Adrenergic and Anti-Adrenergic

Question 1

adrenergic receptors

Answer 1

• alpha: extremities (arms, legs); peripheral vasodilation
• beta1: cardiac (increased chronotropic, inotropic, dromotropic)
  beta2: lungs (bronchodilatation)

Question 2

catecholamines (fx, types)

Answer 2

• produce adrenergic response (mimic SNS)
• endogenous: epinephrine (adrenalin)
• exogenous: isoproterenol (isuprel)

Question 3

catecholamines: clinical uses

Answer 3

• cardiac arrest
• hypotension
• shock
• bronchial asthma
• obstructive pulmonary disease
• • IV not PO, metab. too quickly

Question 4

non-catecholamines (fx, use)

Answer 4

(ephedrine)
similar to catecholamines, effects last longer
* taken PO or inhaler, OTC is dangerous due to drug interactions

Question 5

Adrenergic: ADE

Answer 5

(epinephrine)

• tachycardia, arrhythmias
• angina, CAD (make heart work harder)
• hypertension
• cerebral vascular disease

Question 6

use adrenergic cautiously in patients with…

Answer 6

• anxiety, insomnia, psych disorders, elderly

Question 7

nursing assessments: adrenergics/cat/non-cat

Answer 7

• diabetes: raise blood sugar
• IV site (cat): if it comes out in surrounding tissue will cause severe vasoconstriction and damage tissue
• resp and cardiovascular assessment: before, after, and during meds so able to compare

Question 8

adrenergic: patient teaching

Answer 8

• use as directed: tolerance/toxic/rebound
• anxiety
• chest pain (get immediate help)
• use of epi-pen
• other meds?

Question 9

adrenergics: fx and NT

Answer 9

• mimic SNS (sympathomimetic)

- NT = norepinephrine

Question 10

adrenergic blockers: fx

Answer 10

• inhibit SNS; decrease flight/fight response

- used to suppress abnormal, not the normal physiological response

Question 11

alpha adrenergic blocker

Answer 11

(prazosin - minipress)
- used in skin/kidneys: 
-- vasodilatation will decrease BP and increase peripheral flow
(compensatory mechanism may increase HR)
-- improved UA flow

Question 12

alpha blocker: clinical use

Answer 12

• hypertension (not first line drug)
• frostbite
• prevent necrosis from IV extravasation (vasodilate locally)
• tx benign prostatic hypertrophy (BPH): to increase urine flow

Question 13

ADE: alpha blocker

Answer 13

serious: first dose syncope or phenomenon; can bottom out BP - give before bed when laying down

Question 14

alpha blocker contraindication

Answer 14

• hypotension with tachy, angina, MI, CVA

Question 15

beta blockers

Answer 15

(propanolol - inderal)

• decrease cardiac fxs
• lower BP
• bronchoconstriction
• decrease blood sugar (less effective metab of glucose
• weakness, insomnia

Question 16

beta blocker: clinical use

Answer 16

• hypertension , angina, MI, tachy/arrhythmia
• glaucoma
• migrains
• palpitations/tremors/anxiety (stage fright)
• tumor of adrenal gland (pheochromocytoma)

Question 17

ADE: beta blockers

Answer 17

• common: hypotension, brady cardia, congestive heart failure
• serious: brochoconstriction; heart block (A/V not pumping together)

Question 18

interventions for beta blockers

Answer 18

• monitor BP, HR, periph circ
• no alcohol (more vasodil)
• with food (GI irritation)
• • wean off beta blockers, can rebound (high BP, HR)