4 Receptors in ANS Recept or a1 a2 b1 Structure Arterioles Arterioles Myocardial Cells Agonizing Effect Vasoconstriction=BP Blocks norepinephrine (Vasodilation)=BP HR,contractility,CO,

BP Adequate circulating volume most exist Bronchodilation For asthma Opens up airway, easier to breathe Antagonizing Effect Vasodilation=BP Vasoconstriction=BP HR=BP Vital Sign Check BP BP HR,BP

b2

Bronchioles

Bronchoconstriction Inderal-Propanolol=used for migranes,b1b2 antagonist, dont give to asthmatic patients

RR, SPO2

Sympathomimetics- Adrenergic Agonists stimulate the SNS Epinephrine (adrenaline)

a1 agonist=BP=vasoconstriction b1 agonist=HR=co,cont,bp b2 agonist=RR=bronchodilation Ex: Nurse give epinephrine mixed w/lidocaine for removal of molestays where it is given, keeps localized Ex: ACLS=Heart stops breathing, need epinephrine, inject in heart muscles (myocardium)

Dopamine (Intropin) A1,b1 agonist Stimulates a1 receptors=vasoconstriction=BP Stimulates b1 receptors=HR=Contractility=CO=BP Monitor BP Ex: CHFheart to weak to pump adequatelycongested=HR contractility, missed 3 doses of Lasix, urine cola looking=water not going through kidneysgave Lasix=750 ml urine in 4 hours=BP because got rid of congestion CHF=Full, way over stretched, gave Lasix that usually BP, but BP because it relieved the congestion

Albuterol (Proventil)promotes ventilation b2 agonist Causes bronchodilationfor wheezing sound Nurse impl.How to know if albuterol works?pt. says they feel better & breathe better, RR, SpO2,wheezes Give until it works Causes tachycardia

Clonidine (Catapres) a2 agonist

blocks norepinephrine(potent vasoconstrictor)=BP promotes vasodilation opioid withdrawal

Sympatholytics- Adrenergic antagonists block the SNS Carvedilol (Coreg)regulates CO=HR,Contractility

a1 antagonistblock vasoconstriction=vasodilation b1 antagonist HR,contractility, CO, BP b2 antagonist blocks bronchodilation=bronchoconstrictionshould not be given to asthmatics Nurse implHow to know if it worksBP and then HR Nurse should check BP and HR before giving

Prazosin (Minipress)minimizes/manipulates the pressure

a1 antagonistblock vasoconstriction=vasodilation BP Nurse impwhat to do before givingcheck BP Drug also given for BPH=Benign Prostatic Hypertrophyenlargement of prostate glands=prostate glands surround urethraBPH=trouble urinating Minipress relaxes= urination Nurse impif pt. Has BPH and hypotentiondont give minipress=will further BP Nurse should check BP before giving it

Atenolol (Tenormin)decreases tension

b1 antagonistHR,contractility, BP Beta selectedspecific drugspecific receptor Focuses on b1 receptors Same effect for Metoprolol (Lopressor) Lol=beta blockers

Parasympathomimetics-Cholinergic Agonists Stimulate PSNS=promotes GI motility(peristalsis/movement of GI tract) Metoclopromide (Reglan) Direct acting cholinergic agonist GI motility=cause what it does naturally better Common uses=nausea Removes substance from stomach further down and out For gastroparesis=gastro weaknessstomach doesnt contract very well Metoclopromidestimulates GI motilitypromotes gastric emptying Most commonly in Diabetic pts. Ex: Pt. On reglanhas gastroparesisgive drug 30 minutes before they eat=causes gastric contractilitymovement of food through stomach

Bethanechol (Urecholine)

What does the adrenergic/cholinergic system do to the bladder? Adrenergic Cholinergic Tightens bladder, relaxes urethral

Relaxes bladder, tightens urethral sphincter=cant urinate spincter=urination -

Direct acting cholinergic agonist Stimulates bladder contraction Urecholinetightens bladder, relaxes urethral spincter=urination

Parasympatholytics-cholinergic antagonists block the PSNS Atropinechol. Antagonistblock vagal stimulation Blocks pupil constriction=pupils dilate Blocks GI tract=GI slows BP=HR, SV x HR=CO, elevates HR, BP Relaxes bladder, tightens urethral sphincter=cant pee Chol. System causes 1) oral secretions 2) pulm. Secretions Nurse imp.give atropine preoperatively=so there wont be a lot of oral and pulm secretions during surgerydont want airway to be clogged up Know the route! Ex: drops must be placed in mouth not in eye to oral secretions even though looks like eye drops know why you are putting the drops, know what will happen