Ch. 18 & 19

Question 1

Autonomic Nervous System:

Answer 1

1. ) Sympathetic (Adrenergic)

2. ) Parasympathetic (Cholinergic)

Question 2

Sympathetic & Parasympathetic Systems:

Answer 2

1. ) Act on organs but produce opposite responses
2. ) Drugs act by either:
   - stimulating response
   - depress response

Question 3

Neurotransmitters:

Answer 3

Chemical substance:

-carries impulses from one neuron to another

Question 4

Sympathetic NS:

Answer 4

Norepinephrine:

- Transmits impulses between postganglionic neuron & tissue receptor

Question 5

Parasympathetic NS:

Answer 5

Acetylcholine:

-Transmits impulses between preganglionic & postganglionic neurons

Question 6

Sympathetic NS (Adrenergic Branch):

Answer 6

1. ) “Fight or flight” system
2. ) Physical/Emotional stress
   
   • ANS suppresses non vital body functions

Question 7

Promotes Self-Preservation:

Answer 7

1. ) Pupils
2. ) Bronchioles dilate
3. ) Increase in rate & force of heart concentration
4. ) Shunt blood to major organs
5. ) Breakdown of glycogen to glucose

Question 8

Drugs that Affect the Autonomic NS:

Answer 8

1. ) Sympathomimetic (adrenergic)
   - Sympatholytic (adrenergic blocking)
2. ) Parasympathomimetic (cholinergic)
   - Parasympatholytic (anticholinergic)

Question 9

Adrenergics & Adrenergic Blockers:

Answer 9

Alpha & Beta receptors found in Sympathetic NS

Question 10

Alpha 1 Receptors:

Answer 10

1. ) Smooth muscle tissue of peripheral blood vessels
2. ) Sphincter of GU tracts, prostate & bladder
   
   • causes vasoconstriction
   • control release of norepinephrine

Question 11

Beta 1 Receptors (1):

Answer 11

Muscles of heart

-Kidneys

Question 12

Beta 1 Receptors (2):

Answer 12

Stimulation:

1. ) Increased heart rate
2. ) More forceful heart muscle contraction

Question 13

Beta 2 Receptors (1):

Answer 13

1. ) Bronchial smooth muscles

2. ) Walls of blood vessels, smooth muscle of the GI, Lungs, Uterus

Question 14

Beta 2 Receptors (2):

Answer 14

• Stimulation
• Bronchial muscle relaxation
  
  • Improved gas exchange
  • Tx: bronchial asthma

Question 15

3 Classifications of Sympathomimetics (1):

Answer 15

1.) Direct-acting:
-Directly stimulate the adrenergic receptor
———————————————————-
Ex: epinephrine & norepinephrine

Question 16

3 Classifications of Sympathomimetics (2):

Answer 16

2.) Indirect-acting:
-Stimulate release of norepinephrine from terminal nerve endings
——————————————————————
Ex: Amphetamine

Question 17

3 Classifications of Sympathomimetics (3):

Answer 17

3.) Mixed-acting:
(a): Stimulate adrenergic receptor sites
(b): Stimulate release of norepinephrine from terminal nerve endings
——————————————————–
Ex: pseudoephedrine

Question 18

Nonselective Sympathomimetics:

Answer 18

1. ) Excite all receptors equally

2. ) More side effects occur

Question 19

Nonselective Sympathomimetics - Ex: epinephrine(1):

Answer 19

1. ) Good for emergency situations

2. ) Increased BP, heart rate, & airflow through lungs

Question 20

Nonselective Sympathomimetics - Ex: epinephrine(2):

Answer 20

SE:
-Anorexia, N/V, nervousness, tremors, HA, insomnia, syncope, dizziness
——————————————————————-
Adverse Reactions:
-Palpitations, tachycardia, dsypnea, ventricular fibrillation

Question 21

Selective Sympathomimetics:

Answer 21

1. ) Acts on specific receptors

2. ) Less side effects because more specific

Question 22

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (1):

Answer 22

1. ) Selective for beta 2-adrenergic receptors

2. ) Acts on bronchi for bronchodilation

Question 23

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (2):

Answer 23

Asthmatic –> better to take
-albuterol (acts on beta 2) –> fewer undesired effects
——————————————————
High doses (may affect beta 1 receptors) –> cardiac SE

Question 24

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (3):

Answer 24

Used to prevent/tx bronchospasms

— inhalation, po

Question 25

Ex: albuterol sulfate (Proventil):

Answer 25

SE: -Tremors, dizziness, nervousness, restless ------------------------------------------------------------ Adverse Reactions: -Palpitations, tachycardia, cardiac dysrhythmias

Question 26

Adrenergic Blockers (Sympatholytics, Adrenergic Antagonists):

Answer 26

1. ) Block effects of adrenergic neurotransmitters 2. ) Antagonists to adrenergic agonists (sympathomimetics) - blocking either alpha- or beta- receptor sites

Question 27

Alpha - Adrenergic Blockers:

Answer 27

1.) Selective or Nonselective 2.) Cause vasodilation ---> decreased -BP (dizziness) --> pulse rate increases to compensate (good for PVD) ------------------------------------------------------ Tx: peripheral vascular disease

Question 28

Beta-Adrenergic Blockers (beta blockers) (1):

Answer 28

Decrease heart rate ---> decrease blood pressure | -Selective or Nonselective

Question 29

Beta-Adrenergic Blockers (beta blockers) (2):

Answer 29

Nonseletive ---> use w/ extreme caution in client with COPD or asthma -------------------------------------------------------- causes bronchoconstriction -Ex: propranolol (inderal)

Question 30

Beta-Adrenergic Blockers (beta blockers:

Answer 30

metoprolol tartrate (Lopressor) - Good for resp pts ----------------------------------------------- drug is more selective beta-1 blocker

Question 31

Main Uses for Cholinergic Drugs:

Answer 31

1. ) Stimulate bladder and GI tone 2. ) Constrict pupils 3. ) Increase neuromuscular transmission

Question 32

Anticholinergics (parasympatholytic) (1):

Answer 32

Inhibit action or acetylcholine

Question 33

Anticholinergics (parasympatholytic) (2):

Answer 33

Main body tissues/organs affected: 1. ) Heart 2. ) Respiratory Tract 3. ) GI Tract 4. ) Urinary Bladder 5. ) Eyes 6. ) Exocrine Glands

Question 34

Anticholinergic Drugs:

Answer 34

May cause problems: - Bronchial asthma - Benign prostatic hypertrophy (BPH)

Question 35

Anticholinergic Drugs - Ex: Atropine sulfate:

Answer 35

Derived from: | -Atropa Belladonna plant

Question 36

Atropine sulfate (1):

Answer 36

Reduces: 1. ) Motility of GI tract 2. ) Secretions of saliva 3. ) Bronchial secretions - Sweat

Question 37

Atropine sulfate (2):

Answer 37

1. ) Dilates pupils 2. ) Interferes with ability of eye to focus 3. ) **Contraindicated in clients w/ narrow angle glaucoma 4. ) May increase pressure within the eye

Question 38

Atropine sulfate (3):

Answer 38

Promotes retention of urine by the bladder | **Not for men with BPH**

Question 39

Major SE: Anticholinergics (1):

Answer 39

1. ) Dry mouth 2. ) Constipation 3. ) Urinary Tension 4. ) Blurred Vision 5. ) Photophobia 6. ) Headache

Question 40

Major SE: Anticholinergics (2):

Answer 40

1. ) Can't see 2. ) Can't spit 3. ) Can't pee 4. ) Can't shit

Question 41

Synthetic Anticholinergics:

Answer 41

Less likely to affect pupils compared to natural derivatives | Ex: glycopyrrolate (Robinul)

Question 42

Nursing Interventions (anticholinergics) (1):

Answer 42

DO NOT give to clients with: 1. ) Narrow angle glaucoma 2. ) BPH 3. ) Geriatric clients

Question 43

Nursing Interventions (anticholinergics) (2):

Answer 43

Call physician if: 1. ) Blurred visions 2. ) headaches 3. ) Urinary retention 4. ) Palpitations

Question 44

Nursing Interventions (anticholinergics):

Answer 44

1. ) Monitor bowel sounds 2. ) Encourage adequate fluid intake 3. ) Help relieve dry mouth: - Mouth Care - Hard Candy