Pharmacology: Adrenergic & Anticholinergic Drugs

Adrenergic Drugs: Sympathetic Superpowers

• Mimic the Sympathetic Nervous System (SNS)
• Epinephrine: Opens bronchi, increases blood pressure (e.g., anaphylaxis)
• Dopamine: Enhances cardiac output (e.g., shock management)
• Key Receptors:
  • Beta2-Adrenergic: Bronchodilation (e.g., asthma)
  • Beta1-Adrenergic: Heart rate and strength of contractions
• Patient Teaching:
  • Do not abruptly stop beta-blockers (e.g., Atenolol)
  • Monitor pulse and blood pressure regularly
  • Be aware of hypoglycemia symptoms when using beta-blockers

Anticholinergic Drugs: PNS Blockers

• Block the Parasympathetic Nervous System (PNS)
• Reduce secretions, slow systems
• Glycopyrrolate: Used pre-surgery to reduce oral and GI secretions.
• Oxybutynin: Decreases urinary frequency, helps with bladder control.
• Watch for:
  • Dry mouth
  • Blurred vision
  • Constipation
• Special Notes for Active Seniors: Stay cool to prevent heat stroke due to reduced sweating.

Cholinergic Drugs: Boosting Acetylcholine

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

Disease-Specific Drug Applications

• Heart Conditions: Carvedilol treats mild heart failure. Watch for worsening heart failure symptoms (edema, shortness of breath).
• Respiratory Management: Albuterol helps during acute asthma attacks (tachycardia possible). Salmeterol prevents, but does not treat, sudden asthma symptoms.
• Neurological Focus: Memantine manages symptoms of Alzheimer's Disease. Pyridostigmine improves swallowing in Myasthenia Gravis (take 30 minutes before meals).

Clinical Scenarios

• Phentolamine: Prevents tissue damage from vasopressors (e.g., 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 if taking anticholinergics, stay hydrated.
• Timing Is Everything: Apply Scopolamine Patch 4-5 hours before travel, schedule cholinergic drugs carefully with meals
• Herbal Awareness: Ginkgo biloba increases bleeding risk when combined with aspirin.