drugs blocks the sympathetic system in whole or part? | Antiadrenergic drugs |
| What is the goal of the Antiadrenergic drugs? | to suppress pathological responses to activity stress or other stimuli |
| Alpha adrenergic and beta adreergic are both what kind of agents | blocking |
| what is an Alpha adrenergic blocking agents do? | blocks sympathomimetic agents, dilates vessels in smooth muscle, lower peripheral vascular resistance (decreases BP), relaxes smooth muscle in the prostate |
| what is the uses of alpha adrenergic blocking agents? | hyertension, migraine head aches, benign prostatic, hypertrophy, Raynaud's disease, frostbite |
| What is the caution on alpha adrenergic blocking agents? | renal impairment |
| What are the adverse effects of Alpha Adrenergic blockers? | Nasal congestion, N&V, tachycardia (doesnt always happen b/c of the hypotension) and hypotension |
| Whare are the Alpha Adrenergic Blocking Drugs? | Clonidine (Catapres), Prozosin (Minipress), Phentlamine mesylate (Regitine), Tamsulosin HCVL (Flomax) |
| What does Clonidine (Catapres) do? | decreases BP |
| What does Prozosin (Minipress) do? | decreases BP |
| What does Phentolamine mesylate (Regitine) do? | It is used for Phenochromocytoma hypertension |
| What does Tamsulosin HCL (Flomax) do? | BPH relaxes urinary sphincter |
| Nursing implications for Alpha Adrenergic blockers | Monitor VS, Supine with IV Regitine, change position slowly (orthostatic hypotension), taper doses, give with food, take same time every day |
| What do Beta adrenergic blocking agents do? | block adrenergic stimualation to beta1 and beta2 receptors |
| What happens when Beta 1 block? | decreases BP, decreases pulse, contraction of the heart and cardiac output-used for angina |
| What happens when Beta 2 blocks? | vasodilatation in skeletal muscles-control angina and lower BP |
| What are some other uses for Beta adrenergic blocking agents? | dysrhythmias, after MI decreases mortality, glaucoma, panic attacks |
| What are the LOL drugs? | Propranolol hydrochloride (Inderal), Atenolol (Tenormin) and Carvedilol (Coreg) |
| What are the adverson effects of LOL Drugs? | Bradycardia, shortness of breath, edema, HF, Hypotension, N&V |
| What are the cautions of LOL drugs? | Heart block, bradycardia |
| Prototype for the LOL drugs? | Propranolol hydrochloride (Inderal) |
| What does Propranolol hydrochloride (Inderal) treat? | Hypertension, angina, arrhythmias, MI |
| What does Atenolol (Tenormin) treat? | hypertension, angina, MI |
| What does Carvedilol (Coreg) treat? | heart failure, reduces risk of sudden death |
| Nursing implication for beta blockers | monitor VS espically pulse apical watch symptoms of hypoglycemia change position slowly taper does espically with long term use avoid hot tubs, hot showers, steam and saunas Interacts with alcohol |
| Mimics the effects of the parasympathetic nervous system and direct and indirect acting | Parasympathetic durgs cholinergic |
| What is the action of Direct acting cholinomimetic (Cholinergic) drugs | decrease HR, increase GI muscle tone, increase bladder tone, relax sphincters, increase respiratory secretions, constrict pupils |
| What is the use of direcft acting cholinomimetic (Cholinergic) drugs | glaucoma, urinary retention, post op abdominal distention, N&V |
| Synthetic choline | direct acting cholinomimetic (Cholinergic) drugs |
| Adverse effects of Cholinergics | Bradycardia, hypotension, HA, increased sweating, restlessness, coma |
| Cautions for cholinergic drugs | CAD, MI, Heart block, intestinal obstruction, ulcerative colitis, respiratory disorders |
| Cholinergic Drugs | Donepezil (Aricept), Bethanechol chloride (Urecholine), Metoclopramide hydrochloride (Reglan), Neostigmine (Prostigmin), Endrophonium chloride (Tensilon) |
| Donepezil (Aricept) | Indirect cholinergic-alzheimers |
| Bethanechol chloride (Urecholine) | Given for urinary retention Paralytic intestines |
| Metoclopramide Hydrochloride (Reglan) | delayed gastric emptying |
| Neostigmine (Protigmin) | Myasthenia Gravis |
| Endrophonium chloride (Tensilon) | Diagnose MG |
| Nursing implication of Cholinergics | Monitor HR, respiratory rate, watch for GI problems, Do not give with obstructive conditions, can cause exacerate peptic ulcers |
| What is the antidote for Cholinergics? | Atropine sulfate |
| Inhibits the actio of acetylcholinesterase (the enzyme that breaks down acetycholine) and prolong the effects of acetylcholine, increases muscle tone and strength, imporve neuro transmission in the brain | Indriect acting cholinomimetic (Cholinergic drugs) |
| What are the uses for the indriect acting cholinomimetic (Cholinergic) drugs | myasthenia gravis, glaucoma, bladder distension, and paralytic ileus |
| Adverse effects for Cholinergic drugs | Hypotension, bradycardia, intestinal spasm, diaphoresis, bronchial secretions, respiratory arrest, and vasodilatation |
| Nursing implication of Cholinergic drugs | watch for signs of neuro toxicity, monitor respiratory rate, assess for abdominal cramping, and measure urinary output |
| Contraindications to cholinergics | GI tract obstruction, asthma, recent bowel surger or inflammatory bowel disease, CAD, pregnant women |
| Blocks parasympathetic nerve impulses by compteting with acetylcholine for sites on muscarinic receptors | Anticholinergic drugs |
| What is the use of anticholinergic drugs | for GI disorders that have increased motility, bradycardia, releive spastic bladder, dilate pupil, decrease saliva |
| What are the cautions of anticholinergic drugs | glaucoma, heart disease, and parlytic ileus |
| What are the adverse effects of Anticholinergics? | dry mouth, constipation, tachycardia, difficult urination, blurred vision, confusion, and delusions |
| What is the prototype for Anticholinergics? | Atropine Sulfate |
| What does Atropine Sulfate treat? | Bradycardia |
| Atropine Sulfate does what for Preop? | combats against vagal response, decrease respiratory secreations |
| What is the antidote for cholinergic? | Mushroom, insecticide toxicity |
| What drugs are Anticholinergics? | Atropine Sulfate, Oxybutynin choloride (Ditropan), tolterodine (Detrol), Hyoscyamine (Anaspaz) |
| What does Oxybutynin choloride (Ditropan) do? | increase bladder capacity, decreases frequency |
| What does tolterodine (Detrol) do? | delays urge to void |
| What does Hyoscyamin (anaspaz) do? | Relaxes GI spasm/antispasmotic |
| Nursing Implications for Cholinergic drugs? | monitor pulse/BP, encourage fluids, provide ice chips, eye drops if needed, treat constipation, driving |
| Contraindications to Anticholinergics | Prostatic Hypertrophy, Myasthenia Gravis, Hyperthyroidism, Glaucoma, MI |
Created by:
aconner1
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