Adrenergic Blocking Drugs Flashcards
Alpha blockers drug effects and indications
cause both arterial and venous dilation, reducing peripheral vascular resistance and BP
Used to treat HTN
Effect on receptors on prostate gland and bladder decreases resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of BPH
Used to control and prevent HTN in pts with pheochromocytoma
Adverse effects of alpha blockers
CV: palpitations, orthostatic hypotension, tachycardia, edema, chest pain
CNS: Dizziness, headache, anxiety, depression, weakness, numbness, fatigue
Alpha blockers
phenoxybenzamine HCl (Dibenzyline) phentolamine (Regitine) prazosin (Minipress) terazosin (Hytrin) alfuzosin (UroXatral) tamsulosin (Flomax)
Alpha1 blocker used to treat HTN.
Tx for HTN c/b pheochromocytoma (tumor on adrenals causing increased release of catecholamines)
Tx for extravasation of vasoconstricting drugs (i.e. epinephrine, dobutamine)- SQ injection in circular fashion around extravasation
Phentolamine (Regitine)
Indications for beta blockers
Angina- decreases demand for myocardial oxygen
Cardioprotective- inhibits stimulation from circulating catecholamines
Dysrhythmias- class II antidysrhythmic
Migrane headache-lipophilicity allows entry into CNS
Antihypertensive
Heart failure
Adverse effects of beta blockers
Blood: agranulocytosis, thrombocytopenia
CV: AV block, bradycardia, heart failure
CNS: dizziness, depression, unusual dreams, drowsiness
GI: N/V/C/D
Other: impotence, alopecia, wheezing, bronchospasm, dry mouth
Nonselective beta blockers may interfere with normal responses to hypoglycemia (tremor, tachycardia, nervousness): may mask signs of hypoglycemia. Use with caution in pts with DM.
Beta blockers
atenolol (Tenormin) carvedilol (Coreg) esmolol (Brevibloc) labetalol (Normodyne) metopropolol (Lopressor) propanolol (Inderal) sotalol (Betaspace)
Cardioselective beta blocker
PO
Prevent MI in pts with hx
Tx of HTN, angina, thrytoxicosis
Atenolol (Tenormin)
Very short-acting beta1 blocker
Acute situations to provide rapid temporary control of the ventricular rate in pts with SCT
Short half-life
Continuous IV infusion: titrated to achieve serum levels that control pts sx
Esmolol (Brevibloc)
Prototypical nonselective beta1 and beta2 blocker
PO-IVP
Shown to increase survival in pts experiencing MI
Tx for tachydysrhythmias associated with cardiac glycoside toxicity, hypertrophic sub aortic stenosis, pheochromocytoma, thyrotoxicosis, migraines
Contraindicated in pts with asthma/resp disorders
Propranolol
Beta 1 blocker
PO-IVP
Shown to increase survival in pts experiencing MI
Tx for tachydysrhythmias associated with cardiac glycoside toxicity, hypertrophic sub aortic stenosis, pheochromocytoma, thyrotoxicosis, migraines
Contraindicated in pts with ashtma/resp disorders
Metopropolol (Lopressor)
Adrenergic-blocking drugs: nursing implications
Assess for allergies and hx of COPD, hypotension, cardiac dysrhythmias, bradycardia, heart failure, or other CV problems (any preexisting condition that might be exacerbated by the use of these drugs might be a contraindication to their use). Remember that alpha blockers may precipitate hypotension. Remember that some beta blockers may precipitate bradycardia, hypotension, heart block, HF, and bronchoconstriction. Avoid OTCs because of possible interactions (possible interactions may occur with antimuscarinics/anticholingercis, diuretics and CV drugs, neuromuscular drugs, oral hypoglycemic drugs). Encourage pts to take meds as prescribed. Instruct pts that these meds should never be stopped abruptly. Inform pts to report constipation or the development of urinary hesitancy or bladder distention.
Teach pts to change positions slowly to prevent or minimize postural hypotension. Instruct pts to avoid caffeine (excessive irritability). Instruct pts to avoid alcohol ingestion and hazardous activities until blood levels become stable. Instruct pts to notify their PCP if palpitations, dyspnea, nausea, or vomiting occurs. Monitor for adverse effects. Monitor for therapeutic effects (decreased chest pain in pts with angina; return to normal BP and HR; other specific effects, depending on use)
Nursing implications for adrenergic-blocking drugs
Rebound HTN or chest pain may occur if this medication is discontinued abruptly. Instruct pts to notify their physician if they become ill and unable to take medication. Inform pts that they may notice a decrease in tolerance for exercise (dizziness and fainting may occur with increased activity), and have pts notify the PCP if these problems occur.
Nursing implications: beta-blocking drugs
Inform pts to report the follow to their physician:
weight gain of more thant 2# in 1 day or 5# in one week
Edema of the feet or ankles
SOB
Excessive fatigue or weakness
Syncope or dizziness
Beta-blocking drugs: nursing implications
