Adrenergic and Cholinergic Pharmacology - Review Flashcards

This set covers adrenergic receptors (alpha/beta), agonists/antagonists, dosing concepts (dopamine), key drugs (epinephrine, atropine, bethanechol, albuterol, phenylephrine, doxazosin), and major nursing considerations and toxicity mnemonics from the notes.

Which hormones increase heart rate and blood pressure through sympathetic activation?

Epinephrine and norepinephrine.

Cholinergic medications affect the __ nervous system.

Parasympathetic nervous system.

Cholinergic agonists vs anticholinergics: what do they do?

Agonists mimic acetylcholine at receptors; antagonists block acetylcholine receptors.

Bethanechol is a direct-acting cholinergic agonist used to treat __.

Nonobstructive urinary retention.

Atropine is a cholinergic antagonist; main effects include: __.

Increased heart rate, reduced secretions, mydriasis; may cause urinary retention; bronchodilation; used to treat bradycardia and preoperative secretions.

What is the drug of choice for anaphylaxis that acts on alpha1, alpha2, beta1, and beta2 receptors?

Epinephrine.

Alpha1 receptor activation causes __.

Vasoconstriction and increased blood pressure; can also cause nasal decongestion and, with extravasation, necrosis.

Alpha2 receptor activation tends to __ norepinephrine release.

Inhibit presynaptic release of norepinephrine (decrease sympathetic outflow).

Beta1 receptor activation primarily affects the and .

Heart and kidneys; increases heart rate, force of contraction, and can increase renin release.

Beta2 receptor activation causes __.

Bronchodilation; relaxation of bronchial smooth muscle (and related metabolic effects such as hyperglycemia in diabetics).

Dopamine dose-related receptor effects: low dose, moderate dose, high dose.

Low dose: renal perfusion; moderate dose: beta1 activation; high dose: alpha1 vasoconstriction.

Phenylephrine is a selective alpha1 receptor agonist used for __.

Vasoconstriction to raise blood pressure and to relieve nasal congestion.

Albuterol is a selective agonist used for .

Beta2; bronchodilation.

Alpha1 blockers (e.g., doxazosin) are used for and ; adverse effect: orthostatic hypotension.

Hypertension and benign prostatic hyperplasia (BPH).

Epinephrine in anaphylaxis increases blood pressure and opens airways; caution: can cause __.

Dysrhythmias or tachycardia; potential chest pain due to increased cardiac workload.

What is the antidote for muscarinic agonist overdose?

Atropine (muscarinic antagonist).

Anticholinergic toxicity mnemonic: Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter.

Hyperthermia, dry mucous membranes, flushed skin, mydriasis with blurred vision, delirium.

Contraindications for atropine/anticholinergics include and .

Narrow-angle glaucoma and myasthenia gravis (also bradycardia, hypotension, asthma; obstructive GI/urinary disorders).

Nursing considerations for cholinergic therapy include __, monitoring for side effects, evaluating effectiveness, and __.

Baseline assessment; patient education for safe self-administration.

Which hormones increase heart rate and blood pressure through sympathetic activation?

Epinephrine and norepinephrine.

Cholinergic medications affect the parasympathetic nervous system.

Parasympathetic nervous system.

Cholinergic agonists vs anticholinergics: what do they do?

Agonists mimic acetylcholine at receptors; antagonists block acetylcholine receptors.

Bethanechol is a direct-acting cholinergic agonist used to treat nonobstructive urinary retention.

Nonobstructive urinary retention.

Atropine is a cholinergic antagonist; main effects include: increased heart rate, reduced secretions, mydriasis; may cause urinary retention; bronchodilation; used to treat bradycardia and preoperative secretions.

Increased heart rate, reduced secretions, mydriasis; may cause urinary retention; bronchodilation; used to treat bradycardia and preoperative secretions.

What is the drug of choice for anaphylaxis that acts on alpha1, alpha2, beta1, and beta2 receptors?

Epinephrine.

Alpha1 receptor activation causes vasoconstriction and increased blood pressure; can also cause nasal decongestion and, with extravasation, necrosis.

Vasoconstriction and increased blood pressure; can also cause nasal decongestion and, with extravasation, necrosis.

Alpha2 receptor activation tends to inhibit presynaptic release of norepinephrine (decrease sympathetic outflow) norepinephrine release.

Inhibit presynaptic release of norepinephrine (decrease sympathetic outflow).

Beta1 receptor activation primarily affects the heart and kidneys.

Heart and kidneys; increases heart rate, force of contraction, and can increase renin release.

Beta2 receptor activation causes bronchodilation; relaxation of bronchial smooth muscle (and related metabolic effects such as hyperglycemia in diabetics).

Bronchodilation; relaxation of bronchial smooth muscle (and related metabolic effects such as hyperglycemia in diabetics).

Dopamine dose-related receptor effects: low dose, moderate dose, high dose.

Low dose: renal perfusion; moderate dose: beta1 activation; high dose: alpha1 vasoconstriction.

Phenylephrine is a selective alpha1 receptor agonist used for vasoconstriction to raise blood pressure and to relieve nasal congestion.

Vasoconstriction to raise blood pressure and to relieve nasal congestion.

Albuterol is a selective beta2 agonist used for bronchodilation.

Beta2; bronchodilation.

Alpha1 blockers (e.g., doxazosin) are used for hypertension and benign prostatic hyperplasia (BPH); adverse effect: orthostatic hypotension.

Hypertension and benign prostatic hyperplasia (BPH).

Epinephrine in anaphylaxis increases blood pressure and opens airways; caution: can cause dysrhythmias or tachycardia; potential chest pain due to increased cardiac workload.

Dysrhythmias or tachycardia; potential chest pain due to increased cardiac workload.

What is the antidote for muscarinic agonist overdose?

Atropine (muscarinic antagonist).

Anticholinergic toxicity mnemonic: Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter.

Hyperthermia, dry mucous membranes, flushed skin, mydriasis with blurred vision, delirium.

Contraindications for atropine/anticholinergics include narrow-angle glaucoma and myasthenia gravis (also bradycardia, hypotension, asthma; obstructive GI/urinary disorders).

Narrow-angle glaucoma and myasthenia gravis (also bradycardia, hypotension, asthma; obstructive GI/urinary disorders).

Nursing considerations for cholinergic therapy include baseline assessment, monitoring for side effects, evaluating effectiveness, and patient education for safe self-administration.

Baseline assessment; patient education for safe self-administration.

Where are the hormones epinephrine and norepinephrine primarily released from in the body?

Epinephrine is primarily from the adrenal medulla; Norepinephrine is released from postganglionic sympathetic nerve terminals and also from the adrenal medulla.

What are some specific effects of \alpha_1 receptor activation in various tissues?

Vasoconstriction (increasing blood pressure), pupillary dilation (mydriasis), and contraction of genitourinary smooth muscle.

What is the main presynaptic effect of \alpha_2 receptor activation?

Inhibition of norepinephrine release, leading to a reduction in sympathetic outflow.

How does \beta_1 receptor activation affect the heart specifically?

Increases heart rate (chronotropy), force of contraction (inotropy), and conduction velocity (dromotropy).

What are some additional physiological effects of \beta_2 receptor activation, besides bronchodilation?

Vasodilation in skeletal muscles, glycogenolysis (leading to hyperglycemia), and relaxation of the uterine smooth muscle.

At low doses, dopamine primarily activates what specific receptors in the renal vasculature to increase blood flow?

Dopamine-1 ( D_1 ) receptors.