NCM 106 Week 7 Reviewer
NCM 106 Week 7 Reviewer
NCM 106 Week 7 Reviewer
2 types of Neurons:
1. Afferent (senses, entry point of
information interpretation)
2. Efferent (enacts, the motor which
transmits info from CNS to effector
organ cells)
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Cardio: arrhythmias,
hypertension, palpitations,
Alpha-Specific Adrenergic Agonists
angina, and dyspnea
w/ Indications:
GI: nausea, vomiting, and
constipation 1. Phenylephrine (Neo-
Synephrine)
Drug-to-Drug Interactions:
Treatment of cold/allergies
Increases effects of MAOIs and Shock, glaucoma, allergic
tricyclic antidepressants rhinitis, otitis media medication
Increased risk of hypertension Potent vasoconstrictor with
when given w/ medication that little or no effect on the heart or
increases BP bronchi
Will lose effectiveness when 2. Clonidine (Catapres)
paired with Adrenergic Treatment of essential
Antagonists hypertension, chronic pain
3. Midodrine (ProAmantine)
Treatment of orthostatic
Nursing Responsibilities: hypotension
Accurate dosage
Dilute before use Contraindications and Cautions:
– tissue irritation
➢ Phentolamine Allergy
– for extravasation/soln infused Sever hypertension
leaks out of veins into surrounding Tachycardia
tissue Narrow-angle Glaucoma
Standby: 10 mL NSS + 5-10 mg (exacerbated by arterial
Phentolamine constriction)
Cardiovascular disease
Vasomotor Spasm
Alpha-Specific Adrenergic Agonists Cautioned in Lactation
Renal or hepatic impairment
drugs that bind primarily to alpha-
receptors rather than to beta-
receptors.
Adverse Effects
Prototype: Phenylephrine (Neo-
Synephrine) CNS: anxiety, restlessness,
depression, fatigue, strange
dreams, and personality changes
Blurred vision and sensitivity to
light
Cardio: arrhythmias, ECG
changes, blood pressure
changes, and peripheral vascular
problems
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3. Biltolterol (Tornalate)
Treatment of bronchial Asthma
4. Isoetharine (generic)
Drug-to-Drug Interactions: Treatment of bronchial asthma
5. Levalbuterol (Xopenex)
Phenylephrine + MAOIs should be Treatment of bronchial asthma
avoided due to its effects of sever in patients >4yrs
hypertension, headache, and 6. Metaproterenol (Alupent)
hyperpyrexia treatment of bronchial asthma
Phenylephrine + TCAs increase and acute asthma attacks in
sympathomimetic effects children >6yrs
Clonidine + TCAs decrease 7. Pirbuterol (Maxair Autohaler)
antihypertensive effect Treatment of bronchial asthma
Clonidine + Propanolol = and reversible bronchospasm
paradoxical hypertension 8. Salmeterol (Serevent DIskus)
Treatment of bronchial asthma
and reversible bronchospasm
Nursing Care: 9. Terbutaline (Brethine)
Taper dosage Treatment and prevention of
When giving phenylephrine bronchial asthma and
intravenously, ensure that an reversible bronchospasm
alpha-blocking agent is readily
available to counteract the effects.
Pharmacokinetics:
• Rapidly distributed
Beta-Specific Adrenergic Agonists
• Metabolism – liver
drugs that bind primarily to beta-
receptors rather than to alpha- • Excretion – urine
receptors • Relatively short half-life
Manage and treat bronchial spasm,
asthma and other COPD less than 1 hour
Prototype: Isoproterenol (Isuprel)
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• Diabetes
•Bronchospasm
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Nonselective Alpha-Adrenergic
Blocking Agents
Contraindications and Cautions:
Are:
• Allergy
adrenergic blocking agents that
• Coronary Artery Disease (CAD)
have a specific affinity for alpha-
receptor sites • Myocardial Infarction (MI)
use is somewhat limited because
of the development of even more • Pregnancy
specific and safer drugs • Lactation
Prototype: Phentolamine
(Regitine)
Adverse Effects:
• Excretion – urine
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Nursing Care:
Contraindications and Cautions
Taper dosage
Allergy to any component of the Monitor patient response to drug
drug
Heart failure, heart blocks, or
shock
Bronchospasm
COPD
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Pharmacokinetics:
- Bioavailability is increase with
food intake
- Metabolized in liver
- Excreted through urine
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Adverse effects
Dry mouth
Altered taste perception
Nausea
Heartburn
Constipation
Bloated feeling
Tachycardia
Palpitations
Urinary hesitancy and retention
Decreased sweating
Suppression of lactation
Drug-Drug Interactions
+antihistamines,antiparkinsonism
, MAOi, TCA = increase
anticholinergic effects
+phenothiazines = decrease
effect of phenothiazines
Nursing Care
Allow for adequate hydration and
temperature control
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