Pathophysiology Drug Chart

Adrenergic Agonists

Sympathomimetic drugs that mimic the "fight-or-flight" response by stimulating the body's sympathetic nervous system

• Prototype: Epinephrine

• Alpha 1: Vasoconstriction, mydriasis

• Beta 1: Pos. chronotropic effects, pos. Inotropic effects, pos. Dromotropic effects

• Beta 2: Bronchodilatation

Epinephrine

A nonselective Adrenergic Agonist that is used for Anaphylactic reactions, Cardiac arrhythmias, Hypotensive shock.

• Stimulates Alpha 1, Beta 1, and Beta 2 responses

• Stimulates SNS receptors.

Alpha Adrenergic Agonist

Selective sympathomimetic drugs that mimic alpha-adrenergic receptors

• Prototype: Phenylephrine (Neo-synephrine)

• Stimulates alpha receptors.

• Vasoconstriction, mydriasis

Phenylephrine (Neo-synephrine)

A selective Alpha Adrenergic Agonist that is used for Glaucoma, Nasal Congestion, and Hypotension.

• Vasoconstriction, mydriasis

Neo-synephrine

What is the other name for Phenylephrine?

Beta 1 Adrenergic Agonist

Selective Sympathomimetic drug that increase heart rate, heart contraction strength, and blood pressure

• Prototype: Dobutamine (Dobutrex)

• Stimulate Beta 1 receptors in the heart.

• Pos. Chronotropic

• Pos. Inotropic

• Pos. Dromotropic

Dobutamine (Dobutrex)

A selective Beta Adrenergic Agonist used for Extensive Hypotension and Shock 2○ to MI

Dobutrex

What is the other name for Dobutamine?

Beta 2 Adrenergic Agonist

Selective sympathomimetic 2 drug that causes bronchodilation in the lungs.

• Prototype: Albuterol (Proventil, Ventolin)

Albuterol (Proventil, Ventolin)

A Beta 2 Adrenergic Agonist used for Asthma and COPD (chronic obstructive pulmonary disease)

(Proventil, Ventolin)

What is another name for Albuterol?

Dopamine (Intropin) Nonselective (Definition)

Sympathomimetic drug where the receptor activity is dose activated:

• Low Dose Action (1-10 mcg/kg/min) = Vasodilation of renal & mesenteric arteries

• High Dose Action (10-20 mcg/kg/min = Stimulates Beta 1 receptors (Inotropic effects)

Dopamine (Intropin) Use

A nonselective sympathomimetic drug either used for Acute Renal Failure/ARF (Low Dosage) or Congestive Heart Failure/CHF (High Dosage)

Intropin

What is the other name for Dopamine (sympathomimetic drug)?

• Hypertension

• Tachycardia

• Cardiac Arrhythmias

• Urinary Retention

• Cerebral Hemorrhage

• Angina

• CNS Excitability

• Hyperglycemia

• Extravasation

What are some side effects for Adrenergic Agonists?

• Assess VS and cardiac function.

• Assess urine output.

• Assess therapeutic response.

• Consult HCP before taking OTC cold medications.

• Watch blood glucose levels in diabetics

• Ensure safety 2○ to CNS excitability.

• Monitor EKG for arrhythmias.

• Assess IV for extravasation

What are some nursing implications for Adrenergic Agonists?

Adrenergic Antagonists

Antiadrenergic/Sympatholytic drugs that block the effects of catecholamines like epinephrine, norepinephrine, and dopamine on the body's nervous system receptors.

Alpha Adrenergic Blockers

medications that relax the muscle in the walls of smaller arteries and veins, helping to improve blood flow and lower blood pressure

• Prototype: Prazosin (Minipress)

Prazosin (Minipress)

An Alpha Antagonist Blocker that is used for Hypertension, Frostbite, Raynaud’s Disease, Pheochromocytoma, Glaucoma, Extravasation, Postpartum and Post Abortion Bleeding

Minipress

What is another name for Prazosin?

• Orthostatic hypotension

• Dizziness

• Nausea/vomiting/ Diarrhea

• Edema

• Stimulates uterine contractions.

• Reflex tachycardia

What are some side effects for Prazosin?

Beta-Adrenergic Blockers

An Antiadrenergic/Sympatholytic drug that slow down your heart rate and lower your blood pressure by blocking the effects of adrenaline

• Prototype: Propranolol (Inderal)

• Blocks beta receptors preventing binding of catecholamines

Propranolol (Inderal)

A Beta-Adrenergic Blocker that is used to treat hypertension, angina, tachycardia, migraines

Inderal

What is the other name for Propranolol?

• Impotence

• Bradycardia

• Edema

• Orthostatic Hypotension

• Arrythmias

• Bronchoconstriction

• Nausea/Vomiting

• Dry Mouth

• Drowsiness, Lethargy, and Mental Depression

What are some side effects of Propranolol?

• Assess VS and Cardiac function

• Assess urine output

• Assess therapeutic response

• Assess S/S CHF

• Consult HCP before taking OTC meds

• Watch blood sugar in people with diabetes

• Safety secondary to orthostatic hypotension

• Alpha-blockers are contraindicated in pregnancy

• Beta-Blockers are contraindicated in asthma

• Hold beta blockers if the pulse is <60bpm

• Instruct pts not to stop beta blockers abruptly

What are some nursing implications for Adrenergic Antagonists?

Parasympathomimetic

Medications that stimulate the parasympathetic nervous system—the part of the nervous system that controls "rest and digest" body functions

Direct-Acting Parasympathomimetic

Medications that bind directly to acetylcholine receptors to activate the parasympathetic nervous system, mimicking acetylcholine.

• Prototype: Bethanechol (Urecholine)

Bethanechol (Urecholine)

A direct acting parasympathomimetic used for Paralytic ileus, Post-op urinary retention, Abdominal distention, Glaucoma, and Anticholinergic overdose

Urecholine

What is the other name for Bethanechol?

• Urinary Incontinence

• Flushing, Diaphoresis

• Blurred vision

• Muscular tremors

• Hypotension

• Bradycardia

• Bronchoconstriction (with overdose)

• Cholinergic Crisis

What are some side effects of Bethanechol?

Indirect-Acting Parasympathomimetic

a drug that increases acetylcholine levels in the synapse by blocking the enzyme acetylcholinesterase

• Prototype: Neostigmine

Neostigmine

An Indirect-Acting Parasympathomimetic that is used for Myasthenia Gravis

• a chronic autoimmune condition that causes weakness in voluntary skeletal muscles

• Muscle weakness

What are some side effects of Neostigmine?

• Assess VS and cardiac function.

• Assess urine output.

• Assess therapeutic response.

• Treat overdose with Atropine

• Contraindicated with asthma

What are some nursing implications for Parasympathomimetic drugs?

Cholinergic Antagonist

drugs that block acetylcholine from binding to muscarinic or nicotinic receptors, reducing the activity of the parasympathetic nervous system.

• Prototype: Atropine

• Anticholinergics/Parasympatholytic/Antimuscarinics

Atropine

A drug that Blocks muscarinic receptor sites preventing binding of Ach; used for surgical pre-op, Sinus node dysfunction, Bradycardia, Heart blocks, Asthma, COPD, Parkinson’s Disease

Pilocarpine

What is the antidote of Atropine?

• Dry Mouth

• Drowsiness

• Constipation

• Urinary Retention

• Tachycardia

• Hot, dry, flushed skin

• Confusion

• Increased intraocular pressure

• Blurred Vision

• Bradycardia

What are some side effects of Atropine?

• Assess VS and cardiac function

• Assess urine output

• Assess therapeutic response

• Comfort measures for side effects

  • Ice chips

  • Good Oral Hygeine

  • Fluids for Constipation

• Caution with decrease renal function

• Contraindicated with myasthenia gravis

• Contraindicated with glaucoma.

What are some nursing implications for Cholinergic Antagonists?