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Key Terms
Agonist

Pharmacology Introduction
Gina Maiocco, PhD, RN, CCRN, CCNS

A drug that has an affinity for the cellular receptors of another drug or natural substance that

produces an physiological effect

Antagonist

A drug that binds to a cellular receptor for a hormone, neurotransmitter, or another drug
blocking the action of that substance without producing any physiologic effect itself.
Blocking Agent

Key Terms
Adrenergic

Sympathetic NS

Cholenergic

Parasympathiometic application

Dopaminergic

Dopamine involvement in CNS regulation

Key Terms
Alpha = vasoconstriction
Beta = muscle activity
B1 = myocardium = contraction, HR
B2 = bronchial & vascular smooth muscles = bronchial relaxation and arterial dilation to
skeletal muscles
Chronotrope
Affects rate
Inotrope
Affects force of muscular contraction by activating beta cells
Cardiovascular Applications
Adrenergic Effects
Sympathetic NS - agent that acts like epinephrine
Produces:
Vasoconstriction
HR, BP, CO
Blocking agents
peripheral vasodilation
HR, B/P

Specific Drugs Imparting Adrenergic Effects

Alpha Agents
Alpha = vasoconstriction
Alpha adrenergic agonist

Norepinephrine (levophed)
Action = B/P, work of heart

Blocking agent - competes with catecholamines at peripheral autonomic receptor sites

Regitine = dilation of arteries and veins

Treat dopamine infiltration sites (see tissue necrosis)

Side effect = orthostatic hypotension

Beta Adrenergic Agents
Dobutamine or Dopamine (5 10 mcg)

force of contraction, heart rate

Conditions: shock, CHF, sepsis

Beta adrenergic antagonist - beta blockers (propanolol, labetalol)

HR, force of contraction

Conditions: AMI, HPT

Calcium Channel Blockers

Calcium enhances muscle depolarization ( resting potential)
calcium = b/p, arrhythmias, angina, migraines
Ca+ = B/P, rest
Example:
Verapamil
Cardiazem
Ace Inhibitors
Reduce arterial pressure by preventing generation of angiotensin II from angiotensin I
Angiotensin II = potent vasoconstrictor
Causes: B/P, water retention (aldosterone)
Ace Inhibitors: (I.e. captopril, enalapril, lisinopril)

B/P
renal perfusion

Angiotensin II Inhibitors
Block the binding of angiotensin II to specific tissue receptors in vascular smooth muscle &
adrenal glands
Produces:
B/P

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Example

Losartin

(cozaar)
CNS & Drugs

Cholinergic Effects
Parasympathetic nervous system

Acetylcholine (ACh) is primary neurotransmitter

Nicotinic receptors: HR, B/P, peripheral vasoconstriction

Muscarinic receptors: gastric motility, gastric acid & salivary secretion
Conditions treated

Alzheimers, Parkinsons dx, motion sickness, PUD, IBS, visual disorders, urinary retention

Direct Acting Cholinergics

Structurally similar to Ach
Example:

Urecholine

Treats postoperative or postpartum urine retention

Causes contraction and emptying of bladder
Side effects
Abdominal cramps
Salivation
N/v & diarrhea

Cholinesterase Inhibitor (colinergic)

Elevates acetycholine concentrations in cerebral cortex by slowing degradation by
cholinesterase
Elevated levels of ACh slows the neuronal degradation seen in Alzhiemers.
Example:

Aricept (donepezil)

Side effects: abdominal pain, diarrhea, GI bleed

Anticholinergics
Reverse cholinergic (parasympathetic) effects
Blocks ACh at receptor sites in smooth muscles, secretory glands, SA & AV nodes & cardiac
muscle
Example

Scopolamine motion sickness

Atropine

Treatment for bradycardia, excess secretions (preop)

Dopaminergic Drugs
Dopamine is a CNS neurotransmitter

Action

Inhibits excitatory signals produced by ACh

dopamine produces cholinergic activity

Tremors (pill rolling)

Rigidity (involuntary contraction of muscles)
Bradykinesia general slownes
Akinesia loss of voluntary movement

Parkinsons Disease
Extensive deterioration of neurons at basal ganglia see dopamine levels
Combo therapy
Dopaminergic Drugs
Levodopa
Precursor to dopamine
Anticholinergic Drugs
Cogentin
Artane
Pain and More Pain
Opioids - analgesics
Tx moderate to severe pain by crossing blood brain barrier
Effects:
CNS - LOC
Respiratory depression
Cardiovascular
Orthostatic hypotension
GI - GI muscle tone
GU urinary retention
Opioid Terms
Opioid agonist
Produce maximal response (schedule II drugs)
Examples: codeine, morphine, demerol, oxycodone
Opioid agonist-antagonist
Activate opioid receptor without causing respiratory depression
Example: stadol, nubain, talwin
Opioid antagonist
Blocks or reverses opioid effect
Example: naloxone (narcan)

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Cox 2 Inhibitors
Blocks prostaglandins that arise from the cyclooxygenase (COX) metabolic pathway
A non-steroidal drug to treat arthritic pain
Cautions with Cox 2 & NSAIDS

GI bleed
Renal failure
Asthma reaction

Blood and Drugs

Coagulation Terms
Anticoagulation
Hinder future clot formation by inhibiting conversion of prothrombin to thrombin (heparin or
lovenox) or reducing amount of vitamin K (coumadin)
Antiplatelet
Prevents production of TXA2 causes platelet aggregation and vessel constriction (I.e.
ASA, plavix)
Thrombolytic
Dissolves thrombi after formation (I.e. TPA, retavase)
Used in combo with anticoagulants
More COAG Terms
Glycoprotein IIB/IIA Inhibitors

Inhibits platelet aggregation

Used as adjunct with ASA and heparin to decrease clot formation, especially during invasive
procedures (cath)

Given IV follow up via PO med (plavix) with similar action

Example: Reopro, Integrilin, Aggrastatin
GI & Drugs

H-2 Blockers
Blocks release of histamine, esp w/stress
Histamine stimulates gastric acid secretion
Use:
Stress ulcers
Allergic reactions
Examples
Ranitidine (zantac)
Famotidine (pepcid)

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Proton Pump Inhibitors
Suppress gastric acid secretion by irreversibly binding with proton-pump system that controls
hydrogen ion secretion
Use on high risk patients (expensive in IV form!!)

Vented patients >24 hours

Thrombocytopenic

Example

Prevacid
Prolosec
Drugs Influencing
the Respiratory System

Corticosteroids
Anti-inflammatory effect reduced mucus secretion in respiratory conditions
Uses:

Asthma, COPD, SCI

Example: flovent, solumedrol, azmacort, decadron

Side Effects

Mask Infections
Hyperglycemia
Slow wound healing

Beta Agonists
Relieve bronchoconstriction
Uses

Short term tx acute exacerbations

Long term control symptoms, especially nocturnal

Examples: alupent, serevent, proventil

Side effects

Tachycardia, headache, angina, muscle tremors

This material is based upon work supported by the Ohio Learning Network.
Any opinions, findings, and conclusions or recommendations in this material
are those of the author and do no necessarily reflect the views of the Ohio
Learning Network.
This material was developed by Dr. Gina Maiocco while employed on the faculty
of the Wright State University-Miami Valley College of Nursing and Health
during the 2004-2005 academic year.