Unit 2

Albuterol (Proventil ® or Ventolin ®) is a beta-2 adrenergic agonist, this will cause _____________ of the smooth muscles.

Relaxation

What happens to the urinary bladder when the sympathetic system is stimulated?

Relaxation of urine bladder?

Which is not an anti-cholinergic side effect?

bradycardia

What are some broad uses of beta-blockers

- HTN - Angina - Arrhythmias - Infarction - Heart Failure **All caused by to much norepinephrine and angiotensin II

What NT is involved in the parasympathetic system?

ACH

What is the NT (neurotransmitter) that is released from the preganglionic neuron in the sympathetic system?

ACH

Identify the mechanism of action (MOA) for the major classifications of drugs discussed with the ANS and Respiratory System. (How does the drug work?)

ANS drugs MOA= Respiratory drugs MOA= bronchodialation

Phenylephrine (Neo-Synephrine®) belongs to which drug class?

Adrenergic agonist

Terazosin (Hytrin ®) belongs to which drug class?

Alpha 1 Adrenergic Blocker

Identify the 4 types of adrenergic receptors and locations.

Alpha I is located on the glands, smooth muscle, eyes, and most arteries and veins. Alpha II is located on the adrenergic nerve ending helps regulate Alpha I Beta I is located on the heart. Beta II is located on the smooth muscle, lungs, uterus, skeletal arteries and coronary arteries.

Identify the relationship between bronchoconstriction and bronchodilation as it relates to asthma, COPD, and breathing.

Bronchocontriction is constriction of the bronchi(lungs) making it difficult to breathe. Broncodialation is dialation of the bronchi making it easier to breathe (bronchodialators)

(Use question #9 on albuterol (Proventil®, Ventolin®) to answer this question.) This result will in turn cause ______________ to occur.

Bronchodilation

Match drug name to the appropriate drug classification. For example: _____ chlorpheniramine (Chlor-Trimeton®) A. decongestant _____ pseudoephedrine (Sudafed®) B. bronchodilators _____ albuterol (Proventil®, Ventolin®) C. α-1 blocker _____ terazosin (Hytrin®) D. antihistamine

D. chlorpheniramine (Chlor-Trimeton®) D. antihistamine A. pseudoephedrine (Sudafed®) A. decongestant B. albuterol (Proventil®, Ventolin®) B. bronchodilators C.terazosin (Hytrin®) C. α-1 blocker

Recognize that critical thinking type questions will be used to test knowledge of application. For example, if someone has a stuffy nose, what medication would be recommended?

Decongestants

What drug is used for beta 1 adrenergic agonist. What is it used for and what are the SE/ Pt teaching?

Drug: dobutamine Uses: treatment of shock, increasing blood pressure and increases heart function.

Which drug should not be used if the patient has hypertension?

EPI

Identify the neurotransmitters involved with the cholinergic and adrenergic system.

In the parasympathetic system (cholinergic) the neurotransmitter released at both the ganglia and the post ganglionic nerve endings is acetylcholine(ACH). In the sympathetic system (adrenergic) preganglionic (ACH) .the neurotransmitter released postganglionic nerve endings it is the norepiephrine(NE), epinephrine (EPI), Dopamine (DA).

Beta-2 receptors are located on the:

Lungs

Identify the 3 types of cholinergic receptors, actions, and locations.

Muscarinic is located on the cardiac, smooth muscle and glands Nicotinic I (nn) is located in the ganglia of the parasympathetic and sympathetic nerves (synapse area) Nicotinic II (nm) is located at the neuromuscular junction of the skeletal muscle.

Which receptors are cholingeric receptors?

Muscarinic, Nicotinic

A patient presents with Myasthenia Gravis, which is a neuromuscular disorder caused by the destruction of acetylcholine. Which receptor would be most affected with this conditions?

Nicotinic II

Identify the actions that occur when the dopamine receptors become stimulated at High dose.

Stimulates alpha 1 receptors causing vasoconstriction - increases in BP

Identify the actions that occur when the dopamine receptors become stimulated at Moderate dose.

Stimulates beta 1 receptor - heart, increasing force of contraction and cardiac output.

Identify the actions that occur when the dopamine receptors become stimulated at low dose

Stimulates dopaminergic (D1) receptors in kindneys causing vasodilation and increased renal blood flow.

Identify the main differences between the sympathetic/adrenergic system and parasympathetic/cholinergic system.

Sympathetic Adrenergic system ( flight or fight) Parasympathetic Cholinergic system (rest and digest)

Describe the relationship between vasoconstriction and vasodilation with blood pressure.

Vasconstriction= constriction of the blood vessels. Blood pressure rises. Vasodilation= dilation of the blood vessels. Blood pressure decreases.

Discuss briefly the precipitating factors and symptoms of asthma.

Wheezing, elevated heart rate, bronchoconstriction, difficulty breathing, shortness of breath, chest tightness, dyspnea, cough.

When the cholinergic system is blocked or decreased as a result of administering an anti-cholinergic, what happens to the pupils of the eye?

mydriasis

Which drug or drug class would be the best for treating a patient with Myasthenia Gravis?

neostigmine (Prostigmin) Cholinergic Agonist

What action occurs when the alpha-1 receptor is blocked?

relaxation of smooth muscles vasodilation of blood vessels, decreases BP Relaxes smooth muscles of ureters and increases urine flow.