Cholinergics and Adrenergics

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Cholinergics and Adrenergics
2010-03-17 22:13:51

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  1. Adrenergics
    stimulates the sympathetic nervous system (sympathomimetics)
  2. Adrenergic Blockers
    block the sympathetic nervous system (sympatholytic)
  3. Cholinergics
    stimulate the parasympathetic nervous system (parasympathomimetics)
  4. Anticholinergics
    block the parasympathetic nervous system (parasympatholytic)
  5. Sympathetic Neurotransmitter
  6. Sympathetic Receptors
    Alpha1, Alpha2, Beta1, Beta2
  7. Parasympathetic Neurotransmitter
  8. Parasympathetic Receptors
    Nicotinic or muscarinic receptors
  9. Sympathetic Receptor Sites
    heart, bronchiole walls, GI tract, urinary bladder, ciliary muscle of the eye
  10. Non-selective
    excites all receptors approximately equally - more side effect
  11. Selective Drugs
    excites specific receptor sites (fewer side effects)
  12. Direct Acting Adrenergic
    stimulates adrenergic receptors
  13. Indirect-Acting Adrenergic Drugs
    stimulate release of norepinephrine at nerve endings
  14. Uses of epinephrine
    treat allergic reations, anaphylaxis, bronchospasm, cardiac arrest, orthostatic hypotenstion
  15. Contraindications of epinephrine
    • cardiac dysrhythmias
    • glaucoma (can exacerbate IOP)
    • prolonged used: drug resistance
  16. Side and Adverse effects of epinephrine
    • Side:
    • -anorexia
    • -nausea/vomiting
    • -tremors
    • -insomnia
    • -pallor

    • Adverse:
    • -cardiac dysrhythmias
    • -palpitations
    • -tachycardia
    • -dyspnea
  17. Routes of Administration for Epinephrine
    • IV
    • Injection
    • Nebulizer
    • Instilled (w/ saline)
  18. Nursing Assessments and Teachings for Epinephrine
    • Urine output (retention)
    • Check blood glucose (can increase)
    • Take w/ food (but very rarely PO)
    • No cold/diet pills (can be potentiating)
    • Use of nasal sprays - for inflamed/congested nasal tissue
  19. Uses of Albuterol
    bronchospasm, asthma, bronchitis, COPD
  20. Contraindications for Albuterol
    cardiac disease, hypertension, hyperthyroidism
  21. Side/Adverse Effects of Albuterol
    Side: tremor, dizziness, nervousness, restlessness

    Adverse: palpitations, reflex tachycardia, dysrhythmias
  22. Albuterol is:
  23. Non-Selective Beta Adrenergic Blockers
    • Proprenolol
    • More side-effects - NEVER for COPD/asthma
    • (Beta1 and Beta2)
  24. Selective Beta Adrenergic Blockers
    Atenolol (Beta2)
  25. Uses of Atenolol
    treat angina, cardiac dysrhythmias, hypertension, heart failure
  26. Contraindications for Atenolol
    bradycardia, heart block, overt heart failure
  27. Side/Adverse Effects of Atenolol
    Side: bradycardia, dizziness, fainting, impotence

    Adverse: significant bradycardia, dysrhythmias, masking of hypoglycemia
  28. Nursing Implications of Beta Adrenergic Blockers
    • Vital Signs
    • Assess respirations/bronchospasm (selective vs nonselective)
    • Must tapper (possible rebound tachycardia)
    • Hypoglycemia (may need to decrease insulin dose)
    • Orthostatic hypotension
    • Impotence/Decreased libido