Card Set Information
bronchodilators and drug interactions
What are the two types of nervous systems?
Central nervous system
Peripheral nervous system
What is int he central nervous system?
What is in the peripheral nervous system?
Afferent nerons (to the brain)
Efferent neurons (away from the brain)
Autonomic nervous system (parasympathetic branch and sympathetic branch)
What are the two divisions of the autonomic nervous system?
What are afferent neurons?
To the brain
What are efferent neurons?
away from the brain
What is the purpose of the autonomic nervous system?
To regulate involuntary vital functions
How does the sympathetic nervous system effect the body?
Fight or flight
accelerates heart rate
constricts blood vessels
relaxes bronchial smooth muscle
How does the parasympathetic nervous system effect the body?
Feed or breed
slows heart rate
increases intestinal peristalsis
increases gladn activity
What is norepinephrin?
It is a neurotransmitter for sympathetic system.
It stimulates beta 1, beta 2 and alpha receptors.
What is a Beta 1 receptor?
Located in cardiac muscle
Increases heart rate and ventricular contractility
What is a Beta 2 receptor?
Located in bronchial smooth muscle
Relaxes smooth muscle in the airway
What is an Alpha receptor?
Located in arteriole walls
What is Acetylcholine?
It is a neurotransmitter for the parasympathic system
Stimulates cholinergic receptors
What is a cholinergic receptor?
Located in heart, airway walls, various other places
When stimulated, decreases heart rate and causes bronchoconstriction
What is sympathomimetic drug?
Chemical that causes stimulation of the sympathetic nervous system
Also called Adrenergic agonist
What is Sympatholytic drug?
Chemical that blocks a sympathic response
Also called a beta blocker
What is a cholinergic drug?
Chemical that causes stimulation of the parasympathetic response
What is an anticholinergic drug?
Chemical that blocks a parasympathetic response
Also called parasympatholytic
What are effects of anticholinergic drugs?
Drying of secreations
Treatment of bradycardia
What are some examples of anticholinergic or parasympatholytic drugs?
Atrovent (ipratropium bromide)
Spiriva (tiotrpium bronide)
What are effects of sympathomimetic drugs?
Increase cardiac contractility
Increase heart rate
What are some examples of sympathomimetic or adrenergic agonist drugs?
What are indications of sympathomimetic bronchodilators?
Relieve bronchoconstriciton of obstructive airway disease where it has been shown to improve airflow
What is mode of action of sympathomimetic bronchodilators?
Stimulate beta 2 receptors
cause relaxation of smooth muscles in airway wall
can improve mucociliary clearance
Powerful alpha and beta effects
Nebulized, IV drip, IM or ETT
Powerful cardiac effect
Drug choice for cardiac arrest
: 1% solution 0.25 mL - 0.5 mL qid
: 0.22 mg/puff prn
: Proventil, Ventolin, ProAir
Beta 2 preferential
Little cardiac effect
Nebulizer, MDI, PO
Effects up to 6hrs
: 90 mcg/puff, 2 puffs tid, qid or as needed
: 0.5% solution, 2.5mg tid, qid or as needed
: Maxair Autohaler
Beta 2 preferential, little beta 1 effect
Effects last about 5hrs
: 200 mcg/puff
2 puffs q4-6
Beta 2 selective, no beta 1
Effects last 5-8 hrs
: 45 mcg/puff, 2 puffs q4-6 hr or as needed
: 0.31mg, 0.63 mg, 1.25 mg dose tid or as needed
Effects last up to 12hrs
Beta 2 preferential, little beta 1 effects
: Foradil, Preformist
Effects last about 12hrs
Effects last about 12hrs
Selective beta 2, little beta 1 effects
Effects last about 2hrs
Alpha and beta effects
long acting beta 2 adrenergic agonist bronchodilator
FDA approved for COPD
used as DPI
What are some side effects of sympathomimetics?
What do anticholinergic drugs do?
Block parasympathetic action and dilates the airways
Also called parasympatholytic
Anticholinergic drug indications
relieve bronchoconstriciton associated with COPD
What are some examples of anticholinergic or parasymaptholytic drugs?
Ipratropium bromide (Atrovent)
Tiotropium bromide (Spiriva)
Powerful bronchodilator in COPD
Effects last 4-6 hrs
Effects last about 24hrs
: Tudorza Pressair
Long acting anticholinergic bronchodilator
no longer used
What are side effects to anticholinergic drugs?
Dry mouth and upper airway
Inhibition of tear formation
Worsening of glaucoma
What are combination drugs?
Combivent (albuterol sulfate and ipratropium bromide)
Duoneb (albuterol sulfate and ipratropium bromide)
What falls under drug information?
Indications and usage
Dosage and administration
Method by which the drug is made avalibe to the body
What are routes of administration?
Transdermal-absorbed through the skin
Topical-n the skin or mucous membranes
Outline the movement of the drug through the body
What is the difference between loading dose and subsequent dose?
Loading dose is the initial dose to create desired level of concentration
Subsequent dose maintain concentration
What is the first-pass effect?
orally delivered drug enter bloodstream from stomach, follows portal vein directly to liver where metabolism takes place
tire required to decrease amount of drug in the body by one half, through elimination
Subsequent dosing equal to the rate of elimination to maintain a steady level of drug in the body
Relationship between a drug's chemical structure and its clinical effect
Proteins whos shape or electrical charge match a drug's chemical shape or charge
Blood concentration range, within which a drug has a therpeutic effect
Concentrations above this range can be toxic
A drug that binds to a corresponding receptor and produces a clinical effect
Drug that can bind to a corresponding receptor, but produces no clinical effect
Blocks the agonist
One drug has no effect but increases the effect of another drug
Two drugs hae the same effect, but by different mechanisms or actions
Two drugs both act on the same receptors and their combined effect is additive
What must every drug order include?