Adrenergic Agonists and Blockers Flashcards
Adrenergic Agonists affect the
sympathetic nervous system (fight or flight)
What effects do adrenergic agonists have on the body?
- Mydriasis
- Bronchodialysis
- Increased HR
- Vasoconstriction
- Relaxation of the bladder
- decreased motility of GI
- Relaxation of the Uterus
- fluid retention
- Relaxation of the Uterus
- decreased contraction
Beta1 receptors are located primarily in the
- heart
Stimulation of the Beta1 receptors cause
- increased cardiac contractility (P)
- increased renin secretion (inc. BP and vasoconstriction)
Beta2 receptors are found mostly in
smooth muscles of the
- lungs
- GI tract
- uterine muscle
Stimulation of the Beta2 receptors results in
- bronchodilation
- decreases GI motility and tone (constipation)
- increases blood flow to skeletal muscles
- decreases uterine tone (urine rtn.)
- activates liver glycogenolysis (inc. serum blood glucose)
What are the effects of dopaminergic receptor sites?
- vasodilation
- increases blood flow
What classification is Epinephrine (adrenalin)?
Non-selective: works on ALL receptor sites
primarily alpha1, beta1, and beta2
What is the action/effect of epinephrine
- alpha1 increases blood pressure, contractility (inotropic.)
- beta1 increases HR (vasoconstriction)
- beta2 promotes bronchodilation
What are the contraindications for epinephrine
- cardiac dysrhythmias
- hypertension
- hyperthyroidism
- pregnancy
- closed angle glaucoma
- shock
What are some uses of epinephrine
- anaphylaxis, anaphylactic shock
- bronchospasms
- cardiogenic shock, cardiac arrest
What are the side effects/adverse reactions of epinephrine?
- cardiac dysrhythmias
- flushing
- reflex tachycardia
- IOP
- decreased renal perfusion
- due to vasoconstriction
- HA, anxiety, fear, palpatations,
What types of drugs interact with epinephrine?
- beta-blockers
- decreases epinephrine action
- digoxin
- causes cardiac dysrhythmias
What are the nursing interventions for epinephrine?
- Never give orally
- Monitor BP, P, and urine output
- Report tachycardia, palpitations, tremors, dizziness, hypertension
- Monitor IV site for infiltration
- Avoid cold medications and diet pills if hypertensive, diabetic, CAD, or dysrhythmias
- Avoid adrenergics when nursing infants
- Avoid continuous use of adrenergic nasal sprays
What classification is albuterol
Selective
Acts on beta2 adrenergic receptors
promotes bronchodilation
Alpha1 receptors cause
- increased cardiac contractility
- vasoconstriction
- dilated pupils - mydriasis
- decreased salivary gland secretion
- increased bladder relaxation and urinary sphincter
Alpha2 receptors cause
- inhibit norepinephrine release (vasodilation)
- decreased GI motility and tone
For what is albuterol used?
Treat bronchospasm, asthma, bronchitis, COPD
Albuterol can be used cautiously with
- Severe cardiac disease
- Hypertension
- Hyperthyroidism
- Diabetes mellitus
- Pregnancy
Albuterol can be given by which routes?
- orally
- inhalation
- Nebulizer is by far the fastest route of admin
Epinephrine can be administered by what routes?
- Subq
- IV
- Topically
- Inhalation
- Intercardiac
- Instillation
Side effects/ adverse reactions of albuterol include
- Tremors
- nervousness
- restlessness
- dizziness
- reflex tachycardia
- hallucinations
- cardiac dysrhthmias
What is the effect of alpha1 adrenergic blockers?
- Vasodilation
- decreased BP
- pupil constriction (miosis)
- reflex tachycardia
- suppresses ejaculation
- reduces contraction of smooth muscles in bladder neck and prostate.
What is the effect of beta1 blockers
- Reduces cardiac contractility
- Decreases pulse
What is the effect of beta2 blockers
- Bronchoconstriction
- Contracts uterus
- Inhibits glycogenolysis
What are the uses of alpha blockers?
- Decrease symptoms of
- BPH - benign prostatic hypertrophy
- Terazosin
- PVD - peripheral vascular disease
- BPH - benign prostatic hypertrophy
What are the uses for beta blockers?
- Hypertension
- Angina pectoris
- HF
- MI
Contraindications for beta blockers include
- COPD
- asthma
- 2nd and 3rd degree heart block
Side effects of nonselective beta-blockers include
- bronchoconstriction
- weight gain
- impotence
- decreased libido
- reversible alopecia
Side effects of selective beta blockers include
- Bradycardia
- Hypotension
- fainting
- fatigue
- mental depression
- etc - see slide 20
What assessments should be done before administering adrenergic agonists?
- Baseline VS
- Complete Drug Hx
- Determine Health Hx
- contraindications
- cardiac dysrhythmias
- narrow-angle glaucoma
- cardiogenic shock
- contraindications
- Determine baseline glucose level
What are some nursing interventions and teaching for adrenergic agonists
- Monitor IV sites for extravasation
- Monitor ECG
- Monitor I&O
- Avoid use with OTC cold and diet pills with hypertension and DM
- Avoid continuous use of nasal sprays - rebound nasal congestion
- Do Not Stop use abruptly
- Report side effects
- rapid HR, palpitations, Irregular HB
- rash, itching, flushing
- chest pain
- numbness of fingers and toes
What are some assessments that should be done before administering adrenergic blockers
- Baseline VS and ECG
- Report if pt taking diuretics, NSAIDs, digoxin, MAOIs, or CNS depressants
- Health Hx
- Depression
- peptic ulcer
- heart failure
What are some nursing interventions and patient teaching for adrenergic neuron blockers?
- Monitor VS (teach)
- Report excessive dizziness, lightheadedness, early morning insomnia, mental depression or chest pain
- Assist with ambulation
- Note complaints of stuffy nose
- Adhere to drug regimen
- Teach to rise slowly
- Inform of possible mood changes
- May cause impotence/decreased libido
- Do not drive before effects are known
What is the drug class and mechanism of action for propranolol?
- beta-adrenergic blocker
- acts on beta1 and beta2 receptors
For what is propranolol used
- Hypertension
- dysrhythmia
- angina pectoris
- Prevention of migraine and MI
What is the route of administration for propranolol?
PO
What are the drug class and mechanism of action for metoprolol?
- beta-adrenergic blocker
- acts on the beta1 receptor
For what is metoprolol used to treat?
- Hypertension
- Heart Failure
What is the route of administration for metoprolol?
PO - hypertension
IV - MI
What are the drug class and mechanism of action for atenolol?
- Beta-adrenergic blockers
- Acts on beta1 receptors
For what is atenolol used to treat?
- Hypertension
- angina
- MI
- HF
What is the route of administration for atenolol?
PO
What are the drug class and action of terazosin?
- Alpha-adrenergic blocker
- acts on alpha1 receptors
For what is terazosin used to treat?
- Hypertension
- BPH - benign prostatic hypertrophy
