Final Exam

Adrenergic Agents• Adrenergic nervous system stimulated by 2 classes of

drugs:– Catecholamines – Noncatecholamines

• Neurotransmitter catecholamines– Norepinephrine—secreted at nerve terminals– Epinephrine—adrenal medulla– Dopamine—brain, kidney, GI tract

• Non-catecholamines– Selective– Not quite fast acting– Longer duration of action

Adrenergic Agents

• Assess VS—HR & BP• Adverse effects are dose related• Adverse effects resolve when dose is reduce or

discontinued• Client sensitive are:• Impaired liver function• Thyroid disease• HTN• Heart disease• DM have increase episodes of Hyperglycemia

Adrenergic Agents

• Common Adverse Effects– Palpitations– Tachycardia– Dizziness– Tremors– Orthostatic hypotension

• Serious Adverse Effects—w/cardiac d/c immediately & notify provider– Dysrhythmias– Chest pain– Severe hypotension– HTN– Angina pain– N/V—notify providers

• Interactions: MAOI, TCA, atropine & halothane, OTC meds

Cholinergic Agents• Parasympathomimic• Produce effects of acetylcholine• Other can inhibit acetyl cholinesterase (metabolize ACH)--indirect-

acting cholinergic agent• PNS can be directly stimulated by some agents• Actions:

– Slow heartbeat– Increase GI motility– Increase GI secretions– Increased contraction of urinary bladder w/relaxation of muscle sphincter– Increase contractility of bronchial smooth muscle– Sweating– Miosis of eye which decrease intaocular pressure– Increased force of contraction of skeletal muscle– Sometimes decrease blood pressure

Cholinergic Agents

• VS: HR & BP• The higher the doses the greater the likelihood for

adverse effects• CAE:• N/V/D/AC• Dizziness• Hypotension (monitor orthostatic pressures)• Bronchospasm & wheezing• Bradycardia (withhold the next dose)• Interactions: atropine, antihistamines