Adrenergic Agents

Question 1

Alpha1 adrenergic Antagonist Action

Answer 1

• Blocks the sympathetic nervous system action on arterioles and veins resulting in vasodilation
• Also, causes relaxation of smooth muscles in bladder neck and prostatic capsule (BPH)

Question 2

Alpha1 adrenergic Antagonist Prototype

Answer 2

prazosin (Minipress)

Question 3

SE: Prazosin

Answer 3

-Orthostatic hypotension
- 1st dose phenomenon ( don’t get up fro 3 hours)
-reflex tachycardia
-nasal congestion
-inhibits ejaculation
NOT a 1st line therapy and not used alone

Question 4

Alpha2 adrenergic Agonist

Answer 4

• Centrally acting on alpha2- adrenergic receptors in the brain
• Unique in that receptor stimulation reduced sympathetic outflow to heart and blood vessels
• Acts on pre-synaptic not post-synaptic
• Vasodilation and decreased cardiac output

Question 5

Alpha 2 Adrenergic Agonist Prototype:

Answer 5

Clonidine (Catapres)

Question 6

SE Clonidine:

Answer 6

• Dry mouth and sedation

- rebound HTN

Question 7

USE and dosage

Answer 7

dosing: pill and patch (changed every 7 days)
Used in severe HTN management (PRN orders)
-Can be abused

Question 8

Beta Blockers 2 types

Answer 8

Cardioselective (Beta1)
NON-selective (Beta1 and Beta 2)
- decreases HR (neg chronotrope)
-SLows conduction through myocardium (NEg dromotriope)
- Decreases force of contraction (NEg ionotrope)
Other actions: decreases peripheral vascualr resistance over time and block beta1 juxtaglomerular cells that release renin.

Question 9

Adrenergic Blockers: Beta Blockers

Answer 9

Prototype: “lols”

Metoprolol (Lopressor, Topol XL)

Question 10

Side Effects off Beta Blockers :

Answer 10

• Brady Cardia, AV heart blcok
• decreased co : watch for s/s of HF
• Rebound cardiac excitation
• May mask SNS s/s of hypoglycemia in diabetics
• Nonselective BB- can actuallly cause hypoglycemia
• Common SE: fatigue, drowsy, dizzy, HA sexual dysfunction, depression

Question 11

Nursing Considerations for beta blockers

Answer 11

• Check BP and Pulse before admin ( hold if apical pulse <60 BPM)
• Teach pt not to stop suddenly –> wean off medication
• Teach diabetics to monitor for bld sugar more closely and look for other signs of hypoglycemia
• Watch for s/s of HF (edema, wt gain, SOB)

Question 12

Alpha/ Beta Blockers

Answer 12

• Blocks alpha1, beta1, and beta2 receptors

Question 13

Prototype: Alpha/Beta Blocker

Answer 13

Carvedilol (Coreg)

Question 14

Action of Carvedilol

Answer 14

• alpha blockade: Dilation of arterioles and veins

- beta blockade: dec. HR, contractility and conduction

Question 15

Carvedilol SE

Answer 15

SE: bradycardia, av block, bronchoconstriction, postural hypotension