Studied by 48 PeopleTags & Description
names of the adrenergic receptor organ cells:
alpha 1, alpha 2, beta 1, and beta 2
where are the alpha receptors located?
in the blood vessels, eyes, bladder, and the prostate
what does alpha 1 do?
increases force of heart contraction; results in vasoconstriction of blood vessels (increased BP), mydriasis, decreases secretion of salivary glands, bladder relaxation and prostate contraction increase
what is mydriasis?
dilation of pupils
what is miosis?
constriction of pupils
what does alpha 2 do?
inhibits release of norepinephrine; this dilates the blood vessels (decreased BP), decreases GI motility and tone
where are the beta 1 receptors located?
located primarily in the heart but are also found in the kidneys
what does beta 1 do?
increases heart rate and force of contraction; increases renin secretion and angiotensin (increases BP)
where are the beta 2 receptors located?
smooth muscles of the lung and GI tract, the liver, and the uterine muscle
what does beta 2 do?
bronchodilation; promotes GI and uterine relaxation; increases blood glucose (glycogenolysis in liver), increases blood flow in skeletal muscles
what drug can activate the four receptors?
dopamine
what drug is responsible for the inactivation of neurotransmitters?
norepinephrine
what are the 2 enzymes that inactivate norepinephrine?
monoamine oxidase (inside neuron) and catechol-o-methyltransferase (outside neuron)
what is epinephrine used for? how does it work?
epinephrine is used for anaphylactic shock; it increases blood pressure, heart rate, and airflow through the lungs
it is given intramuscularly, subcutaneously, intravenously (not given IV for anaphylactic shock; give for cardiac arrest), or endotracheally
what is albuterol?
it is a beta 2-adrenergic agonist (noncatecholamines) that is given typically when the patient is unable to breathe. It relaxes the bronchial smooth muscles and promotes bronchodilation to prevent bronchospasm; given for asthma or COPD
what are some of the main side effects of albuterol?
tremors, tachycardia, dizziness, nausea, and urinary retention
what does a cholinergic agonist do?
it stimulates the parasympathetic nervous system by mimicking the neurotransmitter, acetylcholine
types of cholinergic agonists:
direct-acting and indirect acting
what do direct-acting agonists do?
they act on receptors to activate a tissue response
what is bethanechol chloride?
it is a direct-acting cholinergic agonist that acts on the muscarinic receptor; used to increase urination
what do indirect-acting agonists do?
they inhibit the action of the enzyme cholinesterase (AKA, acetylcholinesterase); drugs that inhibit this enzyme are called "cholinesterase inhibitors"
actions of direct-acting (cholinergic agonists) cholinergics:
decrease BP decrease pulse rate constrict bronchioles miosis & increased accommodation increase salivation, perspiration, and tears increase urinary contraction increase peristalsis & tone/motility relaxes sphincter muscles increase neuromuscular transmission and maintenance of strength/tone
actions of indirect-acting cholinesterase (anticholinesterase) inhibitors:
increases muscle tone
types of cholinergic receptors:
muscarinic and nicotinic
what do the cholinergic muscarinic receptors act on?
it affects the smooth muscles and slows the heart rate
what do the cholinergic nicotinic receptors act on?
affects skeletal muscles
anticholinergic (cholinergic antagonists) mechanism of action:
inhibits actions of acetylcholine by occupying the acetylcholine receptors (also called cholinergic antagonists)
actions of anticholinergics:
increase pulse rate; large doses increase, small doses decrease decrease mucous secretions decrease GI motility & relaxed tone/motility increase urinary retention (constriction of sphincter) mydriasis & decreased accommodation decreased salivation, perspiration, and bronchial secretions bronchodilation decreased tremors & rigidity of muscles
drowsiness, disorientation, and hallucinations can result from large doses
what is atropine?
it is an anticholinergic (muscarinic antagonist) used to decrease salivary secretions and increase the heart rate when bradycardia is present
what is used for an antidote for a cholinergic overdose?
atropine sulfate
what is the antidote for atropine?
physostigmine; it reverses the anticholinergic toxicity
what is benztropine?
it is an anticholinergic used to treat Parkinson's disease or drug-induced parkinsonism (helpful in decreasing tremors)
side effects: constipation, blurred vision, ocular hypertension, xerostomia, nausea, anhidrosis, and urinary retention
contraindications: dementia, tachycardia, cardiac disease, etc.
what is ibuprofen (motrin/advil)?
classification: NSAID
action: Inhibits COX-1, COX-2 by blocking arachidonate; analgesic, anti-inflammatory, antipyretic
contraindications: Avoid pregnancy 3rd trimester, NSAIDs, salicylates, asthma, severe renal/hepatic disease
purpose: Used to decrease pain, inflammation, and fever
what is celebrex (celecoxib)?
classification: NSAIDs, COX-2 inhibitor
therapeutic Effects: analgesic, anti- inflammatory, & anti- pyretic
adverse reactions & side effects: GI BLEEDING, dermal rash, GI effects
nursing implications & teaching: assess pain, ROM and swelling. do not give if allergic to sulfonamides, aspirin or NSAIDs. watch for tarry stools.
what is lasix (furosemide)?
classification: loop diuretic
therapeutic effects: diuresis; lowering of blood pressure
adverse reactions & side effects: dehydration, hypochloremia, hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis
nursing implications & teaching: monitor for thirst, dry mouth, lethargy, weakness, hypotension, oliguria and notify physician. monitor K+, Ca++, Mg. can increase BUN, glucose and creatinine, TAKE WITH FOOD
what is phenergan (promethazine)?
classification: antiemetic; antihistamine (H1); sedative/ hypnotic; phenothiazine
therapeutic effects: decrease symptoms of excess histamine, sedation, decrease N/V
adverse reactions & side effects: neuroleptic malignant syndrome, confusion, disorientation, sedation, dizziness
nursing implications & teaching: monitor for extrapyramidal side effects; educate on techniques to help dry mouth; oral care, photosensitivity; orthostatic hypotension risk; avoid ETOH & other CNS depressants; monitor sedation. a known vesicant!
what is morphine?
it is an opioid analgesic (potent) used to treat severe pain (7/10-10/10 pain)
side effects: respiratory depression, orthostatic hypotension, miosis, urinary retention, constipation, and cough suppression
what is the antidote for morphine?
naloxone
what are beta blockers?
used as antihypertensive medications or in combination with a diuretic; reduce cardiac output by diminishing the SNS response
with continued use, beta blockers lower BP and reduce heart rate, contractility, and renin levels
native americans have a reduced or lower response to beta blockers; african americans do not respond well
medications typically end in -lol; acebutolol, atenolol, betaxolol, bisoprolol, and metoprolol
what is a schedule I drug?
substances that have the highest potential for abuse; have no currently accepted medical use; heroin, LSD, marijuana
what is a schedule II drug?
substances that have a high potential for abuse and have a currently accepted medical use (morphine, oxycodone, adderall)
what is a schedule III drug?
substances that have less potential for abuse; abuse may lead to moderate or low physical dependence or high physiological dependence (ketamine, testosterone, tylenol with codeine)
what is a schedule IV drug?
substances that have a low potential for abuse relative to substance in C-III (xanax, ativan, valium)
what is a schedule V drug?
substances that have the lowest potential for abuse; consist primarily of preparations containing limited quantities of certain narcotics (phenergan with codeine, bromfed)
what is aspirin?
aspirin is from a family of salicylates derived from salicylic acid; oldest anti inflammatory agent
it is an anti inflammatory, antiplatelet, and antipyretic
what is the toxic serum level of aspirin?
greater than 300 mcg/ml
salicylates:
interactions: increased bleeding with anti-coagulants and other NSAIDS; risk for hypoglycemia with oral antidiabetics; increased gastric ulcer risk with glucocorticoids; decreased effects of ACE inhibitors, loop diuretics, probenecid
lab interactions: increases prothrombin, bleeding time, INR, and uric acid; decreases cholesterol, T3 and T4 levels, and potassium
foods that contain salicylates: prunes, raisins, licorice, and some spices (curry and paprika)
different types of headaches:
migraine, cluster, and tension
what is a migraine?
a headache characterized by a unilateral throbbing head pain accompanied by nausea, vomiting, and photophobia
preventative treatment includes: beta blockers (propranolol and atenolol), anticonvulsants (valproic acid and gabapentin), and TCAs (amitriptyline and imipramine)
treatment of an attack depends on the intensity of pain; analgesics, opioid analgesics, ergot alkaloids, and selective serotonin receptor agonists
what is a cluster headache?
a headache characterized by a severe, unilateral, nonthrobbing pain usually located around the eye; men are usually affected more
what is a tension headache?
a headache that is typically caused by stress; feels like a "tight band around the head"
what are some examples of medications used to treat anxiety?
benzodiazepines are antianxiety medications that act by binding to a GABA receptor site, making the postsynaptic receptor more sensitive to GABA and its neurotransmission; this decreases signs and symptoms of anxiety
xanax (alprazolam) klonopin (clonazepam) valium (diazepam) ativan (lorazepam) restoril (temazepam)
end in -am
antispasmodics:
synthetic anticholinergic drugs are also used antispasmodics to treat peptic ulcers and intestinal spasticity; used to treat abdominal pain, including spasms and cramps
what are some examples of antilipidemic medications?
medications used to lower lipid levels (cholesterol medications)
lipitor (atorvastatin) zetia (ezetimibe) tricor (fenofibrate) mevacor (lovastatin) pravachol (pravastatin) crestor (rosuvastatin) zocor (simvastatin)
typically end in -statin
what classification of medication is clopidogrel (plavix)?
platelet inhibitor
what are sulfonamides?
first group of drugs used against bacteria
bactrim (trimethoprim/sulfamethoxazole); used for UTIs
what is gout?
an inflammatory condition that attacks joints, tendons, and other tissues; due to too much uric acid (type of arthritis)
what are antigout medications?
zyloprim (allopurinol) colcrys (colchine)
what are antihypertensives?
medications used to treat hypertension; lowers blood pressure (preventative for MI, stroke, renal failure, and death)
tenormin (atenolol) coreg (carvedilol) catapres (clonidine) vasotec (enalapril) microzide (hydrochlorothiazide) prinivil (lisinopril) prinizide (lisinopril and HCTZ) cozaar (losartan) toprol (metoprolol) aldactone (spironolactone) diovan (valsartan)
beta blockers: end in -lol ACE inhibitors: end in -pril ARBs (angiotensin II receptor blockers): end in -sartan
what are hypnotics?
typically ordered for treatment of sleep disorders (sedatives)
ambien (zolpidem); schedule IV drug
what are antiemetics?
antiemetics are used to control vomiting
phenergan (promethazine) zofran (ondansetron) reglan (metoclopramide) - typically used for nausea that accompanies radiation or chemotherapy
what is metoclopramide HCL?
it is a direct-acting cholinergic agonist that is usually prescribed to treat gastroparesis, nausea (from chemo/radiation), and GERD
what are anticoagulants?
anticoagulants are used to inhibit clot formation; thin the blood
used to prevent DVT
heparin lovenox (enoxaparin) coumadin (warfarin)
what does EBL stand for?
estimated blood loss
what are antipyretics used for?
antipyretics are used to reduce elevated body temperature
tylenol (acetaminophen)
what are PCA pumps?
PCA = patient controlled analgesia; it is an alternative route for opioid administration for self-administered pain relief as needed
only the PATIENT can control the pump; the nurse may not touch it
what is COX 1?
COX-1 protects the stomach lining, regulates blood platelets, and promotes blood clotting
what is COX 2?
COX-2 triggers inflammation and pain at the injured site
what are the first generation NSAIDs?
salicylates salicylate derivatives para-chlorobenzoic acid propionic acid fenamates oxicams
aspirin indomethacin ibuprofen naproxen meloxicam nabumetone
what are the 2nd generation NSAIDs?
celebrex (celecoxib)
newer NSAIDs, called COX-2 inhibitors, block only COX-2 and not COX-1
what is demerol (meperidine)?
a narcotic analgesic commonly used in pregnant women; preferred over morphine because it does not diminish uterine contractions and causes less neonatal respiratory depression
where are nociceptors found?
everywhere
what is the fight or flight response? what is it controlled by?
it is a physiological reaction that occurs in response to an emotional situation; typically triggered by feelings of stress, fear, anxiety, aggression, and anger; controlled by the sympathetic nervous system
what is the rest and digest response? what is it controlled by?
it is a physiological reaction that relaxes your body after an emotional situation (due to stress or fear); controlled by the parasympathetic nervous system
what are antihistamines?
medications often used to relieve symptoms of allergies; also used to prevent motion sickness and as short-term treatment for insomnia
reduce or block histamines to stop or reduce allergy symptoms
allegra (fexofenadine) flonase (fluticasone) benadryl (diphenhydramine) claritin (loratadine) zyrtec (cetirizine)