N220 Pharmacology Exam 3 Study Guide 2023.

N220 Pharmacology Exam 3 Study Guide 2023. 1) Know the difference between a beta and alpha adrenergic drugs. ● Alpha Adrenergic Drugs ○ Predominant response is vasoconstriction and CNS stimulation ○ Alpha 1 ■ Receptors located on the postsynaptic effector cells ■ The tissue, muscle, or organ that the nerve stimulates ○ Alpha 2 ■ Receptors located on the presynaptic nerve terminals ■ Control the release of neurotransmitters ● Beta Adrenergic Drugs ○ Response is bronchial, gastrointestinal, uterine smooth muscle relaxation ○ Glycogenolysis ○ Cardiac Stimulation ○ Beta 1 ■ Heart ○ Beta 2 ■ Smooth muscle fibers of bronchioles, arterioles, visceral organs 2) Know about epinephrine. ● Lab Work (Route, Onset of Action, Peak Plasma Concentration, Elimination Half-life, Duration of Action) ○ Subcut, 5-10 minutes, 20 minutes, variable, unknown ○ IV, less than 2 min, Rapid, Less than 5 min, 5-30 min ● Acts directly on both the alpha and beta adrenergic receptors of tissues innervated by the SNS ● Considered prototypical non selective adrenergic agonist ● Used in emergency situations and is one of the primary vasoactive drugs used in many advanced cardiac life support protocols ● Low doses ○ stimulates mostly beta 1 adrenergic receptors, increasing the force of contraction and heart rate. ○ Used to treat acute asthma and anaphylactic shock because of significant bronchodilatory effects (Beta 2 in lungs) ● High Doses(IV Drip) ○ stimulated mostly alpha receptors causing vasoconstriction which elevates blood pressure ● For IV two strengths ○ 1:1000 (1mg/ml) ○ 1:10000 (.1mg/ml)f= 3) Know the effects of beta 1 and 2 and alpha 1 drugs. ● Beta 1 ○ Heart ○ Cardiac Stimulation ● Beta 2 ○ Bronchodilation ● Alpha Drugs ○ Vasoconstriction of blood vessels 4) Be able to recognize beta blocker drugs and know the nursing considerations. ● List of Beta Blockers ○ Carvedilol-Coreg, Coreg CR ○ Labetalol-Normodyne, Trandate ○ Nadolol-Corgard ○ Penbutolol-Levatol ○ Pindolol-Visken ○ Propranolol-Inderal ○ Sotalol-Betapace ○ Timolol-Blocadren, Timoptic ● Nursing Considerations(Indications) ○ Angina(Chest pain) ○ MI(Myocardial Infarction-heart attack) ○ Cardiac Dysrythmias(irregular heart rhythms) ○ Hypertension(high blood pressure) ○ Heart Failure(heart does not pump as well as it should) 5) Know about the client teaching for alpha and beta agonist and antagonist. ● Agonists (Adrenergic Drugs) ○ Medications are to be used only as prescribed with regard to amount, timing and spacing of doses ○ Advise patient to immediately report any complaints of chest pain, palpitations, headaches, or seizures ○ Lung disease patients need to avoid anything that may exacerbate their respiratory system. Example: Smoking ○ Salmeterol ■ Not to be used for relief of acute symptoms ■ 1 puff twice daily 12 hours apart ■ recheck orders and directions ○ If another type of inhaler is used (Such as corticosteroids) ■ Use bronchodilator first with a 5 minute waiting period prior to taking the second drug ○ Ophthalmic forms ■ Expiration Date ■ Clear Solution ■ Do not allow eyedropper to touch eye ■ conjunctival sac not onto the cornea ○ Oral midodrine ■ As prescribed ■ Usually ordered to be given with forcing fluids before the patient gets out of bed in the morning. ■ In the morning because that is when patients with orthostatic intolerance are usually more symptomatic. ■ Avoid taking this med after 6 pm if possible to prevent insomnia and possible supine hypertension ● Antagonists ○ Avoid caffeine ○ medical alert bracelet or necklace identifying the specific medical diagnoses provide list of all medication ○ Encourage intake of water to minimize dry mouth ○ Alpha Blockers ■ Change positions slowly to prevent postural hypotension or syncope ○ Tamsulosin ■ Caution with elderly and while driving ■ Benign prostatic hyperplasia BPH ■ inform all health care providers including dentist ■ Especially before surgery ○ Things to avoid to avoid vasodilation ■ Alcohol ■ excessive exercise ■ exposure to hot climates ■ saunas, hot tubs, heated showers or baths ○ Contact prescriber if patient has ■ Dizziness ■ Fainting ■ Lightheadedness ■ systolic blood pressure is lower than 100 mm hg ■ pulse rate lower than 60 beats per min ■ increase of 2 pounds in 24 hours 5 pounds in 1 week ○ Must be weaned off slowly could lead to rebound hypertension or chest pain 6) Know everything about bethanechol chloride.