Pharmacology of Adrenergic and Anticholinergic Drugs

Study Notes

Adrenergic Drugs

Mimic the sympathetic nervous system (SNS)
Epinephrine: Opens bronchi, increases blood pressure (anaphylaxis)
Dopamine: Enhances cardiac output (shock management), improves heart rate and circulation
Beta2-Adrenergic Receptors: Bronchodilation (asthma)
Beta1-Adrenergic Receptors: Impact heart rate and contraction strength
Patient Teaching: Do not abruptly stop beta-blockers (e.g., Atenolol) to avoid rebound hypertension, monitor pulse and blood pressure, be aware of hypoglycemia symptoms when using beta-blockers

Anticholinergic Drugs

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, helps with bladder control
Side Effects: Dry mouth, blurred vision, constipation
Special notes for active seniors: Stay cool to prevent heat stroke; reduced sweating
Precautions: Prevent dehydration with fiber-rich foods, plenty of water

Cholinergic Drugs

Stimulate the PNS by increasing acetylcholine levels.
Donepezil: Improves memory in Alzheimer's patients (not a cure)
Bethanechol: Eases urinary retention after surgery
Contraindications: Avoid in GI obstruction, bradycardia, or hypotension
Patient teaching: Take bethanechol with meals to prevent nausea and vomiting

Disease-Specific Drug Applications

Heart Conditions:
- Carvedilol: Treats mild heart failure
- Monitoring: Look 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, take 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:
- Apply Scopolamine patch 4–5 hours before travel for motion sickness
- Schedule Cholinergic Drugs carefully with meals for best effect
Herbal Awareness:
- Ginkgo biloba increases bleeding risk when combined with aspirin

Description

This quiz covers key concepts related to adrenergic and anticholinergic drugs, including their actions on the sympathetic and parasympathetic nervous systems. Review important medications such as epinephrine and glycopyrrolate, their uses, side effects, and patient teaching points. Test your understanding of these pharmacological agents and their implications in clinical practice.