Pharmacology Lecture Notes: Autonomic Nervous System Drugs

Vocabulary flashcards covering key pharmacological agents, their classifications, mechanisms of action, therapeutic effects, side effects, contraindications, interactions, and nursing considerations.

Metoprolol (Generic Name)

Metoprolol (Tartrate/Succinate)

Metoprolol Classification

Beta1 Adrenergic Antagonist (Cardioselective Beta Blocker)

Metoprolol Mechanism of Action (MOA)

Selectively blocks β1 receptors (heart), decreasing HR, contractility, and conduction. Decreases Renin release.

Metoprolol Therapeutic Effects

Lowers BP, reduces HR, prevents angina, improves survival in Heart Failure (Succinate form).

Metoprolol Side Effects (Common)

Dizziness, Fatigue, Depression, Bradycardia, Cold extremities, Erectile dysfunction.

Metoprolol Adverse Effects (Serious)

Severe Bradycardia, Hypotension, A-V Block, Bronchospasm, Rebound MI (if stopped abruptly).

Metoprolol Contraindications

Sinus bradycardia, Cardiogenic shock, Decompensated heart failure, 2nd/3rd-degree AV block.

Metoprolol Drug Interactions

CCBs (Verapamil/Diltiazem) or Digoxin (risk of severe bradycardia/block); masks hypoglycemia signs.

Metoprolol Nursing Interventions

Check HR and BP before dose; Hold if HR <50 or SBP low; Monitor for signs of HF or bronchospasm.

Metoprolol Patient Teaching

Do NOT stop abruptly (risk of rebound MI); Teach pulse check; Change positions slowly.

Epinephrine (Generic Name)

Epinephrine (Adrenalin)

Epinephrine Classification

Adrenergic Agonist (α1, β1, β2)

Epinephrine Mechanism of Action (MOA)

Non-selectively stimulates α1, β1, and β2 receptors, causing vasoconstriction, increased HR/CO, and bronchodilation.

Epinephrine Therapeutic Effects

Reverses anaphylaxis, restores rhythm in cardiac arrest, treats severe hypotension.

Epinephrine Side Effects (Common)

Nervousness, Tremor, Tachycardia, Palpitations, Headache.

Epinephrine Adverse Effects (Serious)

Ventricular Arrhythmias, Hypertensive Crisis, Angina/MI, Pulmonary Edema.

Epinephrine Contraindications

Narrow-angle glaucoma, non-anaphylactic shock, caution with halogenated anesthetics.

Epinephrine Drug Interactions

Beta-blockers (may cause unopposed α effects/hypertension); MAOIs/TCAs (potentiate effects).

Epinephrine Nursing Interventions

Monitor HR, BP, and respiratory status continuously; Assess IV site (risk of extravasation).

Epinephrine Patient Teaching

Seek immediate medical attention after EpiPen use; Teach proper injection technique.

Prazosin (Generic Name)

Prazosin (Minipress)

Prazosin Classification

Alpha-1 Adrenergic Antagonist (α1-Blocker)

Prazosin Mechanism of Action (MOA)

Selectively blocks α1 receptors in vessels, causing peripheral vasodilation and lowering BP.

Prazosin Therapeutic Effects

Antihypertensive (lowers BP); reduces symptoms of BPH.

Prazosin Side Effects (Common)

Dizziness, Headache, Drowsiness, Palpitations.

Prazosin Adverse Effects (Serious)

Syncope (First-Dose Effect), Severe orthostatic hypotension, Priapism (rare).

Prazosin Contraindications

Hypersensitivity, caution with angina (due to reflex tachycardia).

Prazosin Drug Interactions

Other Antihypertensives (increased hypotension); Sildenafil/Tadalafil (increased risk of hypotension).

Prazosin Nursing Interventions

Monitor BP closely, especially standing BP; Note 'first-dose effect' risk.

Prazosin Patient Teaching

Take first dose at bedtime; Change positions slowly; Report priapism immediately.

Bethanechol (Generic Name)

Bethanechol (Urecholine)

Bethanechol Classification

Cholinergic Agonist (Muscarinic Agonist)

Bethanechol Mechanism of Action (MOA)

Directly stimulates muscarinic receptors, causing detrusor muscle contraction to promote urination and increase GI motility.

Bethanechol Therapeutic Effects

Treats acute post-op/postpartum non-obstructive urinary retention.

Bethanechol Side Effects (Common)

Nausea, Diarrhea, Abdominal cramps, Sweating, Urinary urgency/frequency.

Bethanechol Adverse Effects (Serious)

Bradycardia, Asthma exacerbation (bronchospasm), Hypotension, Cholinergic Crisis.

Bethanechol Contraindications

Mechanical obstruction of GI/Urinary tract, Hypotension, Asthma/COPD, Peptic ulcer disease.

Bethanechol Drug Interactions

Anticholinergics (counteract effects); Cholinesterase inhibitors (increase toxicity risk).

Bethanechol Nursing Interventions

Monitor Urinary Output; Monitor for Cholinergic Overdose (SLUDGE); Have Atropine available.

Bethanechol Patient Teaching

Take on an empty stomach; Report severe abdominal pain or difficulty breathing.

Atropine (Generic Name)

Atropine

Atropine Classification

Anticholinergic (Muscarinic Antagonist)

Atropine Mechanism of Action (MOA)

Blocks muscarinic receptors (PNS effects), leading to increased HR, decreased secretions, and relaxation of smooth muscle (e.g., GI/bladder).

Atropine Therapeutic Effects

Treats symptomatic bradycardia; reduces secretions; antidote for cholinergic overdose.

Atropine Side Effects (Common)

Dry mouth, Blurred vision, Urinary retention, Constipation, Tachycardia, Photophobia.

Atropine Adverse Effects (Serious)

Ventricular Arrhythmias, Acute Angle-Closure Glaucoma, Hyperthermia (suppressed sweating), Coma.

Atropine Contraindications

Angle-closure glaucoma, Obstructive Uropathy (BPH), Paralytic ileus, Severe ulcerative colitis.

Atropine Drug Interactions

Other Anticholinergics/Antihistamines/TCAs (additive anticholinergic effects).

Atropine Nursing Interventions

Monitor HR and I&O (urinary retention); Provide frequent oral care for dry mouth.

Atropine Patient Teaching

Avoid overheating; Increase fluid/fiber; Use artificial tears/saliva; Report vision changes.