Adrenergic-Blocking Drugs

Question 1

Adrenergic Blockers

Answer 1

• binds to adrenergic receptors but inhibit or block stimulation of the sympathetic nervous system
• Have the opposite effect of adrenergic drugs
• Inhibit or Lyse sympathetic stimulation

Question 2

Other names for adrenergic blockers?

Answer 2

Adrenergic antagonists
sympatholytics
alpha blockers
beta blockers
alpha-beta blockers

Question 3

MOA and Drug effects

Answer 3

• cause both arterial and venous dilation, reducing peripheral vascular resistance and BP
• used to treat hypertension
• Effect on receptors on prostate gland and bladder decreases resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of benign prostatic hyperplasia

Question 4

Indications for Alpha Blockers

Answer 4

control and prevent hypertension in patients with phenochromocytoma
-Raynauds disease, acrocyanosis, and frostbite

Question 5

Phentolamine

Answer 5

• quickly reverses the potent vasoconstrictive effects of extravasated vasopressors such as norepinephrine or epinephrine
• restores blood flow and prevents tissue necrosis

Question 6

Adverse effects: Alpha Blockers

Cardiovascular

Answer 6

palpitations, orthostatic hypotension, tachycardia, edema, chest pain

Question 7

Adverse effects: Alpha Blockers

CNS

Answer 7

dizziness, headache, anxiety, depression, weakness, numbness, fatigue

Question 8

Adverse effects: Alpha Blockers

GI

Answer 8

nausea, vomiting, diarrhea, constipation, abdominal pain

Question 9

Adverse effects: Alpha Blockers

Other

Answer 9

incontinence, dry mouth, pharyngitis

Question 10

Tamsulosin (Flomax)

Answer 10

• alpha blocker used primarily to treat BPH; is exclusively indicated for male patients however, can be used in female patients with kidney stones
• Contraindications: known drug allergy and concurrent use of erectile dysfunction drugs such as sildenafil
• Adverse effects: headache, abnormal ejaculation, rhinitis, and others

Question 11

Beta Blockers

Answer 11

• block stimulation of beta receptors in the SNS
• compete with norepinephrine and epinephrine
• Can be selective or nonselective
  
  • cardioselective beta blockers or beta1-blocking drugs
  • Nonselective beta blockers block both beta1 and beta2 receptors
• Beta2 receptors are located primarily on the smooth muscles of the bronchioles and blood vessels

Question 12

Beta Blockers MAO

Cardioselective beta blockers (beta1)

Answer 12

• reduce SNS stimulation of the heart
• Decrease heart rate
• Prolong SA node recovery
• Slow conduction rate through the AV node
• Decrease myocardial contractility, thus reducing myocardial oxygen demand

Question 13

Beta Blockers MAO

Nonselective beta blockers (beta1 and beta2)

Answer 13

• cause same effects on heart as cardioselective beta blockers
• constrict bronchioles, resulting in narrowing of airways and shortness of breath
• produce vasoconstriction of blood vessels

Question 14

Indications to use Beta Blockers

Answer 14

-Angina-Decreases demand for myocardial oxygen
-Cardioprotective
-dysrhythmias
-Migraine
antihypertensive
-heart failure
-glaucoma

Question 15

What does cardioprotective mean?

Answer 15

inhibits stimulation from circulating catecholamines

-used in patients who have had a MI

Question 16

Adverse Effects: Beta Blockers

Blood

Answer 16

agranulocytosis, thrombocytopenia

Question 17

Adverse Effects: Beta Blockers

Cardiovascular

Answer 17

AV block, bradycardia, heart failure

Question 18

Adverse Effects: Beta Blockers

CNS

Answer 18

Dizziness, depression, unusual dreams, drowsiness

Question 19

Adverse Effects: Beta Blockers

GI

Answer 19

Nausea, vomiting, diarrhea, constipation

Question 20

Adverse Effects: Beta Blockers

other

Answer 20

impotence, alopecia, wheezing, bronchospasm, dry mouth

Question 21

Toxicity and Management of Overdose

Answer 21

• symptomatic and supportive care
• Atropine for bradycardia
• cardiac pacing
• vasopressors for severe hypotension
• Hemodialysis to enhance elimination in severe overdoses

Question 22

what drugs might interfere with Adrenergic-Blocking Drugs?

Answer 22

antacids
antimuscarinics or anticholinergics
diuretics and cardivascular drugs
neuromuscular blocking drugs
oral hypoglycemic drugs

Question 23

Adrenergic-Blocking Nursing Implication

Answer 23

These medications should never be stopped abruptly

• Inform patients to report constipation or the development of urinary hesitancy or bladder distention
• possibility of postural hypotension
• avoid caffeine
• avoid alcohol
• notify is you experience palpitations, dyspnea, N/V

Question 24

Beta-Blocking Drug Nursing implications

Answer 24

• Rebound hypertension or chest pain may occur if this medication is discontinued abruptly
• May notice a decrease in tolerance for exercise and notify if this problem occur
• Report weight gain of more than 2 lb in 1 day or 5 lb in 1 week, edema of feet or ankles, SOA, excessive fatigue or weakness, syncope or dizziness