CNS PT2

SNS

* responsible for fight or flight
* epinephrine, norepinephrine, catecholamine neurotransmitters
* stimulates target organs during stress (heart, liver)

PNS

* responsible foe feeding, digestion, elimination
* acetylcholine neurotransmitter
* uses acetylcholinesterase
* enzyme breaks down acetylcholine

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Alpha receptors

in peripheral blood vessels and smooth muscles, pyloric and urinary sphincters, and pupils

what happens when alpha receptors are stimulated

vasoconstriction, sphincters contraction, and pupillary dilation

Where are beta 1 receptors located

in the heart

where are beta 2 receptors located

In bronchi, bladder wall, intestine, and uterus

what happens if beta 1 receptors are stimulated

increase HR and contractility

what happens when beta 2 receptors are stimulated

bronchodilation, vasodilation, relaxes bladder wall, intestine, and uterus

What do Adrenergic medications do

mimic effects of SNS neurotransmitters

Bronchodilators

* adrenergic
* albuterol, ephedrine, levalbuterol, salmeterol, terbulatine

Nasal Decongestants

* adrenergic
* ephedrine, phenylephrine, tetrahydrozoline

Opthalmic

* alpha antagonist vasoconstrict blood vessels in the eyes to decrease eye pressure
* epinephrine solution dilates pupils during eye surgery

cholinergic drugs

increase or imitate acetylcholine

* wet

anticholingeric drugs

blocks acetylcholine

* dry

MOA cholinergic drugs

* inhibit acetyl- cholinesterase ( which prevents the breakdown of acetylcholine)
* replace acetylcholine
* used to treat ALZHEIMER

common alzheimers medications

* memantine hyrdochloride ( Namenda)
* Namzaric ( donepezil + memantine)

Patient teaching for cholinergic drugs

signs and symptoms of cholinergic crisis: cramps, increased salivation and lacrimation. muscular weakness, paralysis, etc.

Patient teaching for atropine ( anticholinergic drugs)

* side effects: hot, dry, tight, blind, red, mad

Patient teaching for alpha adrenergic

* side effects: headache, restlessness, insomnia, vasoconstriction, chest pain, htn, euphoria
* when given with anesthetics increase risk of cardiac arrhythmia

Beta Blockers

* sns stimulation is blocked
* reduces myocardial O2 demand and workload
* do not give to those with COPD
* Do not give to a CHF patient

alpha blocking agents

* treat life threatening cardiovascular conditions
* counteract vasosupressor drugs
* treats

beta adrenergics

cause mild headaches, nervousness, dizziness, increased heart rate and fluctuation in BP

epinephrine

* stimulates nonspecific alpha and beta receptors
* affects heart and bronchioles
* used for bradycardia, anphaylaxis, Cardiac Arrest, hypotension

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Dopamine

* stimulates alpha, beta dopaminergic receptors
* Used for hypotension and bradycardia
* always begin 0.9% NS before beginning a dopamine drip

Safety precautions for Parkinsons Disease

* monitor for anticholinergic SE, do not overheat
* fall risk
* change positions slowly to avoid orthostatic hypotenstion
* report muscle contractions of the neck, jaundice, itching

Dopamine replacement drugs

* carbidopa- levodopa
* adverse effects are palpitations, hypotension, urinary retention, depression
* work with COMT inhibitors

Direct acting dopamine agonist

stimulate pre/post synaptic dopamine receptors in brain to stimulate production more dopamine

* bromocriptine (Parlodel), Pramipexole (Mirapex)

MAO- B inhibitors

* selegiline
* inhibits the actions of monoamine oxidase that breaks down catecholamines which overall prevents the breakdown of levadopa

Anticholinergic Agents

cogentin

* blocks acetylcholine
* secondary drug for tremor/muscle rigidity