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NRSG 220 > Alphas, BB & CCBs > Flashcards

Alphas, BB & CCBs Flashcards

1
Q

Alpha1Blockers are used to treat

A

HTN and BPH

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2
Q

Where does the most important action of alpha1 adrenergic antagonist act

A

Most important action of these agents is on arterial smooth muscle and cardiovascular system.

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3
Q

First-dose phenomenon with Adrenergic antagonist

When sympathetic nervous system is blocked, the a)..

A

a).. parasympathetic predominates.

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4
Q

How can the first dose phenomenon be prevented in individuals who are recieving Adrenergic antagonist for the first time?

A

low doses and usually given at bedtime

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5
Q

What can occur if Adrenergic antagonist are suddenly stopped?

A

Reflex tachycardia and nasal congestion also occur.

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6
Q

What happens in the first dose phenomenon with Adrenergic antagonist?

A

Hypotension, orthostatic hypotension
- Decreased blood flow to the brain
- Syncope

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7
Q

Selective Alpha1 Blockers

Alpha blockers can be used concurrently with drugs like

A

diuretics.

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8
Q

Selective Alpha1 Blockers

Alpha-Adrenergic antagonist do what to the bladder and prostate?

A

Relax the smooth muscle

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9
Q

Selective Alpha1 Blockers

Alpha-Adrenergic antagonist increases or decrease urine flow

A

increases

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10
Q

Selective Alpha1 Blockers

Alpha-Adrenergic antagonist have what effect on veins?

A

blocks vasoconstriction which decreases venous return (preload) to heart and lowers BP indirectly

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11
Q

Selective Alpha1 Blockers

Alpha-Adrenergic antagonist have what effect on arteries?

A

Arterioles - block vasoconstriction on vascular smooth muscle (afterload) which decreases BP **directly
**

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12
Q

Selective Alpha1 Blockers
Block

A

peripheral catecholamines

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13
Q

Selective Alpha1 Blockers

Two selective agents used in BPH

A

Alfuzosin (Uroxatral)
Tamsulosin (Flomax)

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14
Q

Do Alpha1 blockers cure the condition of BPH?

A

no, you need surgery

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15
Q

what is a Pheochromocytoma and what does it cause

A

(small tumor of adrenal medulla - causing irregular secretion of Epi & NE)

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16
Q

four theraputic uses for Selective Alpha1 Blockers

A

Pheochromocytoma, BPH, HTN, Raynaud disease

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17
Q

Clients on alpha blockers give false positive test for what

A

pheochromocytoma

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18
Q

selective beta adrengeric antagonist have little effect on

A

bronchial smooth muscle

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19
Q

selective beta adrengeric antagonist have fewer a).. side effects

A

Fewer noncardiac side effects

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20
Q

Selective beta adrengeric antagonist block only a) .. receptors

A

a).. Beta 1

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21
Q

Non- selective beta adrengeric antagonist block only a) .. receptors

A

Beta 1 and 2

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22
Q

which type of beta blocker can be safely given to clients with asthma and COPD

A

Selective beta adrenergic antagonist

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23
Q

Intrinsic sympathomimetic activity (ISA) –

A

Beta blockers that exhibit mixed beta-antagonist and beta-agonist activity.

a group of beta blockers that are able to stimulate beta-adrenergic receptors (agonist effect) and to oppose the stimulating effects of catecholamines (antagonist effect) in a competitive way

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24
Q

Why should the nurse be cautious when administering beta blockers with calcium channel blockers?

A

may potentiate HF

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25
three therapeutic effects of beta blockers
* Slow conduction velocity through AV node * Therefore slow HR (chronotropic) * Decrease force of contractions (inotropic)
26
during stress or exercise, beta blockers prevent
normal sympathetic stimulation to heart
27
Most therapeutic actions of beta blockers relate to what system
CV system.
28
Why are beta blockers dangerous in patients with diabetes mellitus
Cause hypoglycemia Mask S&S hypoglycemia
29
What are patients at risk for if they stop taking their beta blockers suddenly
Rebound cardiac excitation (tachycardia)
30
Beta blockers prevent hyperglycemic effect of
catecholamines.
31
When giving propanolol, how often should the nurse take vital signs
q15mins-q1h
32
IV beta blockers should never be given unless the patient is on
telemetry
33
When giving a patient propanolol, what lab values should they be sure to check first
kidney, liver, hematologic, and cardiac functions
34
when giving propanolol, the nurse should keep track of a).. as well as take b)..
a) I&O b) daily weights
35
These patients should be monitored closely for ADRS when taking propanolol
older adults & in patients with impaired renal function
36
if the nurse notice this on the ECG machine, they should take immediate intervention
widening QRS
37
When a patient is taking propanolol, the nurse should be sure to monitor for signs of poor circulation should as
IRR, SOB, BLE edema
38
What mineral should patients be encouraged to decrease when taking propanolol
SALT :(
39
Nonselective Beta Blockers family last name
"olol" black sheep = Carvedilol (Coreg)
40
what concern should the nurse be cautious to look for when giving Sotalol (Betapace, Sorine)
Watch for widening QRS complex
41
When giving metoprolol, the nurse should take the radial pulse and hold the medication if
HR < 60bpm or if SBP < 100 | (watch for symptoms of hypotension)
42
It is important for the nurse to record these three observations when giving metoprolol due to the risk of heart failure
Record I&O, daily weight, bilateral breath sounds
43
during IV administration of metoprolol, the nurse should monitor what two vital signs closely
Monitor BP & HR frequently during IV administration
44
what time of day should admin of metoprolol be avoided
Avoid late evening doses
45
# beta blockers make you feel shitty when taking metoprolol, the nurse should monitor for signs of a)..
depression
46
When caring for a patient taking metoprolol, the nurse should watch for signs of masked
hyperthyroidism
47
When caring for a patient taking metoprolol, the nurse should report any signs or these two things
Visual problems Cold, painful, tender feet, or hands
48
metoprolol should be used cautiously in patients with
diabetes mellitus
49
mothers should contact their HCP if taking metoprolol and interested in starting
breast feeding
50
Alpha antagonist decreases a).. and decreases b)..
a) peripheral resistance b) preload
51
calcium channel blockers reduce a)..
a).. afterload Lower myocardial oxygen demand and less workload for heart
52
CCBs prevent the
influx of Ca into vascular smooth muscle
53
# Calcium channel blockers Myocardium effects:
- Reduces force of myocardial contraction (negative inotropic effect) - Reduces inward movement of calcium during plateau phase of action potential
54
# calcium channel blockers Cardiac conduction effects:
(Negative chronotropic effect) SA node generates fewer action potentials. Slows automaticity Decreases HR
55
Treatment of overdose for Nifendipine | Calcium channel blocker, (dihydropyridine)
- Rapid-acting vasopressors such as dopamine or dobutamine - Calcium infusions
56
What happens when the CCB Nifendipine is mixed with alcohol
Syncope/drop in BP
57
what happens when nifendipine is mixed with digoxin?
increase in serum levels of digoxin - bradycardia
58
What risk exist when mixing CCB's with BB's
conjestive heart failure
59
What effect is had when CCB's are mixed with other antihypertensives
Additive effect
60
CCB's May interact with drugs that induce or inhibit what
CYP3A4
61
When caring for a patient taking CCB's, if the nurse notices signs a).. of they should report it right away as it is a adverse reaction
a) .. gingival hyperplasia
62
what is the family ending name of calcium channel blockers | dihydropyridine type
(“dipine”)
63
a) .. increases CCB serum levels such as verampril
grapefruit juice
64
Verapamil increases a).. levels = neurotoxicity (ataxia)*
carbamazepine (Tegretol) -note- (Increase Tegretol (seizure med) levels when D/C verapamil) | ataxia = poor muscle control that causes clumsy movements.
65
There is a increased significant risk of myopathy if CCB's (vermapril) are taken with what other drug class?
Statins! | cholesteral lowering agent
66
When mixed with CCBs, buspirone plasma concentration is
increased by 3X | buspirone is a antianxiety med
67
mixing CCB's with digoxin will do what?
risk of bradycardia | You are gunna tank the heart is what you are gunna do
68
what effect happens if you mix CCB's with other antihypertensives
Additive effect. hypotension or bradycardia
69
When administering Vermapril (CCB), the nurse should monitor the BP when
Monitor BP before administration of drug and 30 min to 1 hour after and just prior to next dose
70
When should the nurse know to withhold Vermapril (CCB)
Withhold drug if systolic BP < 90 or symptomatic
71
What position should patients be left in after recieving a CCB (vermapril) and for how long
Keep patient recumbent for at least 1hr after administration
72
If the patient is recieving parenteral CCB (vermapril) what should be monitored
Monitor on telemetry continuously if parenteral
73
When taking CCBs (vermapril) what should the nurse monitor in regards to the patients circulation
Monitor I/O and for edema
74
If CCBs (vermapril) is concurrently used with digoxin, what does the nurse NEED to be assessing for
Monitor for heart block or bradycardia
75
Diltiazem is used for what off label | another CCB, similar profile to Verampril
Migraine prophylaxis
76
Diltiazem use | another CCB, similar profile to Verampril
Treatment of atrial dysrhythmias and HTN, stable and vasospastic angina

NRSG 220 (12 decks)

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