Pharm 2; Concept review 2

Adrenergic Drugs: Sympathetic Superpowers

• Mimic the Sympathetic Nervous System (SNS)
• Epinephrine: Opens bronchi, increases blood pressure for life-saving interventions during anaphylaxis
• Dopamine: Enhances cardiac output for shock management by improving heart rate and circulation
• Key Receptors:
  • Beta2-Adrenergic Receptors: Cause bronchodilation (essential for asthma treatments)
  • Beta1-Adrenergic Receptors: Found in the heart, affecting rate and strength of contractions
• Patient Teaching:
  • Do not stop beta-blockers abruptly to avoid rebound hypertension
  • Monitor pulse and blood pressure regularly
  • Be aware of hidden hypoglycemia symptoms when using beta-blockers

Anticholinergic Drugs: PNS Blockers

• Block the Parasympathetic Nervous System (PNS) to reduce secretions and slow systems
• Glycopyrrolate: Used pre-surgery to decrease oral and GI secretions
• Oxybutynin: Decreases urinary frequency and helps with bladder control
• Watch Out For:
  • Dry mouth
  • Blurred vision
  • Constipation
• Special Notes for Active Seniors:
  • Stay cool to prevent heat stroke when outdoors due to reduced sweating
  • Prevent dehydration with fiber-rich foods and plenty of water

Cholinergic Drugs: Boosting Acetylcholine

• Stimulate the PNS by increasing acetylcholine levels
• Donepezil: Improves memory in Alzheimer's patients (but is not a cure)

Disease-Specific Drug Applications

• Heart Conditions:
  • Carvedilol: Treats mild heart failure
  • Watch for signs of worsening heart failure (weight gain, edema, shortness of breath)
• Respiratory Management:
  • Albuterol: Helps during acute asthma attacks (may cause tachycardia)
  • Salmeterol: Prevents, but does not treat, sudden asthma symptoms
• Neurological Focus:
  • Memantine: Used for Alzheimer's Disease to manage symptoms
  • Pyridostigmine: Improves swallowing in Myasthenia Gravis (when taken 30 minutes before meals)

Clinical Scenarios

• Phentolamine: Prevents tissue damage from vasopressors like dobutamine
• Physostigmine: Antidote for atropine overdose

Patient Education Essentials

• Safety Precautions:
  • Notify a doctor if pulse drops below 60 bpm while on beta-blockers
  • Avoid overheating when taking anticholinergics—stay hydrated!
• Timing Is Everything:
  • Apply Scopolamine Patch 4–5 hours before travel for motion sickness
  • Schedule Cholinergic Drugs carefully to align with meals for best effects
• Herbal Awareness:
  • Ginkgo biloba increases bleeding risk when combined with aspirin

Additional Information (page 2)

• Bethanechol: Eases urinary retention after surgery
• Contraindications: Avoid in cases of GI obstruction, Bradycardia, or Hypotension
• Teaching Tip: Take bethanechol with meals to reduce nausea and vomiting