List the effects of Alpha 1 Adrenergic receptors.
 Eye - pupil dilation
 Blood vessels - vasoconstriction
(increased BP)
 Bladder - bladder relaxes (less pressure
= less need to pee); constriction of
bladder sphincter
List the effects of Beta 1 Adrenergic receptors.
 Heart - increased heart rate to pump
more blood, increased conduction
through AV node, increased force of
contraction
Kidney - secretes renin to retain water
List the effects of Beta 2 Adrenergic receptors.
 Smooth muscle of lungs –
bronchodilation
What are the other names for Adrenergic
drugs?
 Adrenergic agonists &
Sympathomimetics (because they
mimic the SNS)
Direct-acting sympathomimetic vs. Indirect
acting sympathomimetic
 Direct-acting = binds directly onto the
specific receptor to cause a response
Indirect-acting = stimulates the
presynaptic neuron to release
neurotransmitters, which then bind to
the specific receptor to cause a
response
What is Anaphylaxis and how is it treated?
 Sever allergic reaction that leads to
shock, decreased BP, increased heart
rate, and bronchoconstriction.
 Managed with EpiPen that injects
epinephrine and stimulates all
adrenergic receptors; only lasts 10-
20mins so must go to hospital still!
What are Beta-Adrenergic Adverse Effects?
 CNS - tremors, headaches,
nervousness, dizziness
 Cardiovascular - Palpitations,
tachycardia, dysrhythmia, angina
 Other - sweating, nausea, vomiting,
muscle cramps
What are Alpha 1 Adrenergic Adverse Effects?
 CNS - headache, restlessness,
excitement
 Cardiovascular - Palpitations,
tachycardia, hypertension,
dysrhythmias
Other - necrosis (death of cells in
tissue/organ) if IV infiltrates
Patient Education for Adrenergic Drugs
 Do NOT stop abruptly
All other medications require
prescriber's approval due to high risk of
bad interactions
Mechanism of action and adverse effects for
Alpha-Blockers (Flomax).
 Decreased vasoconstriction &
decreased prostatic capsule
contraction (decreased
resistance to urinary flow).
Adverse Effects: dizziness, first dose syncope,
orthostatic hypotension, impotence.
Effects of Beta-blockers (atenolol/metoprolol)
and adverse effects.
 Decreased demand for myocardial
oxygen (decreased angina).
Decreased heart rate.
Decreased force of contraction (lowers
hypertension).
Adverse effects = bradycardia, rebound
myocardium excitation (BLACKBOX),
bronchoconstriction, hypoglycemia.
Nursing implications/Patient education for
Beta-Blockers.
  Assess pulse/BP before giving
meds; do not give if patient
already has bradycardia (below
60).
Avoid hot tubs to prevent hypotension
and passing out.
Change positions slowly due to decreased BP.
Mechanism of action of Cholinergic Drugs and
other names for them.
 Stimulate parasympathetic
nervous system by mimicking
acetylcholine (ACh).
Also known as Cholinergic agonists &
Parasympathomimetics.
Direct-acting Cholinergics vs. Indirect-acting
Cholinergics.
 Direct-acting = bind directly to
cholinergic receptors.
Indirect-acting = increases available ACh by
inhibiting acetylcholinesterase enzyme.
Effects of Cholinergic Drugs.
 Increased gastric secretions
Relaxation of bladder sphincter
Pupil constriction
Decreased heart rate/force of
contraction
Bronchoconstriction
Sweating
Indications to use Cholinergic Drug:
Bethanechol
 Post-Op Urinary Retention =
causes contraction of bladder
detrusor muscle and relaxation
of bladder sphincter.
What happens during Cholinergic poisoning?
 S.L.U.D.G.E - salivation,
lacrimation, urinary
incontinence, diarrhea, GI
cramps, Emesis (vomiting)
What happens during a Cholinergic Crisis? What
is the antidote?
 Bronchoconstriction (shortness of
breath), hypotension, cardiac
arrest (bradycardia); Atropine
(anticholinergic)
Mechanism of action of Anticholinergic Drugs
(atropine, tolterodine).
 Block/inhibit the actions of
acetylcholine by blocking the
muscarinic receptors in the
PSNS; blocks cholinergic effect
Effects of Anticholinergic Drugs.
 Dilated pupils
Increased heart rate
Bronchodilation/decreased
bronchial secretions
Relaxed bladder
Decreased sweating
Indications to use Anticholinergic Drugs:
Atropine/Tolterodine
 Symptomatic Bradycardia
Overactive Bladder
Adverse Effects of Anticholinergic Drugs.
 Dilated pupils, tachycardia,
dysrhythmias, constipation,
decreased sweating
What is the antidote for atropine
(anticholinergic) overdose?
 Physostigmine