1. Final Exam

2. Adrenergic Agents
• Adrenergic nervous system stimulated by 2 classes of
drugs:
– Catecholamines
– Noncatecholamines
• Neurotransmitter catecholamines
– Norepinephrine—secreted at nerve terminals
– Epinephrine—adrenal medulla
– Dopamine—brain, kidney, GI tract
• Non-catecholamines
– Selective
– Not quite fast acting
– Longer duration of action

3. Adrenergic Agents
• Assess VS—HR & BP
• Adverse effects are dose related
• Adverse effects resolve when dose is reduce or
discontinued
• Client sensitive are:
• Impaired liver function
• Thyroid disease
• HTN
• Heart disease
• DM have increase episodes of Hyperglycemia

4. Adrenergic Agents
• Common Adverse Effects
– Palpitations
– Tachycardia
– Dizziness
– Tremors
– Orthostatic hypotension
• Serious Adverse Effects—w/cardiac d/c immediately &
notify provider
– Dysrhythmias
– Chest pain
– Severe hypotension
– HTN
– Angina pain
– N/V—notify providers
• Interactions: MAOI, TCA, atropine & halothane, OTC meds

5. Cholinergic Agents
• Parasympathomimic
• Produce effects of acetylcholine
• Other can inhibit acetyl cholinesterase (metabolize ACH)--
indirect-acting cholinergic agent
• PNS can be directly stimulated by some agents
• Actions:
– Slow heartbeat
– Increase GI motility
– Increase GI secretions
– Increased contraction of urinary bladder w/relaxation of muscle
sphincter
– Increase contractility of bronchial smooth muscle
– Sweating
– Miosis of eye which decrease intaocular pressure
– Increased force of contraction of skeletal muscle
– Sometimes decrease blood pressure

6. Cholinergic Agents
• VS: HR & BP
• The higher the doses the greater the likelihood
for adverse effects
• CAE:
• N/V/D/AC
• Dizziness
• Hypotension (monitor orthostatic pressures)
• Bronchospasm & wheezing
• Bradycardia (withhold the next dose)
• Interactions: atropine, antihistamines