Pharm review

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Pharm review
2011-12-07 00:37:30
Pharm review 13 butterbug10

Pharm review
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  1. CNS
    brain and spinal cord
  2. PNS
    somatic and autonomic nervous system
  3. What are the two parts of the autonomic nervous system
    sympathetic and parasympathetic
  4. sympathetic is?
    1. fight or flight
    2. rest and digest
    fight or flight
  5. parasympathetic is?
    1. fight or flight
    2. rest and digest
    rest and digest
  6. sympathomimetric drugs
    • (adrenergics)
    • sitmulate the sympathetic nervous system
  7. adrenergic antagonists or blockers
    inhibit sympathetic nervous system
  8. parasympathomimetic drugs
    • (cholinergics)
    • stimulate the parasympathetic nervous system
  9. anticholinergics or cholinergic blockers
    inhibit parasympathitic nervous system
  10. MOA: adrenergic drugs (sympathomimetric)
    work like naturally produced neurotransmitters: epinephrine and norepinephrine
  11. Actions: adrenergic drugs (sympathomimetrics)
    • relax smooth muscle of bronchi
    • constrict blood vessels
    • decrease gastric motility
    • increase HR
    • increase glucose use
  12. Uses: adrenergic drugs (sympathomimetric)
    • hypotension
    • control of superficial bleeding
    • asthma
    • cardiac arrest
    • anaphylactic shock
    • heart block
    • arrhythmias
    • nasal congestion
  13. Adverse reactions: adrenergic drugs (sympathomimetric)
    • carediac arrhythmias
    • h/a
    • insomnia
    • nervousness
    • anorexia
    • increased BP
  14. Class? dopamine (Inotropin)
    adrenergic drug
  15. What should I know about giving dopamine (Inotropin) IV?
    • must be used for precise infusion
    • dedicated line: do not mix with other drugs
    • titrade rate of flow based on B/P
  16. What vital sign should be monitored every 15 min when administering dopamine (Inotropin)?
  17. What should I know about elderly clients and adrenergic drugs?
    They are especially susceptable to cardiac arrhythmias
  18. nursing interventions for anorexia
    • know food preferences
    • several small meals better tolerated
    • avoid spicy, caffeinated and gas-forming foods
    • provide good oral care
    • provide pleasant environment for meals
  19. nursing interventions for insomnia
    • avoid caffeinated products
    • back rub
    • warm milk
    • hs snack
    • may need sleeping aid
    • avoid interruptions & bright lights when rendering care during the night
  20. What are the four groups of adrenergic blockers?
    • 1. alpha adrenergic blockers
    • 2. beta adrenergic blockers
    • 3. antiadrenergics
    • 4. alph/beta adrenergic blockers
  21. uses: alpha adrenergic blockers
    • peripheral vasodilators
    • adrenal gland tumor
  22. phentolamine (Regitine) is what kind of adrenergic blocker?
  23. Adverse reactions: alpha adrenergic blockers
    • cardiac arrhythmias
    • hypotension
    • tachycardia
  24. MOA: beta adrenergic blockers
    block beta receptors of the heart, decreasing HR & B/P
  25. Uses: beta adrenergic blockers
    • hypertension
    • arrhythmias
    • migraines
    • glaucoma
  26. atenolol (Tenormin) or timolol (Timoptic) are examples of what kind of adrenergic blocker?
  27. adverse reactions: beta adrenergic blockers
    • bradycardia
    • hyperglycemia
    • heart failure
  28. contraindications: beta adrenergic blocker
    other cardiac depressants (ex: digoxin)
  29. What vitals should be monitored when administering beta adrenergic blockers?
    • B/P while standing, sitting, and lying down
    • apical HR before administration
    • monitor for orthostatic hypotension
  30. MOA: antiadrenergic drugs
    • decrease activity of the sympathetic nervous system
    • may be central or peripherally acting
  31. uses: antiadrenergic drugs
    hypertension and cardiac arrhythmias
  32. cental acting clonidine (Catapress) is an example of which adrenergic blocker?
  33. Adverse reactions: antiadrenergic drugs
    • dry mouth
    • drowsiness
    • anorexia
  34. MOA: alpha/beta adrenergic blockers
    • block receptors of alpha and beta receptors
    • result in peripheral vasodilation
  35. uses: alpha/beta adrenergic blockers
  36. labetolol (Normodyne) is what kind of adrenergic blocker
  37. adverse reaction: alpha/beta adrenergic blockers
    • fatigue
    • h/a
  38. MOA: cholinergics
    • mimic parasympathetic system: like acetylcholine and acetylcholinestrerase
    • conserves energy, slows HR, digestion, and elimination
  39. uses: cholinergics
    • glaucoma
    • myasthenia gravis
    • urinary retention
  40. pilocarpine (Isoptocarpine) is a cholinergic used for what?
  41. pyridostigmine (Mestinon) is a cholinergic used for what?
    myasthenia gravis
  42. bethanocol (Urecholine) is a cholinergic used for what?
    urinary retention
  43. adverse effects: cholinergics
    • nausea,
    • diarrhea
    • abdominal cramping
    • salivation
    • flushing of skin
    • cardiac arrhythmias
    • muscle weakness
  44. what is the antidote for cholinergics?
  45. nursing intervention for glaucoma pts recieving cholinergics
    • assist pts to carry out ADLs
    • instill drops in lower conjuctival sac
    • do not touch tip of dropper
    • monitor for fall risk
  46. nursing interventions for myasthenia gravis pts recieving cholinergics
    • complete neuro assessment
    • monitor for overdose/underdose
    • encourage medical alert tag
  47. What might be signs of an overdose for a myasthenia gravis pt recieving cholinergics?
    • rigidity
    • smasms
    • salication
    • clenching of jaw
  48. what might be signs of underdose of myasthenia gravis pt recieving cholinergics?
    • fatigability of muscles
    • drooping eyelids
    • difficulty breathing
  49. what should be closely monitored for any pt on cholinergics?
    • intake and output
    • risk for urinary retention
  50. MOA: cholinergic blockers
    • vlock the action of acetylcholine
    • affects eyes, lungs, heart, GI tract, bladder
  51. affect of cholinergic blockers:
    • CNS: dowsiness, dreamless sleep
    • eye: dilation of pupil, inability to accomodate
    • lungs: dry secretions, bronchodilation
    • heart: increased HR
    • GI: decrease gastric motility
    • bladder: contact detrusor muscle
  52. uses: cholinergic blockers
    • pylorospasm
    • peptic ulcer
    • ureteral colic
    • vagal-induced bradycardia
    • parkinsonism
    • reduce secretion pre-op
  53. adverse reactions: cholinergic blockers
    • dry mouth
    • blurred vision
    • photophobia
    • constipation
    • drowsiness
    • dysuria
    • palpitations
  54. contraindications: cholinergic blockers
    • elderly
    • glaucoma
    • BPH
  55. what should be kept in mind when administering cholinergic blockers in the summer
    monitor for heat prostration (fever, tachycardia, flushing, warm, dry skin, confusion
  56. nursing intervention for pt with heart block taking cholinergic blockers
    • place pt on heart monitor
    • monitor for change in HR or rhythm
  57. nursing interventions for pt pre-op recieving cholinergic blockers
    • have pt void before giving
    • warn of dry mouth and NPO status
    • side rails up for safety
    • administer on time
    • >60 b/o side effects
  58. nursing intervention for managing altered mucous membranes for pts recieving cholinergic blockers
    • good oral care
    • sips of water
    • hard candy
  59. nusing interventions for managing risk of injury
    • assist with abulation
    • make sure room is free form obstacles
  60. nursing intervention for managing constipation
    • encoiurage fluis
    • added fiber
    • exercise
    • stool softener