ANS Drugs and Drugs for Shock

cdunbar4's version from 2017-09-28 16:56

ANS drugs

Question Answer
sympathomimetics/adrenergic agonistsphenylephrine/neo-synphrine (Epi-pen, inhalers)
phenylephrine/neo-synphrine used for treatment in CV + pulmonary conditions: shock, hypoTN, asthma, cardiac arrest, allergy
phenylephrine/neo-synphrine may increaseglucose levels, monitor glucose in DM patients
Antidote for phenylephrine/neo-synphrinealpha blocker: phentolamine (decreases BP)
Adverse effects/potential toxicity are usually r/t dosewatch for CNS changes for toxicity such as increased HR/HTN
Adrenergic antagonist MOAspecific to alpha or beta blockade
adrenergic antagonist prototypeprozosin, Minipress
Primary use prozosinHTN
prozosin side effectsdizziness, h/a, fatigue, palpitations, orthohypoTN; weight gain, edema, dyspnea, cough
What to monitor DAILY for pt's on prozosinBP & weight, tell patient to ask for assistance when ambulating
Cholinergic agents/parasympathomimetics Prototype?bethanechol
NC bethanecholLimit use dt serious AE
MOA bethanecholstimulates skeletal muscle bowel/urinary tract; affects Ach receptors in sk muscles and CNS
bethanechol used to treat?urinary retention, myasthenia gravis, Alzheimer's
Bethanechol is CI in obstruction of GI/GU tract, asthma, bradycardia, hypoTN, or Parkinsons
Antidote bethanchol atropine (anticholinergic)
Anticholinergics/parasympatholytics: Prototype?atropine
NC atropineLimit use d/t AE; there are safer drugs available now
Cholinergic crisishot as hades, blind as a bat, dry as a bone & mad as a hatter
Atropine is CI in which conditions?Glaucoma, asthma, heart disease, HTN, hyperthyroidism, renal and GI conditions
Atropine patient teaching to prevent constipation from anticholinergic effect?Increase fiber and fluids. Also, avoid overheating, use sugar-free candy, gum or ice chips for dry mouth, sunglasses for photosensitivity
Antidote for Parkinson's physotigmine salicylate

Drugs for shock, cardiac arrest & anaphylaxis

Question Answer
dobutamine: nursing considerationsgive through central venous catheter or peripheral vein using infusion pump (Incompatible with other meds)
Adverse effects dobutamineHTN, PVCs, asthmatic episodes, headache
milrinonepositive inotropic agent used for severe heart failure
milrinone adverse effects dysrhythmia, thrombocytopenia, jaundice
sodium nitroprussidedilates cardiac veins and arteries; decreases preload and afterload; increases myocardial perfusion; keep med in dark; use infusion pump
adverse effects sodium nitroprussideincreased ICP; Hypotension
isoproternol used forheart block, ventricular arrhythmias and bradycardia; also a bronchodilator for asthma & bronchospasms
Diphenhydramine HClblocks effects of histamine on bronchioles, GI tract & blood vessels
Adverse effect of drugs for shock, cardiac arrest & anaphylaxisserious rebound effect may occur; balance b/t under-dosing & overdosing