ADRENERGIC AGONIST UNIT 4

Question 1

What system does an adrenergic agonist stimulate?
A. Skeletal
B. Nervous
C Parasympathetic
D. Sympathetic

Answer 1

D. Sympathetic

Question 2

Sympathetic Nervous System

Answer 2

The sympathetic nervous system is also called the adrenergic system. Norepinephrine is the neurotransmi er that innervates smooth muscle. The adrenergic receptor organ cells are of four types: alpha1, alpha2, beta1, and beta2 (Fig. 15.3). Norepinephrine is released from the
terminal nerve ending and stimulates the cell receptors to produce a response.

Question 3

What occurs during Alpha 1

Answer 3

Increases force of heart contraction; vasoconstriction increases blood pressure; mydriasis (dilation of pupils) occurs; secretion in salivary glands decreases; urinary bladder relaxation and urinary sphincter contraction increases

Question 4

What occurs during Beta 1

Answer 4

Increases heart rate and force of contraction; increases renin secretion, which increases blood pressure

MAINLY AFFECTS HEART

Question 5

What occurs during Beta 2

Answer 5

Dilates bronchioles; promotes gastrointestinal and uterine relaxation; promotes increase in blood glucose through glycogenolysis in the liver; increases blood flow in skeletal muscles

MAINLY AFFECTS LUNGS

Question 6

What is the bodies response to Sympathetic System?

Answer 6

EYE- pupil dilation

LUNGS- dilated bronchioles

HEART- Increased heart rate

BLOOD VESSELS- vasoconstriction

GASTRO- decreased peristalsis relax

BLADDER- relaxed bladder ( urinary retention)

UTERUS- relax uterus

Question 7

Which of the following drugs is a Adrenergic Agonist?

A. Acetominophen
B. Vitamin K
C. Atenolol
D. Epinephrine

Answer 7

D. Epinephrine

Question 8

What does Epinephrine stimulate? Select All that Apply

A. Cox-1
B. Beta 1
C. Alpha 1
D. COX 2
E. Beta 2

Answer 8

C. Alpha 1. B. Beta 1. E. Beta 2

Epinephrine
* Nonselective – stimulates alpha 1, beta 1, and beta 2
* Action
* Activates the sympathetic nervous system.
* Alpha 1 increases the blood pressure
* Beta 1 increases the heart rate
* Beta 2 promotes bronchodilation

Question 9

What is Epinephrine Used to treat?

Answer 9

To treat nasal congestion,
allergic reaction,
anaphylaxis,
asthma exacerbation,
bronchospasm,
angioedema,
status asthmaticus,
cardiac arrest,
cardiac resuscitation

used to bring back a person without a heartbeat and a person who is not breathing

Question 10

Side effects of Epinephrine

Answer 10

Nausea and vomiting,
restlessness,
tremor, agitation
, sweating, headache,
pallor,
oliguria,
weakness,
dizziness,
hyperglycemia,
hypo/hyperglycemia,
paresthesia

Question 11

Mechanism of action for Epinephrene

Answer 11

Mechanism of Action: Acts on alpha and beta receptors; promotion of CNS and cardiac stimulation and bronchodilation; strengthens cardiac contraction, increases cardiac rate and cardiac output; reduces mucosal congestion by inhibiting histamine release; reverses anaphylactic reactions

Question 12

Adverse Effect of Epinephrine

Answer 12

Palpitations,
tachycardia,
hypertension,
dyspnea,
MI, renal insufficiency, injection site reaction

Life threatening:
Dysrhythmias, pulmonary edema

Question 13

Contraindications of Epinephrine

Answer 13

: Cardiac dysrhythmias, cerebrovascular disease, labor, closed-angle glaucoma, hypertension, pulmonary edema, cardiac disease, hyperthyroidism, diabetes mellitus, renal dysfunction, pregnancy.

Question 14

Interaction of Epinephrine

Answer 14

• MAOI’s tricyclic antidepressants – intensify and prolong effect
• Beta blockers – block effect
• Digoxin – can increase risk of dysrhythmia

Lab: Increased blood glucose, serum lactic acid

Question 15

Adrenergic Agonist Drugs Nursing Interventions

Answer 15

Adrenergic Agonist Drugs Nursing
Interventions
* Nursing interventions
* Monitor blood pressure, heart rate and urine output
* Monitor IV site for infiltration. Give IV push slowly (1 mg/minute)
unless in cardiac arrest
* Patient on cardiac monitor when giving IV
* Monitor for side effects/adverse reactions – report hypertension,
irregular heart rate, tachycardia
* Monitor blood glucose in diabetic patients

Question 16

Adrenergic Agonist Drugs Teaching

Answer 16

Adrenergic Agonist Drugs Teaching

Teaching
* The side effects/adverse reactions to report (palpitations)
* Avoid drugs that increase the blood pressure such as cold medication
and diet pills
* Avoid adrenergics when breastfeeding
* Nasal sprays should only be used 3-5 days
* Take medication as prescribed
* How to use inhaled drugs or drops – return demonstration

Question 17

Epi-Pen Teaching

Answer 17

Teaching
* Inform provider if Epipen is used more than twice a week
* Have Epipen with you at all times
* Do not refrigerate Epipen but store in cool, dark place
* Use Epipen at first sign of reaction
* Inspect the contents for particles and do not use if particles are pink or brown
* Inject subcutaneously in the outer thigh and hold in place for 5-10 seconds
* After administration massage the injection site
* Report side effects/adverse reactions

Question 18

1. The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect?
   a. Increased blood glucose
   b. Increased blood pressure
   c. Increased heart rate
   d. Increased gastrointestinal (GI) motility

Answer 18

ANS: A
Drugs that act on beta2 receptors activate gluconeogenesis in the liver, causing increased blood glucose. Selective beta2 drugs act on beta2 receptors only and not on beta1 receptors, so they do not cause increased blood pressure or increased heart rate. Adrenergic agonists cause decreased GI motility.

Question 19

3. The nurse administers epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect which of the following?
   a. Bradycardia
   b. Decreased urine output
   c. Hypotension
   d. Nausea and vomiting

Answer 19

b. Decreased urine output

ANS: B
Epinephrine can cause renal vasoconstriction and thereby reduce renal perfusion and decrease urinary output. Epinephrine causes tachycardia and elevates blood pressure. Nausea and vomiting are not expected to occur.