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NCLEX > Adrenergic Drugs > Flashcards

Adrenergic Drugs Flashcards

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0
Q

Dobutamine

Chemical Classification

A

Catecholamine

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1
Q

Dobutamine

Functional Classification

A

Adrenergic direct-acting Beta1-agonist, cardiac stimulant

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2
Q

Dobutamine

Mechanism of Action

A

Causes increased contractility, increased cardiac output without marked increase in heart rate by acting on Beta1-receptors in heart; minor alpha and beta2 effects

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3
Q

Dobutamine

Uses

A

Cardiac decompensation due to organic heart disease or cardiac surgery

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4
Q

Dobutamine

Contraindications

A

Hypersensitivity, idiopathic hypertrophic subaortic stenosis

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5
Q

Dobutamine

Side Effects

A

CNS: Anxiety, headache, dizziness, fatigue
CV: palpitations, tachycardia, hyper/hypotension, PVCs, angina
ENDO: hypokalemia
GI: heartburn, nausea, vomiting
MS: muscle cramps (leg)
RESP: dyspnea

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6
Q

Dobutamine

Nursing Considerations

A

ASSESS:

  • HYPOVOLEMIA; if present, correct first; administer cardiac glycoside before DOBUTamine
  • OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
  • HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses; report if extremities become cold or mottled or if peripheral pulses decrease
  • ECG during administration continuously; if BP increases, product is decreased; CVP or PCWP, cardiac output during inf; report changes
  • Serum electrolytes, urine output
  • SULFITE SENSITIVITY, which may be life threatening
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7
Q

Dobutamine

Overdose Treatment

A

Administer a Beta1-adrenergic blocker; reduce IV or discontinue, ensure oxygenation/ventilation; for severe tachydysrhythmias (ventricular), give lidocaine or propranolol

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8
Q

Dopamine

Functional Classification

A

Adrenergic

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9
Q

Dopamine

Chemical Classification

A

Catecholamine

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10
Q

Dopamine

Mechanism of Action

A

Causes increased cardiac output; acts on beta1- and alpha-receptors, causing vasoconstriction in blood vessels; low dose causes renal and mesenteric vasodilation; beta1 stimulation produces inotropic effects with increased cardiac output

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11
Q

Dopamine

Uses

A

Shock, increased perfusion, hypotension, cardiogenic/septic shock

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12
Q

Dopamine

Contraindications

A

Hypersensitivity, ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypovolemia

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13
Q

Dopamine

Side Effects

A

CNS: Headache, anxiety
CV: Palpitations, Tachycardia, Hypertension, Ectopic Beats, Angina, Wide QRS Complex, peripheral vasoconstriction, hypotension
GI: Nausea, Vomiting, Diarrhea
INTEG: necrosis, tissue sloughing with extravasation, GANGRENE
RESP: dyspnea

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14
Q

Dopamine

Nursing Considerations

A

ASSESS:

  • Hypovolemia; if present, correct first
  • OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
  • HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses
  • I&O ratio: if urine output decreases without decrease in BP, product may need to be reduced
  • ECG during administration continuously; if BP increases, product should be decreased; PCWP, CVP during inf
  • BP, pulse q5min
  • Paresthesias and coldness of extremities; peripheral blood flow may decrease
  • Inj site: tissue sloughing; if this occurs, administer phentolamine mixed with NS
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15
Q

Dopamine

Overdose Treatment

A

Discontinue IV, may give a short-acting alpha-adrenergic blocker

16
Q

Epinephrine

Functional Classification

A

Bronchodilator nonselective adrenergic agonist, vasopressor

17
Q

Epinephrine

Chemical Classification

A

Catecholamine

18
Q

Epinephrine

Mechanism of Action

A

Beta1- and Beta2-agonist causing increased levels of cAMP, thereby producing bronchodilation, cardiac, and CNS stimulation; high doses cause vasoconstriction via alpha-receptors; low doses can cause vasodilation via Beta2-vascular receptors

19
Q

Epinephrine

Uses

A

Acute asthmatic attacks, hemostasis, bronchospasm, anaphylaxis, allergic reactions, cardiac arrest, adjunct in anesthesia, shock

20
Q

Epinephrine

Contraindications

A

Hypersensitivity to sympathomimetics, closed-angle glaucoma, nonanaphylactic shock during general anesthesia

21
Q

Epinephrine

Side Effects

A

CNS: Tremors, Anxiety, insomnia, headache, Dizziness, confusion, hallucinations, CEREBRAL HEMORRHAGE, weakness, drowsiness
CV: Palpitations, Tachycardia, hypertension, Dysrhythmias, increased T wave
GI: Anorexia, Nausea, Vomiting
MISC: sweating, dry eyes
RESP: Dyspnea

22
Q

Epinephrine

Nursing Considerations

A

ASSESS:

  • ASTHMA: auscultate lungs, pulse, BP, respirations, sputum (color, character); monitor pulmonary function studies before and during treatment
  • ECG during administration continuously; if BP increases, decrease dose; BP, pulse q5min after parenteral route; CVP, ISVR, PCWP during inf if possible; inadvertent high arterial BP can result in angina, aortic rupture, cerebral hemorrhage
  • Inj site: tissue sloughing; administer phentolamine with NS
  • SULFITE SENSITIVITY; may be life-threatening
  • Cardiac status, I&O; blood glucose in diabetes
  • ALLERGIC REACTIONS, BRONCHOSPASMS: withhold dose, notify prescriber
23
Q

Epinephrine

Overdose Treatment

A

Administer alpha-blocker and beta-blocker

24
Q

Norepinephrine (Levophed)

Functional Classification

A

Adrenergic

25
Q

Norepinephrine (Levophed)

Chemical Classification

A

Catecholamine

26
Q

Norepinephrine (Levophed)

Mechanism of Action

A

Causes increased contractility and heart rate by acting on beta-receptors in heart; also acts on alpha-receptors, thereby causing vasoconstriction in blood vessels; BP is elevated, coronary blood flow improves, and cardiac output increases

27
Q

Norepinephrine (Levophed)

Uses

A

Acute hypotension, shock

28
Q

Norepinephrine (Levophed)

Contraindications

A

Hypersensitivity to this product or cyclopropane/halothane anesthesia; ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypotension, hypovolemia

29
Q

Norepinephrine (Levophed)

Side Effects

A

CNS: Headache, anxiety, dizziness, insomnia, restlessness, tremor, CEREBRAL HEMORRHAGE
CV: Palpitations, Tachycardia, Hypertension, Ectopic Beats, Angina
GI: Nausea, Vomiting
GU: decreased urine output
INTEG: necrosis, tissue sloughing with extravasation, GANGRENE
RESP: dyspnea
SYST: ANAPHYLAXIS

30
Q

Norepinephrine (Levophed)

Nursing Considerations

A

ASSESS:

  • I&O ratio; notify prescriber if output <30ml/hr
  • BP, pulse q2-3min after parenteral route, ECG during administration continuously; if BP increases, product is decreased, CVP or PWP during inf if possible
  • Paresthesias and coldness of extremities; peripheral blood flow may decrease
  • EXTRAVASATION: inj site: tissue sloughing
  • sulfite sensitivity, which may be life-threatening
31
Q

Norepinephrine (Levophed)

Overdose Treatment

A

Administer fluids, electrolyte replacement

NCLEX (40 decks)

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