Key Terms

 Agonist
Pharmacology Introduction
This material was developed by Gina Maiocco, PhD, RN, CCRN, CCNS, while
she was faculty in the Wright State University-Miami Valley College of Nursing
and Health.
This material is based upon work supported by the Ohio Learning Network.
Any opinions, findings and conclusions or recommendations expressed in this
material are those of the author and do not necessarily reflect the views of the
Ohio Learning Network.
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 Key Terms

 Adrenergic
Sympathetic NS-mimics the “fight or flight” response
selectively stimulating alpha & beta adrenergic receptors
Includes vasoconstrictors (Norepinephrine) & Inotropes
(Dopamine & Dobutrex)
 Dopaminergic
Dopamine involvement in CNS regulation, having a major
effect on the akinesia of Parkinson’s (Sinemet & Levodopa)
 Cholinergic Drugs- Parasympathiometic application-
ex: Urecholine to promote muscle contraction &
bladder emptying treating urinary retention
 Anticholinergic Drugs- Inhibit the response to
acetylcholine-ex: Ditropan/ Detrol to relax the detrusor
muscle & internal sphincter muscle contraction
increases the bladder capacity of pt’s with a spastic
bladder

Key Terms Cardiovascular Applications

 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

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Adrenergic Effects
Specific Drugs with Adrenergic
 Sympathetic NS - agent Effects
that acts like epinephrine
 Produces:
Vasoconstriction
 HR, BP, CO
 Blocking agents
peripheral vasodilation
 HR, B/P

Alpha Agents Beta Adrenergic Agents

 Alpha = vasoconstriction  Dobutamine or Dopamine (5 –10 mcg)
 Alpha adrenergic agonist  force of contraction,  heart rate
Norepinephrine (levophed) Conditions: shock, CHF, sepsis
Action =  B/P, work of heart  Beta adrenergic antagonist - beta blockers
 Blocking agent - competes with catecholamines (propanolol, labetalol)
at peripheral autonomic receptor sites
 HR, force of contraction
Regitine = dilation of arteries and veins
– Treat dopamine infiltration sites (see tissue necrosis)
Conditions: AMI, HPT
Side effect = orthostatic hypotension

Calcium Channel Blockers Ace Inhibitors

 Calcium enhances
muscle depolarization
( resting potential)
 calcium =  b/p,
arrhythmias, angina,
migraines
  Ca+ = B/P,  rest
 Example:
Verapamil
Cardiazem
 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

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Angiotensin II Inhibitors CNS & Drugs
 Block the binding of
angiotensin II to specific
tissue receptors in
vascular smooth muscle
& adrenal glands
 Produces:
 B/P
 Example
Losartin (cozaar)

Cholinergic Effects Direct Acting Cholinergics

 Parasympathetic nervous system  Structurally similar to Acetylcholine
Acetylcholine (ACh) is primary neurotransmitter  Example:
– Nicotinic receptors: HR, B/P, peripheral vasoconstriction Urecholine
– Muscarinic receptors: gastric motility, gastric acid & – Treats postoperative or postpartum urine retention
salivary secretion
– Causes contraction and emptying of bladder
 Conditions treated – Side effects
Alzheimers, Parkinson’s dx, motion sickness, PUD,  Abdominal cramps
IBS, visual disorders, urinary retention  Salivation
 N/v & diarrhea

Cholinesterase Inhibitor
(colinergic) Anticholinergics
 Elevates acetycholine concentrations in cerebral  Reverse cholinergic (parasympathetic) effects
cortex by slowing degradation by cholinesterase  Blocks ACh at receptor sites in smooth muscles,
 Elevated levels of ACh slows the neuronal secretory glands, SA & AV nodes & cardiac muscle
degradation seen in Alzhiemer’s.  Example
 Example: Scopolamine – motion sickness
Aricept (donepezil) Atropine
– Side effects: abdominal pain, diarrhea, GI bleed – Treatment for bradycardia, excess secretions (preop)

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Dopaminergic Drugs Parkinson’s Disease
 Extensive deterioration of
 Dopamine is a CNS neurotransmitter neurons at basal ganglia –
 Action see ↓ dopamine levels
Inhibits excitatory signals produced by ACh  Combo therapy

 dopamine produces cholinergic activity Dopaminergic Drugs

– Levodopa
Tremors (pill rolling)  Precursor to dopamine
Rigidity (involuntary contraction of muscles) Anticholinergic Drugs
Bradykinesia – general slowness – Cogentin
– Artane
Akinesia – loss of voluntary movement

Pain Management 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 Cox 2 Inhibitors

 Opioid agonist  Blocks prostaglandins that arise from the
Produce maximal response (schedule II drugs)
cyclooxygenase (COX) metabolic pathway
Examples: codeine, morphine, demerol, oxycodone
 Opioid agonist-antagonist  A non-steroidal drug to treat arthritic pain
Activate opioid receptor without causing respiratory  Cautions with Cox 2 & NSAIDS
depression
Example: stadol, nubain, talwin
GI bleed
 Opioid antagonist Renal failure
Blocks or reverses opioid effect Asthma reaction
Example: naloxone (narcan)

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 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 GI & Drugs

 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

H-2 Blockers Proton Pump Inhibitors

 Blocks release of  Suppress gastric acid secretion by irreversibly
histamine, esp w/stress binding with proton-pump system that controls
 Histamine stimulates hydrogen ion secretion
gastric acid secretion
 Use on high risk patients (expensive in IV form!!)
 Use:
Vented patients >24 hours
Stress ulcers
Allergic reactions Thrombocytopenic
 Examples  Example
Ranitidine (zantac) Prevacid
Famotidine (pepcid) Prolosec

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 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 (inhalers)
 Side effects
Tachycardia, headache, angina, muscle tremors