Uses: 1- Relief of respiratory distress due to bronchospasm. 2- Rapid relief of hypersensitivity reactions. 3- Cardiac arrest. 4- Open- angle glaucoma. 5- To prolong the action of anesthesia. 6- Topically to stop bleeding. Contraindications: - Narrow angle glaucoma. - Shock - Lactation. - Tachycardia - During labor (it may delay the 2 nd 8 loge do labor).
Side effects : Fatal ventricular fibrillation. Cerebral hemorrhage urinary retention, headache, necroses at injection side, blurring of vision, photophobia. Dose : Available in ampules of 1ml containing 1 mg adrenaline Can be given by I.M injection., I.V. & S.C. 0.2 – 0.5 mg, IM or S.C. + Q 20 min – 4 hr as needed. N.B. : For cardiac resuscitation 0.5 mg diluted to 10 ml with normal saline may be administered I.V. or intracrdiac to restore myocardial contractility. Nursing considerations: - Never administer 1 : 100 solution IV., use 1 : 1000 mg sol. For I.V. use. - Use tuberculine (1cc) syringe to measure adrenaline. - Administer adrenaline using piggyback set to adjust the rate of infusion. - Administer infusion by electronic infusion device for safety & accuracy. - Closely monitor patients receiving I.V. adrenaline infusion. - Note the client for signs of shock “loss of consciousness, clammy, cold skin, cyanosis…. etc.). - Briskly massage site of S.C. or I.M. injection to hasten the action of the drug. *Adrenergic blocking (sympatholytic) Agents * Beta blockers: were discussed before. Parasympathomimetic (cholinergic) Drugs - The neurohormone acetylcholine is necessary for nerve impulses transmission in the parasympathetic (cholinergic) portion of the autonomic nervous system. - The receptors of parasympathetic nervous system are classified into muscarinic type and nicotonic type. - Cholinergic drugs can be divided into 2 classes: 1- Directly acting drugs that mimic the action of acetylcholine.
2- Indirectly acting drugs that increase the concentration of acetylcholine, usually by inhibiting acetylcholinestrase. - Cholinergic drugs have the following pharmacological effects on various structures: 1- GIT : - Enhance secretion by gastric & other glands & this may cause: Belching, heartburn, nausea & vomiting. Increase smooth muscle tone & stimulate bowel movement. 3. GU system : Stimulation of ureter & relaxation of urinary bladder resulting in micturation . 4. Cardiac muscle: - Slowing heart rate (Bradycardia). - Decrease atrial contractility, impulse formation & conductivity. 5. Blood vessels : Vasodilation skin temperature & local flushing. 6. Respiration : Mucus secretion & bronchial constriction wheezing. coughing, shocking (specially in asthmatic patients). 7. Eyes : Pupillary constriction (miosis), in intraocular pressure. 8. Skin : activation of sweat & salivary glands. Drugs: 1. Pyridostigmine Bromide: Trade name: Mestinon. Class. : Indirectly acting, cholinergic – acetylcholinestrase inhibitor.
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- Summer '18
- EDQWR EDWEDF