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Nursing Pharmacology

Nursing Pharmacology. NURS200 Lansing Community College. Drugs Acting On the Autonomic Nervous System (ANS). UNIT III. Nervous System Organization. How do Drugs Affect Synaptic Transmission?. Transmitter synthesis Increase transmitter synthesis Decrease transmitter synthesis

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Nursing Pharmacology

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  1. Nursing Pharmacology NURS200 Lansing Community College

  2. Drugs Acting On the Autonomic Nervous System (ANS) UNIT III

  3. Nervous System Organization

  4. How do Drugs Affect Synaptic Transmission? Transmitter synthesis Increase transmitter synthesis Decrease transmitter synthesis Cause the synthesis of transmitter molecules Transmitter storage Cause receptor activation to decrease Transmitter release Promote or inhibit release Receptor binding Cause activation Block activation Enhance activation Termination of transmission Block transmitter reuptake Inhibit transmitter degradation

  5. Divisions of the ANS • The ANS is divided into two branches: Sympathetic • Fight or Flight: • Widespread activation Parasympathetic • Daily maintenance of the body: • Localized activation: 1 or a few structures

  6. Memorize this for Clarity! • Sympathetic Nervous System • Adrenergic • Sympathomimetic • Catecholamines • Parasympathetic Nervous System • Cholinergic • Muscarinic • Parasympathomimetic

  7. Autonomic Nervous SystemVISUAL – NO AUDIO

  8. Parasympathetic Nervous System (PNS) • Cholinergic Transmission • Acetylcholine

  9. Classifications of Parasympathetic Receptor Sites • Muscarinic Receptors • Nicotinic Receptors

  10. Activation of Parasympathetic Nervous System • Heart rate • GI tract effects • Bronchi • Bladder • Pupils

  11. Sympathetic Nervous System (SNS) • Adrenergic Transmission SNS Neurotransmitters (endogenous) • Norepinephrine • Epinephrine • dopamine

  12. Classifications of Sympathetic Receptor Sites • Alpha-receptors • Alpha1 • Alpha2 • Beta-receptors • Beta1 • Beta2 Dopamine

  13. Activation of the Sympathetic Nervous System • Blood pressure and heart rate • Respiratory rate • Bronchi • Pupils • Others

  14. Muscarinic Agonists(Cholinergic Blocking Agents: anti cholinergics, Parasympatholytics) • Bethanechol - direct • Pilocarpine - direct • Pyrostigmine - indirect Toxicology

  15. Muscarinic Antagonists Anticholinergics - Parasympatholytics Atropine - Prototype

  16. Overactive Bladder Treatment • Symptoms • Treatment • Toxicology

  17. Muscarinic Antagonists • Major Nursing Implications

  18. Adrenergic Agonists Called sympathomimetic drugs because they mimic the effects of the sympathetic nervous system (SNS)

  19. Alpha & Beta Adrenergic Agonists • Epinephrine • Norepinephrine • Dopamine • Dobutamine • Ephedrine

  20. Adrenergic AgonistsAlpha & Beta • Actions

  21. Adrenergic Agonists • Catecholamines • Noncatecholamines

  22. Alpha & Beta Agonists cont. Indications Adverse reactions

  23. Alpha & Beta Agonists cont. NURSING CONSIDERATIONS • Assessment (history and physical exam) • Consider drug effects/adverse reactions and how to care/safeguard/teach the patient for each one • Implementation • Evaluation

  24. Adrenergic Antagonists • Adrenergic Blockers • Therapeutic • Adverse Effects

  25. Adrenergic AntagonistsAlpha1-Selective Adrenergic Blocking Agents • Prototype: Prazosin (Minipress): hypertension, alone or in combination with other drugs • Doxazosin (Cardura): hypertension, benign prostatic hypertrophy (BPH) • Tamsulosin (Flomax): BPH only

  26. Adrenergic AntagonistsAlpha1 Blocking Agents • Actions • Indications • Pharmacokinetics • Adverse effects

  27. Beta-Adrenergic Blocking AgentsBeta Blockade • Indications • Adverse reactions

  28. Beta Adrenergic Blocking Agents • Propranolol (inderal) • Non selective

  29. Beta1 selective adrenergic blocking agents • Metoprolol - selective • Atenolol (tenormin)

  30. Beta Blocking Agents cont. NURSING CONSIDERATIONS • Assessment (history and physical exam) • Consider drug effects/adverse reactions and how to care/safeguard/teach the patient for each one • Implementation • Evaluation

  31. Indirect-Acting Antiadrenergic Agents • Prototype: Reserpine • Action: depletes NE from sympathetic neurons • Non-Specific • Indication: Hypertention • Adverse Effect: Depression

  32. Indirect-Acting Antiadrenergic Agents Prototype: Clonidine (Catapres) Alpha2-Adrenergic Agonists Stimulates alpha2 receptors in CNS Results in DECREASED release of catecholamines Indications Hypertension Adverse Effects Drowsiness (CNS depression) Rebound hypertension Xerostomia

  33. Section Ends

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