Epinephrine “Epi-Pen” - Think running from a bear’
Nonselective – Stimulate Alpha, beta 1 and 2
Given for: Allergic reaction, cardiac arrest
Stimulate the sympathetic nervous system
Dilated lungs and pupils
Receptors
Alpha “Arteries” – vasoconstriction
Beta 1 “One Heart” – Increase Heart rate
Beta 2 “Two Lungs” Bronchi dilatation, liver glycogenolysis (increases blood sugar)
Epi Pen Teaching – Know it!
5-10 secs, CAN massage site, outer thigh subQ, go to ER after use
Atropine for low heart rate
Adverse – cardiac dysrhythmias
Side Effect – Low blood glucose (expected)
Adrenergic Blockers
Atenolol (More selective for Beta 1) A-M Medications
Contraindicators – Heat Block, Bradycardia
Given for: Antihypertensive, Reynaud’s, BPH
Beta Blocker – Heart and Lungs
Constricts lungs – no COPD Patient (But beta 1 would be safer to give to lung patient)
Heart Rate low! Below 60
Orthostatic Hypotension – Safety
Always take at same time a day/ Several Weeks to work/ do not drive
Do not stop Abruptly – Rebound Hypertension
Cholinergic Agonist “Think of colon”
Wet & Moist & Mucousy
Constricts pupils, increase secretion, runny eyes, do not give to Gerd/Ulcers, loss stool/diarrhea
Bethanechol Chloride – Decreases BP
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The outflow of aqueous humor in the eyes is increased
Anti Cholinergic – Dry up
Patient working out and not sweating – overheated
Exact opposite of above
Decrease secretions
Tolterodine Tartrate – for overactive bladder, not given for pulse (can increase) , decrease in
urination (TT no more )
*Other Notes in Pharm Book*
UNIT 5
Parkinson’s Disease
Not enough dopamine, too much acetylcholine
Carbidopa-Levodopa
Carbidopa disguises levodopa to get into blood brain barrier
This drug improves nerve impulse transmission in the brain
Side Effects – GI Distress, dry mouth, Dark Urine, Orthostatic Hypotension
Adverse Reactions- Palpitations, hypotension, Urinary retention, Psychosis, Severe depression
Contraindications- Antipsychotics
Contact PCP if undergoing glaucoma treatment
Do not take with high protein foods, Vitamin B-6 it will decrease absorption
COMT Inhibitors
Tolcapone – Adjunct to Parkinson’s!
Inhibits COMT because it inactivates dopamine, usually given with Levodopa
Not given alone (Adjunct) Prolongs Levodopa action
Monitor LFT, AST ALT, Hepatotoxic Monitor Liver
Assessment – Vitals orthostatic hypertension, S/S of Parkinson’s, Med Hx
Avoid high protein foods
Monitor for Suicidal ideation
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