COURSE MODULE

NURSING PHARMACOLOGY
NCM 106
 LESSON MODULE 5
(Week 5)
Drugs Affecting the Nervous System
The Mechanism of Actions, Indications, Adverse Effects and
the Nursing Responsibilities of the representative drugs.

_______________________________________

Prepared by Giovanni Clyde E. Rebadulla

 INTRODUCTION
_________________________________

This lesson module will serve as the basis for the students
understanding on the drugs related to the nervous system
particularly with the Adrenergic and Cholinergic drugs and its
Its antagonists. The Nursing responsibilities will also be discussed.
This lesson module 5 will cover the following:

14. ADRENERGIC/ADRENERGIC BLOCKERS

15. CHOLENERGIC and ANTI- CHOLENERGIC BLOCKERS

LEARNING OBJECTIVES

1. Site the names, functions, common usage and major

side effects of adrenergic agents.
2. List and describe the commonly used adrenergic
blockers.
3. Describe the main distinction of direct acting
cholinergic drugs
4. Discuss the indirect acting cholinergic drugs
5. Explain the functions, administrations and adverse
reactions of Anti-cholinergic drugs
6. Discuss the importance of the nursing role in caring
for clients taking autonomic nervous system agents
General Instructions

SGEN Gmail Account: Utilized for important

announcement.
Lesson Content will be uploaded in Moodle
Google Classroom: Class work , post exams and Etc.
Google Drive: Docs , Sheets and Slides
Google Calendar
MOODLE:
Google MEET or Zoom for Synchronous Weekly
sessions : ZOOM ID: 828 802 7631
PASSWORD: 8SArkR
Short Answer Assignment
1. State the main difference between the alpha 1 and alpha 2
adrenergic receptors
2. Compare the effects of beta 1 and Beta 2 receptors
3. What are the main effects of adrenergic drugs?
4. Why is epinephrine the drug of choice for emergency
cases related to shock.
5. Why is beta blockers good for the heart but bad for the
lungs?
6. Give the MOA of Bethanicol, contra indications and
adverse reactions
 Review

CNS PNS

Brain Spinal Cord Autonomic Somatic

Efferent Afferent

Parasympathetic Sympathetic
 DRUGS THAT AFFECTS THE SYMPATHETIC
NERVOUS SYSTEM
• ADRENERGICS
(SYMPATHOMIMETICS OR ADRENOMIMETICS)

• ADRENERGIC BLOCKERS
(SYMPATHOLYTICS OR ADRENOLYTIC)
 ADRENERGICS
• Other names :
Adrenergic agonist
Sympathomimitics
Adrenomimetics
Function : mimics the sympathetic
neurotrnamitters
Epinephrine
Norepinephrine
 Adrenergics
Sympathetic Nervous system

Pupil: dilation
Lungs: Bronchodilation
Heart: Increased HR
Blood vessels: Constrict
GI: relax
Bladder: relax
Uterus: relax
• Adrenergic Receptors :
Alpha 1 = Vascular tissues and muscles,Vessels of smooth
muscles
Effects : Blood vessels : vasoconstrictions
Increase HR. BP .Mydriasis
Bladder & Prostate contraction

Alpha 2 = Post ganglionic sympathetic nerve endings

Effects : Vasodilation
Decrease in BP , Hypotension
Decrease intestinal motility and Tone
Inhibits the release of Norepinephrine> vasodilation
( reduced norepinephrine)
• Beta 1 = Heart
Effects : Increases H.R
Increase in Myocardial contractility
Increase in BP
• Beta 2 = smooth muscles of lungs
Arterioles of skeletal muscles and
skeletal muscles
Effects : Bronchodilation
Increase in blood flow to the
skeletal muscle
Relaxation of the Uterus
Increase in blood sugar

DOPAMINERGIC = Dilation of the arteries in

Kidneys,Intestines,Heart and Brain. Increase in blood flow
Dopaminergic receptors
Arteries: Renal, Mesenteric, Coronary, Cerebral
VASODILATION
*Dopamine

Classification :
DIRECT ACTING :
directly stimulate the adrenergic receptors
INDIRECT ACTING :
stimulate the release off norepinephrine
from terminal nerve endings
MIXED ACTING : Adreneric and Norepinephrine
• Cathecolamines :
-produce sympathomimetic response
Ex ; Epinephrine
norepinephrine
Dopamine
• EPINEPHRINE
K: Sub Q ,IV, Topical ,inhalation,intracardiac,intillation
methods.
XXXXX Oral
metabolized in the liver
Excretion : Kidneys
PD : EMERGENCIES ANAPHYLAXIS Vasoconstriction
Bronchodilation

Increase Cardiac output

Increase in BP
Inreaes H.R

Note : Cardiac Dysrythmias

Renal vasoconstrition > decrease renal perfusion, decrease cardiac output.
ALBUTEROL (Proventil) Salbutamol ventolin
MOA: BETA ADRENERGIC agonist
EFFECT : Bronchodilation
INDICATION; Asthma, Bronchitis,COPD
CONTRAINDICATION: Don’t take with Mao Inhibitors >>>> Hypertensive Crisis. Hypertension.
Cardiac diseases
ADVERSE REACTION : Increase in H.R, Tremors, Restlessness, nervousness
NURSE NOTES: Inhalation is faster than oral, Don’t take with MAO

CLONIDINE(CATAPRES)METHYLDOPA (Aldomet)
MOA: Selective Alpha adrenergic Drugs
EFFECT: Regulate release of Norepinephrine
Stimulate alpha 2 receptors
DECREASE IN BP
INDICATION: Hypertension
CONTRAINDICATION:
ADVERSE REACTION ; Tachycardia, Palpitation Dysrhythmias, Dizziness
Nausea and vomiting
DRUG & aCTION Administration EFFECTS INDICATION CONTRAINDICATI ADVERSE RXN NURSE NOTES:
Half life ON

ADRENERGIC
DRUGS
Ephedrine HCL Sub Q,oral,IV Hypotension
Bronchospasm
hypotension
Relief of Sinusitis
Mild asthma

Norepinephrine IV by infusion VASOCONSTRICT Always monitor

9LEVARTERENOL) OR the BP
Inc. C.O
Inc. BP
Shock

PhenylephrineHe By intillation Nasal Colds Bloe the nose

HCL spray decongestant sinisitis before
adminisration
Peudo ephedrine oral decongestan Hypertension
Cardiac disease
diabetes
Phenyl oral Nasal Withdrawn from
Propanolamine decongestant OTC
(Dimetap Pseudoephedrine
is alternative
Dexatrim,dietac oral Appetite Control weight
suppressant gain

Albuerol bronchodilation COPD

DRUG & aCTION Administration EFFECTS INDICATION CONTRAINDICATI ADVERSE RXN NURSE NOTES:
Half life ON

ADRENERGIC
DRUGS
Metaproterenol Oral / inhalational Bronchodilation Bronchospasm
sulfate Puffs Increase heart Acute Heart rate
bock

DOBUTAMINE ENHANCES Cardiogenic shock

MYOCARDIALK
CONTRACTILITY,V
OLUME AND
OUTPUT

Terbutaline oral Bronchodilation Astma

Sulfate Decrease Uterine Premture labor
Contractions
• What should you do if a patient is given
adrenergic drugs ?
Ans : always check the BP every 5 mins.
Main EFFECTS of Adrenergic drugs:
Tachycardia,palpitation,tremors inc. in BP.
In cardiac resuscitation,the main drug given to the
patient is :
Epinephrine
What is the Antidote for Norepinephrine and
Dopamine ?
Phentolamine Mesylate
In the IV administration of Epinephrine or Dobutamine,is
there a need to dilute these drugs ?
Yes.if given undiluted,it will cause tissue
necrosis

Reminder : adrenergic nasal sprays may cause nasal

congestion by rebound phenomenon

The main side effects of Adrenergic drugs Are :

Tachycardia,palpitations and dizziness
 Adrenergic Blockers or Antagonists
• Other names :
Adrenergic antagonists
Sympatholytics
Block the Alpha and Beta receptor sites
how : occupies the alpha and Beta receptors
Inhibits the release of nore
epinephrine and epinephrine
Alpha adrenergic Blockers or ALPHA Blocker
DRUG & aCTION EFFECTS INDICATION ADVERSE RXN

ALPHA ADRENERGIC Decreases symptoms of BPH Hypertension Ortostatic Hypotension

bLOCKERS Vasodilation Peripheral Vascular disease Reflex Tachycardia
Decrease libido
Impotence

####### Peripheral vascular diseas

Tolazoline Pulmonary Hypertension

Phentolamine Mesylate Same

*dopamine antidote

Doxazosin Mesylate Hypertension Orthostatic hypotension

BPH Dizziness

Prazosin HCL hypertension

Terazocin HCL Hypertension Headache

Dizzness
hypotension
DRUG & aCTION EFFECTS INDICATION CONTRAINDICATION

Carvedilol DECREASE CARDIAC RATE hypertension

A1 B1 B2.
Labetalol DECREASE CARDIAC RATE Hypertension
Angina Pectoris
BB
Carteolol DECREASE CARDIAC RATE Hypertension
beat 1 & 2 Glaucoma

Penbutolol DECREASE CARDIAC RATE Hypertension Asthmatic patients

BB

PROPRANOLOL DECREASE CARDIAC RATE MI, angina

B1 B@ Hypertension,angina
Thyrotoxicosis

Nadolol DECREASE CARDIAC RATE Hypertension Asthma COPD

B1 B2 Angina

Pindolol B1B2 DECREASE CARDIAC RATE same same

SotalolB1B2 Ventricular Arrythmias

Angina
DRUG & aCTION EFFECTS INDICATION CONTRAINDICATION ADVERSE RXN

SELECTIVE BETA BETA

ADRENERGIC BLOCKERS

Metropolol titrate Hypertensio Bradycardia

Angina Dizziness

Acebutolol same same

isoprolol Fumarate same

Esmolol Hypertensio Heart block

Bredy cardia
Shock
Heart Failure
Betaxolol Decrease IOP Hypertension
Glaucoma
DRUG & aCTION Administration EFFECTS INDICATION CONTRAINDICATION ADVERSE RXN
Half life

ALPHA ADRENERGIC Decreases Hypertension Ortostatic

bLOCKERS symptoms of BPH Peripheral Vascular Hypotension
Vasodilation disease Reflex Tachycardia
Decrease libido
Impotence

BETA ADRENERGIC Oral Decrease H.R Hypertension Asthma Drowsiness

Blockers HL: 3-6 hrs Dec. BP Angina heart blocks Dizziness
Uterine contractions Cardiac dysrythmias Fainting
BETA BLOCKERS Heart failure Depression
Bronchoconstriction palpitation

Adrenergic neuron BLOCKS NOR

blockers EPINEPHRINE

(guanadrel sulfate0 Decrease BP.

POTENT
ANTIHERTENSIVE
AGENTS
• Reminders:
Always check the vital sign before giving adrenergic and adrenergic
blockers

- Note the adverse reaction; Hypotension

- Don’t abruptly stop the intake of Beta blockers
- teach the patients on how to take the vital signs
-avoid orthostatic Hypotension
- Mood changes may occur
- Some beta blockers may decrease libido
Inactivation of Neurotransmitters
After the transmitter has performed its function, the
action must be stopped to prevent prolonging its effect.

1. Reuptake of transmitter back into neuron

2. Enzymatic transformation or degradation
3. Diffusion away from receptor

Norepinephrine:
Monoamine oxidase (MAO): inside neuron
Catechol-O-methyltransferase (COMT): outside
Classification of Sympathomimetics
Ephedrine: mixed-acting

Indirect: release of norepinephrine

Direct: Alpha 1, Beta 1, Beta 2

Chemical structures of a substance that can produce an adrenergic response

Epinephrine
Norepinephrine
Dopamine

Isoproterenol
Dobutamine
 Catecholamines
Non-catecholamines: stimulate adrenergic receptors

Phenylephrine
Metaproterenol
Albuterol

*Longer duration
 Epinephrine (Adrenalin)

Alpha 1 + Beta 1 + Beta 2

Useful: emergencies
Cardiogenic + Anaphylactic shock

IV / SQ / Topical / Inhalation

Non-selective: more side effects

*ECG Monitoring
 Albuterol sulfate (Proventil)
Beta 2 receptors

Bronchodilation: asthma
*fewer side effects
*high dosages: may stimulate Beta 1: HR increase

Oral / inhalation

*Tremors, Restlessness, Nervousness

Isoproterenol HCl (Isuprel)
Beta 1 and 2
Bronchodilation + Increase in HR
*Not completely selective

Terbutaline Sulfate (Bricanyl)

Primary purpose: Bronchospasm
*Halt premature labor

Clonidine (Catapres)
Methyldopa (Aldomet)
Alpha 2: for Hypertension
 Note :
• Read labels on OTC medications
• Lactating mothers: avoid taking medications
• Nasal sprays: rebound congestion
• Self-administration
• Bronchodilator sprays: Tachycardia
• Side effects
Adrenergic Blockers
Block alpha and beta receptors
Direct: occupying receptors
Indirectly: inhibit release of norepi/epi

Selective VS Non-selective

Orthostatic Hypotension
Reflex Tachycardia
*Not frequently prescribed

BPH
Peripheral Vascular Disease

Prazosin HCl (Minipress)

Phentolamine Mesylate (Regitine)
Beta-Adrenergic Blockers
Decrease HR + BP: Beta 1 and 2

Non-selective: use with extreme caution: COPD

*Bronchoconstriction
*Propanolol HCl (Inderal)
*drug interactions

*Metoprolol / Acebutolol / Atenolol : Beta 1 blocker

“OLOL”

Side effects (Alpha-blockers)

decreased libido, Depression , Cardiac dysrhythmias, Flush
Hypotension, Reflex Tachycardia, Impotence
Side effects (Beta-blockers)

Bradycardia
Dizziness
Hypotension
Headache
Hyperglycemia
Intensified hypoglycemia
Agranulocytosis

*dose-related
 Adrenergic Neuron Blockers
Block release of norepinephrine
decrease blood pressure

Guanethidine monosulfate (Ismelin)

Guanadrel sulfate (Hylorel)

Clinical use:
Note :

• Baseline VS , ECG, UO
• Assess respiratory status : wheezes, dyspnes
• Drugs concurrently taken
• Side effects: dizziness, nasal congestion
• Side effects: bradycardia, hypotension, cardiac
dysrhythmias
• Health history: DM
 Note :
X stop medication abruptly: rebound

• Compliance
• Insulin therapy: signs of hypoglycemia, monitoring
• Self-administration: PR & BP
• Side effects: rise slowly

*Mood changes, impotence, decreased libido

CHOLINERGICS AND
ANTICHOLENERGICS
 Parasympathetic Nervous
System

1. CHOLINERGICS -
Parasympathomimetics

2. ANTICHOLINERGICS –
Parasympatholytics
Cholinergics or Parasympathmimetics
stimulate the Parasympathetic Nervous
System by mimicking the action of
Acetylcholine

Other names :
Cholinomimetics
Cholinergic stimulants
Cholinergic agonist
LIST OF CHOLINERGIC AGONIST
• DIRECT ACTING
ACETYLE CHOLINE
BETHANECOL
CARBACHOL
CEVIMELINE
PILOCARPINE

INDIRECT ACTING
( REVERSIBLE )
AMBENOMIUM
DAMECARIUM
DONEZEPIL
EDPROPHONIUM
GALANTAMINE
NEOSTIGMINE
PHYSOSTIGMINE
PYRIDOSTIGMINE
RIVASTIGMINE
TACRINE
INDIRECT ACTING
( IRREVERSIBLE )
ECHOTHIOPHATE

REACTIVATION OF ACETYLE CHOLINE ESTERASE

PRALIDOXINE
• Acetylcholine
- a neurotransmitter located at the gangleon and
parasympathetic nerve endings

Two types of Cholinergic receptors

1. Muscarinic receptors
stimulate the smooth muscles
Slows the Heart Rate

2. Nicotinic Receptors
simulates the skeletal muscle
 MAJOR EFFECTS OF
Cholinergics
Parasympathetic Nervous system

Pupil: Constrict
Lungs: Bronchoconstriction + increased secretions
Heart: decreased
Blood vessels: dilate
GI: increased peristalsis + secretions
Bladder: contracts
Salivary gland: increased salivation
 Cholinergics

Direct-acting: act on receptors

Indirect-acting inhibit action of ChE

*Cholinesterase Inhibitors

Reversible VS Irreversible
• Direct acting Cholinergic drugs
-act directly on the receptors to activate the

response
• Indirect acting Cholinergic drugs
- inhibit the action of enzyme Cholinesterase
other names : Cholinesterase inhibitors
Acetylcholinesterase Inhibitors
Anticholinesterases
- destroy the acetylcholine before it reaches the receptors
- more acetylcholine becomes available, - -receptors are
stimulated
- more time for the acetlylcholine to stay with the receptors
• Direct acting Cholinergics
selective to muscarinic receptors
- smooth muscles of GI,genito-urinary and
Heart
Ex. Bethanechol chloride (uricholine)
increases urination
Metochlopramide HCL for GERD
increase gastric emptying time
*GERD
• NOTE:

• Muscarinic receptors are found in the

ganglia of the peripheral nervous system and of autonomic
effector organ these can also be found in:

M1 : receptors ; found also in the gastric parietl cells

m2 : cardiac ad smooth muscle
M3; receptors for bladder , exocrine glands and smooth
muscles
NICOTINIC RECEPTORS
- Found in CNS, adrena l medulla, autonomic ganglia and in
neuromuscular junctions.
 CHOLINERGICS
• DIRECT ACTING CHOLINERGICS
DRUG AND ADMINISTRATI ACTION INDICATION CONTRAINDICATION ADVERSE RXN NOT
CLASSIFICATIO ON ES
N
BETHANECOL ORAL ,IM,IV Increase GERD
(Uuricholine ) Gastric
METOCLOPRA emptying time
MIDE
CARBACHOL Miosis
PILO)CARPINE Reduce IOP
• ACETYLCHOLINE
• - rapidly inactivated by acetylcholinesterase
• Functions :
1.Decrease in heart rate and cardiac output
2. Decrease in blood pressure
3. Increase salivary secretions and intestinal motility
4. miosis
• BETHAHENICOL
• - strong muscarinic activity
• - Increases intestinal motility
• - major action is on the smooth muscle of the o the bladder and gastrointestinal tract.
• ORAL AND SUB-Q

• Main action : stimulates the bladder to contrac and relaxes the shincter nad trigone
realeasing urine

• Therapeutic applicaton : for bladder atony/ post partalneurogenic atony

Megacolon
CONTRAINDICATION
Intestinal and urinary obstruction
Hypotension
Astma
ADVERSE REACTION
Hypotension
Bradycardia
• Cholinergic Direct Acting Bethanechol
Check the urine output
Cholinergic drugs will aggravate the symptoms of
peptic ulcers,asthma and urinary obstruction

side effects of Bethanecol: Orthostatic Hypotension

Give the drug 1 hour before or 2 hours after
meals
side effects ; gastric pain,abdominal cramping
Report decrease of bowel sounds
Diaphoresis may be observed
• Direct Acting Cholinergics :

Pilocarpine : for eyes

- Used primarily in ophthalmology
for Glaucoma : constrict the pupils
opens the canal of schlemn

*Glaucoma = relieve intraocular presssure

*Nicotinic receptor
 Other actions of Pilocarpine:
Causes rapid miosis and contraction of ciliary muscles
Stimulates secretions like saliva and tears. ( for xerostomia)

Sjogrens syndrome: dry mouth and lack of tears.

 Side Effects
Hypotension
Excessive salivation
Increased gastric acid secretion
Abdominal cramps
Diarrhea
Bronchoconstriction
Cardiac dysrhythmias
Dizziness
Bradycardia less than 60
Orthostatic Hypotension
Respiratory distress
*Contraindications
Indirect : Advise the client to take the medication on time.
• Signs of Cholinergic overdose

Salivation
Sweating
Abdominal cramps Signs of overdose
Flushing

Overmedication : CHOLINERGIC CRISIS

( muscular weakness and increased Salivation )

Antidote : IV ATROPINE SULFATE

INDIRECT ACTING CHOLINERGICS
- Inactivate the enzyme Cholinesterase
- Result : acetylcholine accumulate in the receptors
- Other names :
Cholinesterase Inhibitors
Acetylcholinesterase Inhibitors
Anticholinesterase
- Breaks down choloine and acetic acid
- RESULT : Acetylcholine persist
- Activaton of muscarinic and cholinergic receptors
- Increase force of muscular contractions

*Myasthenia Gravis
• Drug for :
Myastenia Gravis
Glaucoma
Alzheimers disease
Muscarinic poisoning as an antagonist
• REVERSIBLE CHOLINESTERASE INHIBITORS
- miotics for glaucoma
- myasthemia gravis

Neostigmine (Prostigmin): ( short acting)

Pyridostigmine Bromide (Mestinon): ( moderate acting)
Ambenomium Chloride ( Long acting )
- For diagnostic purposes :
Edrophonium Chloride - For Tensilon Test
Physostigmine – reversible anticholine esterase
inhibitor

CONTRAINDICATED : Intestinal and urinary obstruction

 Reversible Cholinesterase Inhibitors
Purposes:
Pupillary constriction
Increase muscle strength
IRREVERSIBLE CHOLINESTERASE INHIBITORS
-used for organophosphates insecticides
- Miosis
PRALIDOXINE = antidote irreversible
organophosphate poisoning

Long-lasting effect

Pralidoxime (Protopam)
 Note
Antidote: Atropine Sulfate
*Early signs:
salivation, sweating, abdominal cramps, flushing

Indirect-acting cholinergics: Cholinergic crisis

*muscular weakness + increased salivation
ANTIDOTE for Irreversible and Reversible Cholinesterase
Inhibitor
DRUG AND CLASSIFICATION ADMINISTRATI ACTION INDICATION
ON

PRALIDOXINE IM/IV/PO Decrase muscle peralysis Organophosphate

Poisoning
Reversis cholinesterase
inhibitors Over medication in
Myasthemia Gravis

CHOLINESTERASE INHIBITORS
 INDIRECT ACTING Cholenergics/ Choline
DRUG ANDesterase ADMINISTRATION
inhibitors forACTION
the EYE INDICATION
CLASSIFICATION

DEMECARIUM DROPS Miotic Glaucoma

BROMIDE Reduce IOP

ECHOTHIOPHATE drops same Glaucoma

IODIDE

ISOFLUROPHATE ointment same Glaucome

 ANTICHOLINERGICS
-inhibits the action of acetylcholine by occupying the acetylcholine
receptors
- Opposite effects
- Other names : Anticho,linergics

- - Parasymphatolytics
- -Cholinergic Blocking Agents
- Cholinergic or muscarinic Antagonists
- Antiparasympathetic agents
- Antimuscarinic agents
- Antispasmodic
BLOCKS THE PARASYMPATHETIC. Result :
SYMPATHETIC PREDOMINATES
• ANTICHOLINERGICS : will CAUSE:
Decrease I GI motility
decrease in salivation
Mydriasis
Increase in pulse rate
decrease in bladder contraction > Retention
Decrease rigidity and tremors

ANTIDOTE : Organophosphate Ingestion

Cholinesterase Inhibitors Toxicity
 Anticholinergics
DRUG AND ADMINI ACTION INDICATION CONTRINDIC ADVERSE NOTES
CLASSIFICATIO STRATI ATION RXN
N ON

ATROPI Po/im/
IV/
Reduce Salivation
Increase heart rate
Preop meds
Peptic ulcers as
NARROW
ANGLE GLA
Dry mouth
Constipation
NE instill Mydriasis antispasmodic
Bradycardia
UCOMA Blurred
vision
Antidte for Photophobia
BLOCKS acetylcholin muscarinic agonist Urinary
Decrease peristalsis poisoning retention
DEC. Secretions Tachycardia
INC. constriction of paralytic
detrussor muscle ileus
Dilate pupil Decreased
Parlyzes the ciliary [erspiration
body
DEC . Tremors and
Rigidity of muscles
 Atropine Sulfate
*Scopolamine

*Muscarinic antagonist

Pre-operative medication: decreased salivation

Anti-spasmodic: peptic ulcers
Increase heart rate
Antidote for cholinergics: Bethanecol / Neostigmine
 Side Effects & Adverse Reactions
Dry mouth Decreased perspiration
Blurred vision Tachycardia
Constipation Urinary retention
Nausea Headache
Dry skin Abdominal distention
Impotence Photophobia
Coma Hypotension / Hypertension

Contraindications:
Narrow-angle glaucoma
Gastrointestinal obstruction
BPH
Myasthenia Gravis
 NOTE :
• Void before taking medication
• Adequate fluid intake: Report decreased UO
• Record bowel sounds
• Check for constipation
• Raise bedrails: confusion
• Mouth Care
 NOTE :
• Avoid hot environments & excess physical exertion
• Client with glaucoma: X atropine meds
• Read OTC labels

X drive / activities that require alertness

X alcohol, cigarettes, caffeine, aspirin

Use sunglasses: photophobia

Side effects: long-term use
Increase fluid intake + Fiber-rich foods
Urinate prior to taking medication
Hard candy, ice chips or chewing gum
Eye drops
 Anticholinergics
• side effect of Atropine
TACHYCARDIA
• Effect of atropine in the Eyes
MYDRIASIS
• Effect of Atropine in Urinary System
URINARY RETENTION
• Effects in the Mouth
DRY MOUTH
• Effect in CNS
EXCITEMENT,CONFUSION /DROWSINESS
• Effect in GIT
CONSTIPATION
Never give this drug to a patient with Glaucoma
ATROPINE
Can a patient drive a motor vehicle if with Atropine ?
NO…. Drowsiness
What would you recommend for a patient to wear if
Atropine was applied on his eyes ?
SUNGLASSES
What would you suggest to the patient if He is
experiencing DRY MOUTH ?
Ice chips, chewing gums, hard candies
SUMMARY
You have just learned:
1. The main difference between the Adrenergic and
adrenergic blockers.
2. The role of adrenergic receptors as the basis for the MOA
of medications.
3. The opposing effects of Cholinergic and anti-cholinergics
in the parasympathetic nervous system
4. The role of Cholinergic receptors (Muscarinic and
Nicotinic) as the basis for the MOA of medications.
5. The nursing responsibilities of adrenergic, adrenergic
blockers, cholinergic, cholinergic blockers when
administered to the clients.
What’s next ?
Preview
WEEK 6 : PRELIM EXAMINATION

WEEK 7:
ANTI- DRUGS FOR REVIEW OF NURSING
CONVULSANT NEUROMUSCULAR MOTION SICKNESS RESPONSIBILITIES FOR
DISORDERS NEUROLOGIC DRUGS
MEDICATIONS
PHARMACOLOGY REFERENCES:
• PHARMACOLOGY A PATIENT CENTERED NURSING PROCESS APPROACH BY:
KEE/HAYES/MCCUISTION (2015)

• FOCUS ON NURSING PHARMACOLOGY BY: AMY KARCH (2013)

Thank you
REFERENCES:
• PHARMACOLOGY A PATIENT CENTERED NURSING PROCESS APPROACH BY:
KEE/HAYES/MCCUISTION (2015)

• FOCUS ON NURSING PHARMACOLOGY BY: AMY KARCH (2013)

• http://docshare04.docshare.tips/files/27843/278436401.pdf