ADRENERGIC BLOCKER UNIT 4 Flashcards
What does Adrenergic blockers do to Alpha 1, Beta 1 and Beta 2
alpha 1
Vasodilation: decreases blood pressure; reflex tachycardia might result; mydriasis (constriction of pupil) occurs; suppresses ejaculation; reduces contraction of smooth muscle in bladder neck and prostate gland
beta 1
Decreases heart rate; reduces force of contractions
beta 2
Constricts bronchioles; contracts uterus; inhibits glycogenolysis, which can decrease blood glucose
Which of the following drugs is an Adrenergic Blocker
A. Albuterol
B. Benztropine
C. Atenolol
D. Norepinephrine
C. Atenolol is a Beta1-adrenergic blocker
What is the action of Adrenergic Blockers?
Action
* Block the alpha1 receptor sites – will come up later in quarter
* Results in vasodilation, decreased blood pressure, pupil constriction, reduces
contraction of the smooth muscle in the bladder neck and prostate
Action
* Beta 1 Blocker
* Blocks beta adrenergic receptor sites
* Decreases movement of epinephrine
* Suppresses renin-angiotensin-aldosterone system
- Beta2
- Bronchoconstriction
- Contracts uterus
- Inhibits glycogenolysis
- Leads to hypoglycemia
What is Adrenergic Blockers used to treat
- Use
- Antihypertensive
- Benign prostatic hypertrophy (BPH)
- Reynaud’s disease
- All drugs in this class end in ‘sin’- these drugs works mainly on the vessels
What is a subclass of Adrenergic blockers>?
A. Anti- Parkinsonism
B. Valproic
C. Cox stimulater
D. Beta Blockers
D. Beta Blockers
Beta Blockers selective and non-selective and use
Uses
* Antihypertensive
* Angina
* Heart failure
* Dysrhythmias
* Drugs in this class end in ‘olol’ – these drugs work on the heart and vessels
- Selective versus non-selective
- Drug starts with A-M more selective to beta 1
- Drug starts with N-Z non-selective and blocks beta 1 and beta 2
Side effects of beta blockers- ATENOLOL
Drowsiness, dizziness, headache, depression, fatigue, nausea, diarrhea, edema, cool extremities, erectile dysfunction
Adverse effects of beta blockers- ATENOLOL
Bradycardia, tachycardia, hypotension, chest pain, heart failure, dyspnea
Life threatening: Bronchospasm, renal failure, dysrhythmia, thrombocytopenia
Containdications of Adrenergic Blockers – Beta Blockers
‘olol’s
Adrenergic Blockers – Beta Blockers
‘olol’s
* Contraindications
* Heart block, bradycardia
* Asthma (unless selective beta 1 – these begin with letters A-M as a rule –
atenolol. These are safer than non-selective)
* Pregnancy
* Caution
* Renal dysfunction
* Diabetes
* Interactions
* Decreased effect with NSAIDS
* Increased effect with other antihypertensives and antidysrhythmics
* Increased risk of hypoglycemia with insulin and sulfonylureas and masks the
symptoms
Caution: Renal dysfunction, diabetes mellitus, bronchospasm, myasthenia gravis, pheochromocytoma
Nursing Intervention - Atenolol
Adrenergic Blockers – Beta Blockers
‘olol’s
* Interventions
* Monitor vital signs – report marked changes in blood pressure or
pulse below 60
* Report bothersome side effects that don’t improve such as
dizziness, lightheadedness, stuffy nose, or depression
* Provide for safety – orthostatic hypotension
Patient teaching Atenolol
Adrenergic Blockers – Beta Blockers
‘olol’s
* Teaching
* Take medication at the same time every day
* Therapeutic effect can take several weeks
* Patient to monitor their blood pressure and pulse and record
* Get up slowly to help prevent orthostatic hypotension
* To side effects/adverse reactions to report
* Do not drive until response to drug is known
Evaluation Atenolol
Adrenergic Blockers – Beta Blockers
‘olol’s
* Evaluation
* Blood pressure decrease
* Pulse decrease
* Side effects managed
- A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug will be the safest to give this patient?
a. Pindolol (Visken)
b. Metoprolol (Lopressor)
c. Nadolol (Corgard)
d. Propranolol (Inderal)
ANS: B
Metoprolol is a cardioselective adrenergic blocker that has a greater affinity for receptors that decrease heart rate and blood pressure and is less likely to cause bronchospasm. The other adrenergic blockers are not selective and can cause bronchoconstriction.
- The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication?
a. The drug must be taken twice daily.
b. The patient must rise slowly from a chair or bed.
c. The medication is safe to take during pregnancy.
d. Use NSAIDs as needed for mild to moderate pain.
b. The patient must rise slowly from a chair or bed.
ANS: B
The side effects commonly associated with beta blockers include bradycardia, hypotension, and dizziness. Patients should be instructed to use caution when rising from a sitting or lying position to avoid orthostatic hypotension. Atenolol may be taken once daily. Atenolol is contraindicated in the pregnant patient. NSAIDs decrease the effects of beta blockers and should be avoided.
- The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do?
a. Hold the next dose until the provider can be notified of these side effects.
b. Reassure the patient that these symptoms are common and not worrisome.
c. Recommend that the patienNt discuss these effects with the provider.
d. Suggest that the patient request a different beta-adrenergic blocker.
ANS: C
Beta-adrenergic blockers can cause these side effects, which are often dose related. Patients experiencing these side effects should be encouraged to discuss them with their providers. Beta blockers should not be discontinued abruptly, or rebound symptoms may occur. Since symptoms may be dose related, reassuring the patient is not correct. All beta blockers have similar side effects.
