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NR-291 Pharmacology I Exam 2 Study Guide
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1NR-291 Pharmacology I Exam 2 Study Guide
Effects of the Peripheral Vascular System
Cholinergic – Parasympathetic Nervous System (feed and breed; rest and digest)
o Cholinergic effects (SLUD)
Salivation, Lacrimation, Urination, Defecation
o Anticholinergic effects (Mad as a Hatter)
Hyperthermia, blindness, confused, dry mouth, urinary retention, shaking,
grabbing invisible objects, tachycardia, absent bowel sounds, flushed skin,
mydriasis
Adrenergic – Sympathetic Nervous System (fight or flight)
o Alpha effects
Vasoconstriction (treat hypotension), CNS stimulation, relaxation of GI smooth
muscles (decreased motility), constriction of bladder sphincter, contraction of
pupillary muscles of the eye (dilated pupils), contraction of uterus, male
ejaculation
o Beta1 and Beta2 effects
1 – increased force of contraction (positive inotropic effect). Increased HR
(positive chronotropic effect), increased conduction through AV node (positive
dromotropic effect)
2 – bronchodilation (relaxation of the bronchi), glycogenolysis in the liver,
increased renin secretion in the kidneys, relaxation of GI smooth muscles
(decreased motility), uterine relaxation, inhibits histamine release from mast cells,
increases intraocular pressure
o Dopaminergic effects
Vasodilation (resulting in increased blood flow) to: renal (diuresis), mesenteric,
coronary (increase CO and contractility without increasing HR), cerebral
Chapter 36: Antihistamines, Decongestants, Antitussives, and Expectorants
Know and apply pharmacology treatment for the common cold
o Combination use of: antihistamines, nasal decongestants, antitussives, expectorants
o Treatment is symptomatic only, not curative
o Treatment is empiric therapy
Antihistamines (-dine) (-iramine) (-tadine)
o Know and apply common uses of H1 versus H2 blockers or antagonists
H1 – relief of allergy symptoms, treat non-allergy conditions (insomnia, motion
sickness, Parkinson-like reactions due to anticholinergic effects)
H2 – reduce gastric acid , gastric and duodenal ulcer, GERD, acid indigestion,
heartburn
o Nice to know:
Adv Eff – dry mouth, difficulty urinating, constipation, mild drowsiness to deep
sleep, changes in vision
o Good to know:
Due to Adv Eff, use with caution in pts with – HTN, angina, MI, Asthma or
COPD, hyperthyroidism, peptic ulcer disease (antihistamines stimulate gastric
acid secretion), BPH or urinary retention
Antihistamines appear on Beers List (geriatric clients at risk for orthostatic
hypotension)
o Got to know:
, 2
Pt education: report excessive sedation, confusion or hypo/hypertension, avoid
driving or operating heavy machinery, advise againse consuming alcohol or other
CNS depressant
Contraindicated in glaucoma (angle-closure) – due to anticholinergic properties
Diphenhydramine has multiple uses and is often combined with many other OTC
meds
o Diphendydramine
o Cimetidine
Decongestants
o Vasoconstrict blood vessels of the nose, throat and paranasal sinus, decreases
inflammation and mucous formation
o Good to know:
Oral (adrenergics) – prolonged decongestant effects but delayed onset, less potent
than topical, no rebound congestion
Pt education – avoid caffeine, report a fever, cough, or other symptoms lasting
longer than a week
o Got to know:
Topical or nasal adrenergics – prompt onset, rapid absorption, rapid decline in
therapeutic activity, potent, sustained use over several days causes rebound
congestion making the condition worse (cause overuse and dependency)
Avoid or consult with prescriber – HTN, palpitations, BPH
o Oral – pseudooephedrine
o Intranasal – phenylephrine, fluticasone, ipratropium
Antitussives – only for nonproductive coughs
o Opioid – codeine
Suppress the cough reflex by direct action on the cough center in the medulla
o Nonopioids – benzonatate, dextromethorphan
Suppress the cough reflex by numbing the stretch receptors in the respiratory tract
and preventing the cough reflex from being stimulated\
o Good to know:
Report any of the following symptoms to the caregiver: cough that lasts more than
a week (possible CHF), a persistent headache, fever, rash
o Got to know:
Antitussive drugs are for nonproductive coughs only!
Expectorants
o Irritates GI tract which causes a loosening and thinning of respiratory tract secretions
o Guaifensin
o Good to know:
Report a fever, cough, or other symptoms lasting longer than a week
o Got to know:
Pt education – encourage more fluids, if permitted, to help loosen and liquefy
secretions
Chapter 37: Respiratory Drugs
Know Evidence-Based Practice Guideline from GINA (stepwise plan)
Know classifications and actions of respiratory drugs (Bronchodilators, etc…)
o Bronchodilators – relax smooth muscles that line airway
o Beta-agonists – increase mucociliary clearance
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