topic 4 (NSG-318)

sympathetic nervous system nickname

fight or flight

parasympathetic nervous system nickname

rest and digest

sympathetic nervous system neurotransmitter

norepinephrine

parasympathetic nervous system neurotransmitter

acetylcholine (ACh)

sympathetic effect on heart rate

increases heart rate

parasympathetic effect on heart rate

decreases heart rate

sympathetic effect on bronchioles

bronchodilation

parasympathetic effect on bronchioles

bronchoconstriction

sympathetic effect on pupils

dilates pupils

parasympathetic effect on pupils

constricts pupils

sympathetic effect on GI tract

decreases motility and secretions

parasympathetic effect on GI tract

increases motility and secreations

easy way to remember Beta receptors

1 heart 2 lungs

beta 1 receptor location

heart

beta 1 stimulation causes what?

increased heart rate and contractillity

beta 2 receptor location

lungs/bronchi

beta 2 stimulation causes what?

vasoconstriction and increased blood pressure

alpha 1 stimulation causes what?

vasoconstriction and increased blood pressure

alpha 2 stimulation causes what?

inhibits norepinephrine release and lowers blood pressure

adrenergic agonists stimulate which system?

sympathetic nervous system

another name for adrenergic agonists

sympathomimetics

agonists means what?

stimulates receptor activity

direct acting adrenergic agonists work how?

directly stimulate adrenergic receptors

indirect acting adrenergic agonists work how?

cause norepinephrine release

mixed acting adrenergic agonists work how?

stimulate receptors and release norepinephrine

major effects of adrenergic agonists

increase heart rate, increase blood pressure and bronchodilation

epinephrine stimulates which receptors?

alpha 1 beta 1 and beta 2

is epinephrine selective or nonselective?

nonselective

why is epinephrine nonselective?

stimulates multiple receptor types

main uses of epinephrine

anaphylaxis, cardia arrest, bronchospasm

common side effect adrenergic agonists

tremors, restlessness, hyperglycemia

serious adverse effect of epinephrine

tachycardia

life threatening adverse effect of epinephrine

ventricular fibrillation

what should be monitored before giving epinephrine

vital signs and blood glucose

why monitor blood glucose with epinephrine?

can increase blood sugar

adrenergic antagonists are also called what?

blockers

adrenergic antagonists do what?

blood sympathetic stimulation

alpha blockers cause what?

vasodillation

alpha blockers lower what?

blood pressure

major adverse effect of beta blockers

orthostatic hypotension

what is first dose phenomenon?

severe orthostatic hypotension after first dose

alpha blockers are commonly used for what condition?

Benign Prostatic Hyperplasia

beta blockers block which receptors?

beta 1 and beta 2

beta 1 blockers cause what effect on the heart?

decreased heart rate

beta 1 blockers cause what effect on blood pressure

decreased blood pressure

beta 2 blockers cause what effect on blood pressure?

bronchoconstriction

why are nonselective beta blockers dangerous in asthma?

can cause bronchospasm

atenolol is selective for which receptor?

beta 1

use of atenolol

hypertension, angina, MI

hold atenolol if HR is below what?

60 bpm

common side effects of atenolol

fatigue, dizziness and drowsiness

serious adverse effect of atenolol

bradycardia

why should beta blockers never be stopped abruptly?

rebound hypertension and tachycardia

cholinergic agonists stimulate which system?

parasympathetic nervous system

another name for cholinergic agonists

parasympathomimetics

cholinergic agonists mimic which neurotransmitter?

acetylcholine

muscarinic receptors affect what?

organs and smooth muscle

nicotinic receptors affect what?

skeletal muscle

cholinergic agonists cause what effect on heart rate?

decrease heart rate

cholinergic agonists cause what effect on GI tract?

increase motility and secreations

cholinergic agonists cause what effect on pupils ?

constriction

bethanechol is used for what?

urinary retention

bethanechol works by doing what?

increasing bladder contraction

bethanechol side effect

diarrehea

life threatening effect of bethanechol

bronchospasm

why is bethanechol contraindicated in asthma

causes bronchoconstriction

cholinergic crisis means what?

too much cholinergic stimulation

what acronym helps remember cholinergic crisis?

SLUDGE

S in SLUDGE

salivation

L in SLUDGE

lacrimation

U in SLUDGE

urination

D in SLUDGE

defecation

G in SLUDGE

GI distress

E in SLUDGE

emesis

another name for cholinergic antagonists

anticholinergics

cholinergic antagonists block what?

acetylcholine

cholinergic antagonists produce effects similar to which system

sympathetic nervous system

effect on heart rate w/ cholinergic antagonists

increased heart rate

effect on lungs w/ colinergic antagonists

bronchodilation

effect on GI tract w/ cholinergic antagonists

decreased motility

effect on bladder w/ cholinergic antagonists

urinary retention

effect on pupils w cholinergic antagonists

dilation

effect on saliva production w cholinergic antagonists

decreased salivation

atropine is what type of drug?

cholinergic antagonist

main uses of atropine

bradycardia, pre op secretions, pupil dilation

common atropine side effect

dry mouth, constipation, urinary retention, glaucoma

Anticholinergic Crisis: hot as a hare

hyperthermia

Anticholinergic Crisis: dry as a bone

dry skin/mouth

Anticholinergic Crisis: blind as a bat

dilated pupils/blurred vision

Anticholinergic Crisis: red as a beet

flushed skin

Anticholinergic Crisis: mad as a hatter

confusion/delirium