Term
| Adrenergic Effect/receptors |
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Definition
Sympathetic nervous system ["what's up SA" (sympathetic adrenergic)] stimulation
--Alpha-adrenergic receptors: respond to NE
--Beta-adrenergic receptors: respond to EPI
--Dopaminergic receptors: respond to dopamine |
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Term
| Alpha-adrenergic receptors |
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Definition
alpha1 and alpha2;
Controls release of neurotransmitters
--Alpha-adrenergic agonist response
1) vasoconstriction
2) CNS stimulation |
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Term
| Beta-Adrenergic Receptors |
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Definition
Beta1=1 heart
Beta2=2 lungs (and organs)
Result: Relaxation of bronchioles, GI, uterine smooth muscle
glycogenolysis, cardiac stimulation |
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Term
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Definition
Causes dilation of the following blood vessels, resulting in increased blood flow
--Renal
--Mesenteric
--Coronary
--Cerebral |
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Term
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Definition
Increased force of contraction (positive inotropic effect)
Increased heart rate (positive chronotropic effect)
Increased conduction through the AV node (positive dromotropic effect) |
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Term
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Definition
incr. force of contraction
Treats CHF
1) Cardiac glycosides
--digoxin
2) Phosphodiesterase inhibitors |
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Term
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Definition
Digoxin (Lanoxin) & Digitoxin
--For CHF or Supraventricular dysrhythmias (atrial flutter)
Incr contractility, decr. conduction by prolonging refractory period
Promotes diuresis
Improvement of symptoms: exertional and paroxysmal nocturnal dyspnea, cough, and cyanosis
----Very narrow therapeutic window----
Monitor electrolytes (low K)
Colored vision (seeing green, yellow, purple)= Adverse effect
--Before giving any dose, count apical pulse for 1 full minute
If less than 60 or more than 120 hold and call physician
Avoid administration with high fiber foods
IF weight gain more than 2 pounds in a day or 5 in a week report stat |
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Term
| Phosphodiesterase Inhibitors |
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Definition
Short-term management of CHF (given with pt. who had no response to digoxin, dieuretics, or vasodilators
Results in:
Positive inotropic response
Vasodilation
Two agents ((weekly 6h infusions))
--Amrinone (thrombocytopenia most worrisome) and
--milrinone (dyrhythmias , atrial most worrisome)
Monitor for therapeutic effects:
Increased urinary output
Decreased edema, shortness of breath, dyspnea, rales, fatigue
Resolving of paroxysmal nocturnal dyspnea
Improved peripheral pulses, skin color, temperature |
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