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NCLEX > Adrenergic-Blocking Drugs > Flashcards

Adrenergic-Blocking Drugs Flashcards

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0
Q

Atenolol

Chemical Classification

A

Beta-Blocker, Beta1-, Beta2-blocker (high doses)

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1
Q

Atenolol

Functional Classification

A

Antihypertensive, antianginal

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2
Q

Atenolol

Mechanism of Action

A

Competitively blocks stimulation of Beta-adrenergic receptor within vascular smooth muscle; produces negative chronotropic activity (decreases rate of SA node discharge, increases recovery time), slows conduction of AV node, decreases heart rate, negative inotropic activity decreases O2 consumption in myocardium; decreases action of renin-aldosterone-angiotensin system at high doses, inhibits Beta2 receptors in bronchial system at higher doses

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3
Q

Atenolol

Uses

A

Mild to moderate hypertension, prophylaxis of angina pectoris; suspected or known MI (IV use); MI prophylaxis

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4
Q

Atenolol

Contraindications

A

Pregnancy (D), hypersensitivity to Beta-Blockers, cardiogenic shock, 2nd- or 3rd degree heart block, sinus bradycardia, cardiac failure, Raynaud’s disease, pulmonary edema

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5
Q

Atenolol

Side Effects

A

CNS: Insomnia, Fatigue, Dizziness, Mental Changes, memory loss, hallucinations, depression, lethargy, drowsiness, strange dreams, catatonia
CV: PROFOUND HYPOTENSION, BRADYCARDIA, CHF, Cold Extremities, Postural Hypotension, 2nd or 3rd-Degree Heart Block
EENT: sore throat; dry, burning eyes; blurred vision; stuffy nose
ENDO: increased hypoglycemic response to insulin
GI: Nausea, Diarrhea, vomiting, MESENTERIC ARTERIAL THROMBOSIS, ISCHEMIC COLITIS
GU: impotence, decreased libido
HEMA: AGRANULOCYTOSIS, THROMBOCYTOPENIA PURPURA
INTEG: rash, fever, alopecia
RESP: BRONCHOSPASM, dyspnea, wheezing, pulmonary edema

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6
Q

Atenolol

Nursing Considerations

A

ASSESS:

  • I&O, weight daily; watch for CHF (rales/crackles, jugular vein distention, weight gain, edema)
  • Hypertension: BP, pulse q4hr; note rate, rhythm, quality; apical/radical pulse before administration; notify prescriber of any significant changes (<50bpm); ECG
  • Baselines in renal/hepatic studies
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7
Q

Atenolol

Overdose Treatment

A

Lavage, IV atropine for bradycardia, IV theophylline for bronchospasm, dextrose for hypoglycemia, digoxin, O2, diuretic for cardiac failure, hemodialysis

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8
Q

Esmolol

Functional Classification

A

Beta-Adrenergic Blocker (Antidysrhytmic II)

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9
Q

Esmolol

Mechanism of Action

A

Competitively blocks stimulation of Beta1-adrenergic receptors in the myocardium; produces negative chronotropic, inotropic activity (decreases rate of SA node discharge, increases recovery time), slows conduction of AV node, decreases heart rate, decreases O2 consumption in myocardium; also decreases renin-aldosterone-angiotensin system at high doses; inhibits Beta2-receptors in bronchial system at higher doses

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10
Q

Esmolol

Uses

A

Supraventricular tachycardia, noncompensatory sinus tachycardia, hypertensive crisis, intraoperative and postoperative tachycardia and hypertension

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11
Q

Esmolol

Contraindications

A

2nd or 3rd-degree heart block; cardiogenic shock, CHF, cardiac failure, hypersensitivity, severe bradycardia

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12
Q

Esmolol

Side Effects

A

CNS: confusion, lightheadedness, paresthesia, somnolence, fever, dizziness, fatigue, headache, depression, anxiety, SEIZURES
CV: hypotension, bradycardia, chest pain, peripheral ischemia,
SOB, CHF, conduction disturbances, 1st-,2nd-,3rd-degree heart block
GI: Nausea, vomiting, anorexia, gastric pain, flatulence, constipation, heartburn, bloating
GU: urinary retention, impotence, dysuria
INTEG: Induration, Inflammation at Site, discoloration, edema, erythema, burning pallor, flushing, rash, pruritus, dry skin, alopecia
RESP: BRONCHOSPASM, dyspnea, cough, wheeziness, nasal stuffiness, PULMONARY EDEMA

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13
Q

Esmolol

Nursing Considerations

A

ASSESS:

  • CHF: I&O ratio, weight daily, jugular venous distention, weight gain, crackles, edema
  • DYSRHYTHMIAS: BP, pulse q4hr; note rate, rhythm, quality; rapid changes can cause shock; if systolic <60, notify prescriber before giving product; ECG continuously during inf, hypotension common
  • Baselines in renal/hepatic studies, blood glucose before therapy begins
  • BRONCHOSPASM: breath sounds, respiratory pattern
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14
Q

Esmolol

Overdose Treatment

A

Discontinue Product

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15
Q

Metoprolol (Lopressor)

Functional Classification

A

Antihypertensive, antianginal

16
Q

Metoprolol (Lopressor)

Chemical Classification

A

Beta1-Blocker

17
Q

Metoprolol (Lopressor)

Mechanism of Action

A

Lowers BP by Beta-Blocking effects; reduces elevated renin plasma levels; blocks Beta2-adrenergic receptors in bronchial vascular smooth muscle only at high doses; negative chronotropic effect

18
Q

Metoprolol (Lopressor)

Uses

A

Mild to moderate hypertension, acute MI to reduce cardiovascular mortality, angina pectoris, NYHA class II, III heart failure

19
Q

Metoprolol (Lopressor)

Contraindications

A

Hypersensitivity to beta-blockers, cardiogenic shock, heart block (2nd, 3rd degree), sinus bradycardia, pheochromocytoma, sick sinus syndrome

20
Q

Metoprolol (Lopressor)

Side Effects

A

CNS: Insomnia, Dizziness, mental changes, hallucinations, depression, anxiety, headaches, nightmares, confusion, fatigue
CV: Hypotension, BRADYCARDIA, CHF, Palpitations, dysrhythmias, CARDIAC ARREST, AV BLOCK, PULMONARY/PERIPHERAL EDEMA, CHEST PAIN
EENT: sore throat; dry, burning eyes
GI: Nausea, Vomiting, colitis, cramps, Diarrhea, constipation, flatulence, dry mouth, Hiccups
GU: impotence
HEMA: AGRANULOCYTOSIS, EOSINOPHILIA, THROMBOCYTOPENIA, PURPURA
INTEG: rash, purpura, alopecia, dry skin, urticaria, pruritus
RESP: BRONCHOSPASM, dyspnea, wheezing

21
Q

Metoprolol (Lopressor)

Nursing Considerations

A

ASSESS:

  • ECG directly when giving IV during initial treatment
  • I&O, weight daily; check for CHF (weight gain, jugular venous distention, crackles, edema, dyspnea)
  • BP during initial treatment, periodically thereafter; pulse q4hr; note rate, rhythm, quality
  • Apical/radial pulse before administration; notify prescriber of any significant changes or pulse <50bpm
  • Baselines of renal, hepatic studies before therapy begins
  • Skin turgor, dryness of mucous membranes for hydration status
22
Q

Metoprolol (Lopressor)

Overdose Treatment

A

Lavage, IV atropine for bradycardia, IV theophylline for bronchospasm, digoxin, O2, diuretic for cardiac failure, hemodialysis, administer vasopressor

23
Q

Propranolol (Inderal)

Functional Classification

A

Antihypertensive, antianginal, antidysrhythmic (class II)

24
Q

Propranolol (Inderal)

Chemical Classification

A

Beta-Adrenergic Blocker

25
Q

Propranolol (Inderal)

Mechanism of Action

A

Nonselective Beta-Blocker with negative inotropic, chronotropic, dromotropic properties

26
Q

Propranolol (Inderal)

Uses

A

Chronic stable angina pectoris, hypertension, supraventricular dysrhythmias, migraine prophylaxis, pheochromocytoma, cyanotic spells related to hypertrophic subaortic stenosis

27
Q

Propranolol (Inderal)

Contraindication

A

Hypersensitivity to this product; cardiogenic shock, AV heart block; bronchospastic disease; sinus bradycardia; bronchospasm; asthma

28
Q

Propranolol (Inderal)

Side Effects

A

CNS: depression, hallucinations, dizziness, Fatigue, lethargy, paresthesias, bizarre dreams, disorientation
CV: BRADYCARDIA, hypotension, CHF, palpitations, AV block, peripheral vascular insufficiency, vasodilation, cold extremities, PULMONARY EDEMA, DYSRHYTHMIAS
EENT: sore throat, LARYNGOSPASM, blurred vision, dry eyes
GI: nausea, vomiting, diarrhea, colitis, constipation, cramps, dry mouth, hepatomegaly, gastric pain, acute pancreatitis
GU: impotence, decreased libido, UTIs
HEMA: AGRANULOCYTOSIS, THROMBOCYTOPENIA
INTEG: rash, pruritus, fever
META: hyperglycemia, hypoglycemia
MISC: facial swelling, weight change, Raynaud’s phenomenon
MS: joint pain, arthralgia, muscle cramps, pain
RESP: dyspnea, respiratory dysfunction, Bronchospasm, cough

29
Q

Propranolol (Inderal)

Nursing Considerations

A

ASSESS:

  • ABRUPT WITHDRAWAL: taper over a few weeks, do not discontinue abruptly; dysrhythmias, angina, myocardial ischemia, or MI may occur, taper over 2 wk
  • BP, pulse, respirations during beginning therapy; notify prescriber if pulse 5lb
  • I&O ratio, CCR if kidney damage is diagnosed; fatigue, weight gain, jugular distention, dyspnea, peripheral edema, crackles

NCLEX (40 decks)

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