PH Test 1 - Ch. 1,3,9,11,15,16
10 Rights of a pt
1. Medication 2. Pt 3. Dosage 4. Route 5. Time 6. Reason 7. Assessment 8. Documentation 9. Response 10. Educate the pt 11. Pt can refuse
PNS Cholinergic receptors
1. Muscarinic receptors... affect smooth muscles by lowering intraocular pressure for pt with glaucoma 2. Nicotinic receptors... affect skeletal muscles
How do you know when the Adrenergic system is activated?
Dilated pupils; increased resp, pulse and BP; flushing; decreased peristalsis; increased glucose levels(watch levels in hospital, increases the risk for infection)
Antagonist
Drug binds to receptor and prevents and response; blocks a response
sympathomimetic
Drug binds to receptors and mimics the response the neurotransmitter has on the receptor; direct, indirect and mixed.
Receptors
Drug binds with a receptor to elicit or block a response, the better the fit the better the response
Nonspecific drugs
Drug that affects multiple receptor sites; same type of receptor is located in multiple places and the drug affects all the receptor sites
Nonselective drugs
Drugs that affect various receptors; Med affects different types of receptor sites
Stimulating drug
Enhance intrinsic activity; Epinephrine
sympathetic nervous system (Adrenergic)
Fight or flight; norepinephrine is the neurotransmitter
Tetrahydrozoline
Glaucoma and eye exams stimulates alpha 1 receptors causing vasoconstriction and reduction in intraocular pressure and pupil dilation
autonomic nervous system
Goal= Homeostasis Functions independent; Pulse, BP, RR, Temp, Digestion
Irritant drug
Have a noxious effect; Astringents
Beta 2 Receptors Adrenergic SNS
Located in lungs, GI tract, Uterus, and liver Lungs = Bronchodilation GI tract = decrease in tone and motility uterus= relax the uterus's muscles liver = increases blood sugar
Beta 1 Receptors Adrenergic SNS
Located in the heart and kidneys stimulation... Heart = increased pulse and contractility Kidneys = increased renin secretion causes increases blood pressure
Alpha 1 Receptors Adrenergic SNS
Located in... and stimulating causes... Blood vessels = Vasoconstriction(increase in BP and contractility of the heart) Eyes = dilated pupils Bladder = relaxation of bladder Prostate = contraction
Alpha 2 Receptors Adrenergic SNS
Located in... stimulating causes... blocks norepinephrine Blood vessels= Vasodilation (decrease in blood pressure) Smooth muscles of the GI tract on presynaptic nerve membranes = decrease in gastric tone and motility (prevent nausea and vomiting)
Epinephrine
Nonselective = bind to all receptors goal= dilate bronchi alpha 1; increase BP beta1; increase pulse beta2; promotes bronchodilation
Atropine antidote
Physostigmine Symptoms of overdose... flushing dry skin and mucous membranes altered mental status fever
Antimicrobial drug
Prevent, inhibit, or kill infectious organisms; penicillin
Replacement drug
Replace essential bodily compounds; Insulin
Albuterol (Proventil)
Selective acts on beta 2 adrenergic receptors promotes bronchi dilation (beta 2 located in the lungs)
Direct acting cholinergic agonists
Selective to muscarinic receptors in the smooth muscles in heart, GI, GU & Glands Increase bronchi secretions 1. metoclopramide (Reglan)... nausea and GERD 2. pilocarpine (Pilocar)... Glaucoma 3. bethanechol chloride (Urecholine)...urinary retention causes pt to void
Cytotoxic drug
Selectively kills cancers or parasites; chemotherapy
Adrenergic (SNS) Neurotransmitters (catecholamines)
Short duration of action 1. Norepinephrine 2. Epinephrine 3. Dopamine
Phenylephrine
Topical nasal decongestant stimulates alpha 1 receptors causing vasoconstriction and reduction in nasal blood flow
Alpha adrenergic blockers
block alpha 1 receptors causing vasodilation (decrease in BP), tachycardia, pupil constriction, reduces contraction of smooth muscles in bladder neck and prostate. used to treat BPH enlarged prostate
Agonist
drug binds to the receptor; there is a response
parasympathomimetic drugs
drugs that enhance or mimic the function of the parasympathetic system
Anticholinergics
effects... decrease in GI motility, salvation, dilation of pupils, increased pulse, decreased bladder contraction resulting in urinary retention, decreased rigidity and muscle tremors, blurred vision
parasympathetic nervous system (Cholinergic) rest and digest
goal homeostasis and conserving energy neurotransmitter= Acetylcholine
Epinephrine antidote
phentolamine mesylate (Regitine)
Anticholinergics for motion sickness
scopolamine, dimenhydrinate, cyclizine, meclizine hydrochloride
Adrenergic Agonists
stimulate the sympathetic nervous system causing a response. ex... epi and albuterol
Pharmacokinetics
what the body does to the drug
Pharmacodynamics
what the drug does to the body
Beta adrenergic blockers
Beta 1 = reduces cardiac contractility, decreases pulse, decreases BP Beta 2 = Bronchoconstriction, contracts uterus, inhibits glycogenolysis (glycogen into glucose)
Adrenergic Antagonists
Block response directly by occupying the receptor sites.
Indirect acting cholinergic agonists
Complications... dry mouth tachycardia blurred vision
Depressive drug
Decrease neutral activity and bodily function; Opioid analgesics
Atropine (anticholinergic)
Action... increased pulse, decreased motility and peristalsis, decrease in salivary secretions. do not use for glaucoma.
Adrenergic (SNS) receptors
Alpha 1 alpha 2 beta 1 beta 2
Half-life
Amount of time the drug takes to be broken down by the body; ex... 50mg after 24hours = 50mg...(8hrs) 25mg...(8hrs) 12.5...(8hrs) 6.25mg
Indications for Beta adrenergic blockers
Angina, dysrhythmias, hypertension ex... atenolol, carvedilol, labetalol, metoprolol
When to use Albuterol
Asthma and bronchitis stimulates beta 2 receptors causing bronchodilation
Peripheral Nervous System (PNS)
Autonomic nervous system (Sympathetic and Parasympathetic) and Somatic nervous system
