Adrenergic-Blocking Drugs Flashcards
Atenolol
Chemical Classification
Beta-Blocker, Beta1-, Beta2-blocker (high doses)
Atenolol
Mechanism of Action
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
Atenolol
Uses
Mild to moderate hypertension, prophylaxis of angina pectoris; suspected or known MI (IV use); MI prophylaxis
Atenolol
Contraindications
Pregnancy (D), hypersensitivity to Beta-Blockers, cardiogenic shock, 2nd- or 3rd degree heart block, sinus bradycardia, cardiac failure, Raynaud’s disease, pulmonary edema
Atenolol
Side Effects
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
Atenolol
Nursing Considerations
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
Atenolol
Overdose Treatment
Lavage, IV atropine for bradycardia, IV theophylline for bronchospasm, dextrose for hypoglycemia, digoxin, O2, diuretic for cardiac failure, hemodialysis
Esmolol
Functional Classification
Beta-Adrenergic Blocker (Antidysrhytmic II)
Esmolol
Mechanism of Action
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
Esmolol
Uses
Supraventricular tachycardia, noncompensatory sinus tachycardia, hypertensive crisis, intraoperative and postoperative tachycardia and hypertension
Esmolol
Contraindications
2nd or 3rd-degree heart block; cardiogenic shock, CHF, cardiac failure, hypersensitivity, severe bradycardia
Esmolol
Side Effects
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
Esmolol
Nursing Considerations
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
Esmolol
Overdose Treatment
Discontinue Product
Metoprolol (Lopressor)
Functional Classification
Antihypertensive, antianginal