Pharm Week 6 - Ch 14, 17, & 18

Beta Adrenergic Antagonists all have the suffix...

-OLOL

The two primary anticholinergic Muscarinic ANATGONISTS used are...

ATROPine (from the Atropa Belladonna plant; -ine meaning pertaining to) & Oxybutynin (used for urinary incontinence)

The specific Beta 2 adrenergic agonist is known as...

Albuterol.

The two major groups of Adrenergic Antagonists (Blockers) are...

Alpha-adrenergic blocking agents, & Beta-adrenergic blocking agents

The three primary conditions that are treated with Beta1-Adrenergic Antagonists are...

Angina Pectoris (reduction of oxygen needed by heart), Hypertension (prevents vasoconstriction), & heart failure

The primary cholinergic drug used as a Muscarinic receptor ANTAGONIST (which acts by decreasing heart rate, dilating the pupils, & decreasing salivary secretions during surgery) is...

Atropine

The primary CHOLinergic drug used as a Muscarinic AGONIST is...

BethaneCHOL [be-than-i-kawl, -kol]

The primary cholinergic drug used as a Muscarinic acetylcholine receptor AGONIST is...

Bethanechol [be-than-i-kawl, -kol]

The adverse effects of Atropine (muscarinic antagonist) can be identified with the acronym BUDCAT, which stands for...

Blurred vision/ increased IOP, Urinary retention, Dry oral and bronchial secretions, Constipation, Anhidrosis (deficient sweating), & Tachycardia

The four therapeutic effects of Beta 2 adrenergic receptor activation are...

Bronchodilation, Uterine muscle relaxation, Glycogenolysis, & enhanced skeletal muscle contraction.

Bethanechol acts on muscarinic receptors of the bladder to both...

CONTRACT the detrusor urinae muscle & RELAX the urethral sphincter muscle

Because of their action on the heart, four therapeutic applications for Beta 1 adrenergic receptor activation are treatment of...

Cardiac Arrest (although not the drug of choice), Heart Failure (by increasing contractility), Shock (increases HR by positive inotropic effect), & Heart Blocks (enhanced AV node conduction)

The two categories of Adrenergic Agonists are...

Catecholamines & Noncatecholamines

Muscarinic receptor activation causes vaso...

DILATION

The selective Beta 1-Adrenergic Receptor agonist that is used in the treatment of heart failure and cardiogenic shock is...

Dobutamine.

The Adrenergic Agonist that was once used for burning fat, and is similar to Epinephrine in it's ability to bind to Alpha 1 & 2 and Beta 1 & 2 receptors, is...

Ephedrine

The four Beta 2 adrenergic agonists are...

Epinephrine, Ephedrine, Isoproterenol, & Albuterol.

The three Adrenergic antagonists that are specific for Alpha 2 adrenergic receptors are...

Epinephrine, Norepinephrine, & Ephedrine

The five Adrenergic Agonists that are able to bind specifically to Beta 1 adrenergic receptors are...

Epinephrine, Norepinephrine, Dopamine, Ephedrine, Isoproterenol, & Dobutamine

The two adverse effects of Beta 2 adrenergic activation are...

Hyperglycemia (only in diabetics), & Tremors (very common).

The three primary adverse effects of Alpha 1 Adrenergic receptor activation are...

Hypertension (due to widespread vasoconstriction), Necrosis (due to vasoconstriction), & Reflex Bradycardia (due to vasoconstriction and elevated BP).

The Beta adrenergic agonist that is used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma, because it binds to both Beta receptors, is known as...

Isoproterenol

Catecholamines cannot be given orally due to degradation from the enzymes...

MAO and COMT (MonoAmine Oxidase & Catchol-O-MethylTransferase)

The discontinued cholinergic drug used as a Nicotinic N receptor ANTAGONIST, which was used as a ganglion-blocking drug administered to lower high blood pressure, is known as...

Mecamylamine

Three nursing implications for the administration of Bethanechol are...

Monitor I's & O's (causes increased urination), Monitor BP and HR (causes vasodilation and decrease HR), & be sure bedpan or bathroom is readily available.

Noncatecholamine adrenergic agonists have a longer half-life than catecholamines because they are more slowly degraded by...

MonoAmine Oxidase (MOA)

Anticholinergic drugs, parasympatholytic drugs, antimuscarinic drugs, & muscarinic blockers are all alternative names for...

Muscarinic Antagonists

Bethanechol is used therapeutically usually postoperative or postpartum for...

NONOBSTRUCTIVE URINARY RETENTION

The primary cholinergic drug used as a Nicotinic N & Nicotinic M acetylcholine receptor AGONIST is...

Nicotine (the doses needed to activate Nicotinic M receptors at NMJs is much higher than the doses needed to activate Nicotinic N receptors in autonomic ganglia)

Acetylcholine works on both...

Nicotinic (N & M) & Muscarinic receptors

The three subtypes of cholinergic receptors are...

Nicotinic Neuronal (N) receptors, Nicotinic Muscle (M) receptors, & Muscarinic receptors.

The reduction in venous muscle tone causes pooling of blood in veins, and upon standing, Alpha1 adrenergic antagonists cause...

Orthostatic Hypotension.

The prototype drug used for overactive bladder (urge incontinence), which happens to be a anticholinergic drug, is known as...

Oxybutynin

6 contraindications for the administration of Bethanechol are...

Peptic ulcer Disease (PUD), urinary obstruction, intestinal obstruction, hypotension, asthma, & hyperthyroidism

The Adrenergic Agonist that is used as a nasal decongestant, and is specific to ONLY Alpha 1 Adrenergic receptors is...

Phenylephrine

The five Adrenergic Agonists that are capable of activating Alpha 1 Adrenergic receptors are...

Phenylephrine (specific to alpa1), Ephedrine (all but dopamine), Epinephrine (all but dopamine), Norepinephrine (alpha 1&2, beta 1), & Dopamine (alpha1, beta1, & Dopamine)

The alpha 1 adrenergic blocker prototype is known as...

Prazosin

The two primary Beta-Adrenergic Antagonists are...

PropanOLOL & MetoprOLOL (second generation; specific for Beta1)

The four primary adverse effects of Alpha1 blockers are...

Reflex Tachycardia (due to baroreceptor reflex of low BP), Nasal congestion (dilation of blood vessels of nasal mucosa), Inhibition of ejaculation (alpha1 required for ejaculation), & sodium retention.

Muscarinic (acetylcholine) effects can be described using the acronym SLUG BAM, which stands for...

Salivation/ Secretions/ Sweating Lacrimation (the flow of tears) Urination Gastrointestinal upset Bradycardia/ Bronchoconstriction/ Bowel movement Abdominal cramps/ Anorexia Miosis (excessive constriction of pupil of eye)

The cholinergic drug used as a Nicotinic M receptor ANTAGONIST, which causes short-term paralysis and muscle relaxation, is known as...

Succinylcholine, colloquially referred to as "Sux"

Because they mimic the action of the sympathetic nervous system, Adrenergic Agonists are also known as...

Sympathomimetic drugs.

Three adverse effects of Beta 1 adrenergic receptor activation are...

Tachycardias, Dysrhythmias, & Angina Pectoris (due to ischemia of heart caused by increased cardiac oxygen demand)

The cholinergic drug used as a Nicotinic M acetylcholine receptor ANTAGONIST, which has historical roots of being used as arrow poison and is obtained from curare or from frog skin, is...

TuboCURARine

A sudden and intense urge to urinate, even if you emptied your bladder a short while ago, is known as...

URGE incontinence (NOT stress urinary incontinence)

The two therapeutic applications for the activation of Alpha1 Adrenergic receptors are both...

Vasoconstriction & Pupil Dilation (Mydriasis)

Most cholinergic drugs mimic or block the actions of....

acetylcholine

Muscarinic acetylcholine receptors are more sensitive to muscarine than to nicotine, and are also sensitive to...

acetylcholine

Anticholinergic Muscarinic Antagonists work by competitively blocking the actions of...

acetylcholine at muscarinic receptors.

Adrenergic Agonists produce their effect by activating...

adrenergic receptors (within the Sympathetic Nervous System).

Avoid using Oxybutynin with other drugs that have significant anticholinergic properties, including:...

antihistamines, tricyclic antidepressants, & phenothiazines

The two primary therapeutic applications for Beta 2 adrenergic receptor activation are...

asthma, & delay of preterm labor.

Reflex Bradycardia is an ANS feedback method of decreasing BP by decreasing cardiac output, and is sensed by...

baroreceptors (pressure receptors)

Adrenergic Agonists activate adrenergic receptors by DIRECTLY...

binding to them.

Alpha-adrenergic antagonists are used for Essential (primary) hypertension because they lower blood pressure by...

blocking Alpha1 receptors on arterioles and veins

Adrenergic Antagonists (Blockers) acts by...

blocking adrenergic receptors.

Because they are polar, Catecholamines cannot cross the...

blood-brain barrier.

When administering Atropine, teach patient to avoid hazardous activity because of...

blurred vision (decreased accommodation).

A contraindication for the use of Beta1-adrenergic antagonists are patients with asthma, since the beta1 blockade causes...

bronchoconstriction.

Bethanechol acts on muscarinic receptors of Respiratory and GI smooth muscles by...

causing contraction

Cholinergic receptors are agents that influence the activity of...

cholinergic receptors (Nicotinic N, Nicotinic M, & Muscarinic).

Muscarinic receptor activation causes the lenses of the eyes to focus on things nearby, by causing contraction of...

ciliary muscles (acts on lens, not pupil)

Activation of Alpha 2 adrenergic receptors has minimal...

clinical significance.

Muscarinic receptor activation causes Miosis, which is...

constriction of the pupils

Muscarinic receptor activation causes urination by causing both...

contraction of the detrusor muscle, & relaxation of the urethral sphincter.

Alpha 1 adrenergic receptor activation causes MYDRIASIS (excessive dilation of pupil) by causing...

contraction of the radial muscles of the eyes

Muscarinic receptor activation causes the Heart Rate to...

decrease

The three therapeutic applications for the usage of Beta1 Adrenergic Antagonists (Metoprolol) are...

decreased HR, decreased contractility of heart, & reduction of speed of impulses through AV node

The three primary effects of muscarinic acetylcholine receptor activation are...

decreased heart rate, increased gland secretion, & smooth muscle contraction

Alpha 1 adrenergic receptor activation is used as an adjunct to local anesthesia because it...

delays absorption of local anesthetic. (by vasoconstriction?)

When treating Essential (primary) Hypertension, alpha1 blockers are often combined with...

diuretics.

Four clinical uses for Adrenergic Agonists include...

elevation of BP (by causing vasodilation), treatment of anaphylactic shock (via vasodilation), treatment of heart failure (by increasing HR), & treatment of Asthma (by causing bronchodilation)

Because of it's ability to cause vasoconstriction, the adrenergic agonist of choice for anaphylactic shock is...

epinephrine.

Nicotinic Neuronal (N) acetylcholine receptors are located at all...

ganglia of the autonomic nervous system (somatic, sympathetic and parasympathetic)

The three primary concerns with anaphylactic shock are...

hypotension, bronchoconstriction, & edema of the glottis.

The three effects on the heart that occur with Beta 1 adrenergic receptor activation are:...

increased HR, increased force of contractions, & increased impulse conduction through AV node.

Bethanechol acts on muscarinic receptors of exocrine glands (sweat, saliva, bronchi, gastric juice) by...

increasing secretions

Propranolol, a beta adrenergic antagonist, can cross the BBB and cause...

insomnia, nightmares, & hallucinations

URGE incontinence often results from the bladder having...

involuntary contractions.

Bethanechol acts on muscarinic receptors of the eye by causing both...

miosis and accommodation (near-sighted)

Alpha 1 adrenergic receptor activation causes nasal decongestion by...

mucosal vasoconstriction.

Nicotinic Muscular (M) acetylcholine receptors are located at...

neuromuscular junctions.

Alpha 2 adrenergic receptors are located on prejunctional terminals where it inhibits the release of...

norepinephrine (noradrenaline)

Catecholamines CANNOT be given...

orally (Noncatecholamines can)

Activation of Alpha 2 adrenergic receptors in the CNS causes relief of...

pain.

Three types of patients to avoid giving Oxybutynin to are...

patients with glaucoma (effects visual acuity/ accommodation), patients with GI or GU obstruction (decreases urination and bowel movement), & patients with urinary retention.

Muscarinic acetylcholine receptors are clinically important because they act as the main end-receptor stimulated by acetylcholine released from...

postganglionic fibers in the Parasympathetic Nervous System

Cholinesterase inhibitors indirectly...

prevent the breakdown of acetylcholine.

The five therapeutic uses for the Muscarinic Antagonist Atropine (from the Atropa Belladonna plant; -ine meaning pertaining to) are...

prevent/ treat bradycardia, decrease GI motility, decrease secretions, dilate pupils, & reverse muscarinic poisoning (from mushrooms).

The effect of Nicotinic N Acetylcholine receptor activation is...

promotion of ganglionic transmission.

A nursing implication for the administration of Propranolol (beta blocker) is to assess for history of severe allergic reactions, since...

propranolol blocks the beneficial effects of epinephrine

The first form of a drug or medication that is used to create alternative forms is known as a...

prototype drug.

When administering Atropine, teach patient to wear sunglasses because...

pupils will not constrict with sunlight (decreased constriction)

The blockade of alpha1 adrenergic receptors on the veins causes the venous wall to have...

reduced muscle tone.

The most significant adverse effect associated with alpha2 blockade is potentiation of the...

reflex tachycardia

Bethanechol acts on muscarinic receptors of vascular smooth muscles by causing...

relaxation (vasodilation)

With the exception of one, all Adrenergic Antagonists (Blockers) all produce...

reversible (competitive) blockade

Muscarinic receptor activation causes increased glandular...

secretions.

The effect of Nicotinic M acetylcholine receptor activation is...

skeletal muscle contraction.

Bethanechol acts on muscarinic receptors of the heart by...

slowing heart rate

When administering Atropine, monitor for Xerostomia (dry mouth; xero=dry, -stomia=mouth) as it may impact...

swallowing

The THREE places muscarinic acetylcholine receptors are located are...

sweat glands, blood vessels, & all organs regulated by the parasympathetic nervous system

When administering Atropine monitor heart rate on do not administer with...

tachycardia being present

The three primary targets of Cholinergic drugs are...

the GI tract, the Bladder, & the Eyes

The two occasional targets of cholinergic drugs are...

the Heart and Lungs

Most adrenergic antagonists are MORE SELECTIVE than...

the adrenergic agonists

Muscarinic receptor activation causes smooth muscle CONTRACTION in both...

the bronchi, & the GI tract,

Tremors are very common with Beta 2 adrenergic agonist administration due to...

the presence of Beta 2 adrenergic receptors on skeletal muscles.

The Sodium retention caused by administration of Alpha1 blockers is due to...

the response in decrease in BP

The two therapeutic uses for Prazosin (Alpha1-Adrenergic Antagonist) are...

treatment of Essential Hypertension, & Benign Prostatic Hyperplasia (BPH)

The three primary therapeutic applications for Alpha-adrenergic antagonists are...

treatment of Essential Hypertension, reversal of alpha 1 agonist toxicity, & treatment of benign prostatic hyperplasia.

Because of its effects on the GI and Urinary tract, when administering Atropine monitor for both...

urinary retention & constipation.

The three major symptoms of URGE incontinence (overactive bladder) are...

urinary urgency (sudden compelling urge to urinate), urinary frequency, & nocturia (waking up to urinate)

Alpha 1 adrenergic receptor activation causes elevation of BP by...

vasoconstriction

Alpha 1 adrenergic receptor activation causes HEMOSTASIS by arresting bleeding via...

vasoconstriction.

Activation of Peripheral Dopamine receptors causes...

vasodilation of renal blood vessels