ANS Drugs

Question 1

Dopamine/
Epinephrine

Answer 1

Correct
hemodynamic
imbalances in
shock
(↓ heart rate,
↓ blood
pressure)
Adverse: Arrhythmias,
hypotension
Dyspnea
Extravasation
Monitor peripheral
pulses:
vasoconstriction
may limit peripheral
circulation (necrosis
of fingers / toes)
Monitor BP and urine
output, respiratory
function
Caution:
administering to
someone with
previous cardiac
disease because of
↑workload on the
heart

Question 2

Dopamine/
Epinephrine Class

Answer 2

Adrenergic
Agonists.
Activate
sympathomimetic
response (both alpha
and beta) to
↑ BP, cardiac and
urine output
Mimics sympathetic
nervous system

Question 3

Phenylephrine

Answer 3

Shock
Topical:
decongestant:
nasal
congestion,
middle ear
infections
Eye: dilate
pupils
Adverse: restlessness,
anxiety
blurred vision
Arrhythmias,
hypotension
N, V, anorexia
Extravasation if
given IV
May be found as
addition to other
meds- cold or ocular
Do not stop abruptly
rebound
hypertension,
arrhythmias.
Taper over 2 – 4
days

Question 4

Phenylephrine Class

Answer 4

Alpha Specific
Adrenergic
Agonists
Activates
sympathomimetic
response acting on
alpha receptors:
vasoconstriction -
↑ BP, cardiac and
urine output

Question 5

Carvedilol/
Labetalol

Answer 5

HTN
C-Improves CO,
slows
progression of
HF.
Adverse: Hypotension,
Orthostatic
hypotension since
blocks alpha 1
receptors
cardiac
arrhythmias-
bradycardias, HF,
stroke
Bronchospasm
erectile
dysfunction
Carvedilol:
Associated with
hepatic failure
**food slows
absorption: take
with food to
prevent
hypotension
CAUTION:
Patients with asthma
because of
norepinephrine and
bronchodilation is
lost with these drugs
Usual signs and
symptoms
hypoglycemia/
hyperglycemia are
blocked
Abruptly stopping
can lead to MI,
stroke, and
arrhythmias

Question 6

Carvedilol/
Labetalol Class

Answer 6

Non-selective
adrenergic
blocking.Blocks the effect of
norepinephrine at
alpha and beta
receptors;
Blocks
A1(Arterial and
venous dilation);
B1(myocardial) and
B2 (pulmonary,
vascular, and
uterine) adrenergic
receptor sites
↓ HR and BP

Question 7

Propranolol/
Timolol

Answer 7

Hypertension,
angina,
prevent re-
infarction
Migraines,
stage fright
(lowers heart
rate – Not
approved by
FDA for this use)
Timolol (drops):
Glaucoma
Adverse: fatigue,
weakness
Bradycardia, HF,
hypotension
bronchospasms,
pulmonary edema
erectile
dysfunction
Timolol:
Blurred vision
Abruptly stopping
can lead to MI,
stroke, and
arrhythmias
Monitor blood
glucose levels – signs
and sx of heart block
may be altered
Monitor liver
function
NSAIDs + Beta
blockers lowers anti-
hypertensive effect

Question 8

Propranolol/
Timolol Class

Answer 8

Nonselective Beta
Adrenergic
Blocking Agents.
Total blocking of
beta effect in SNS in
heart and nephron
to ↓BP, oxygen
consumption and
workload of heart &
↓intraocular
pressure in glaucoma

Question 9

Metoprolol/
Atenolol

Answer 9

Essential
Hypertension
Angina
stable heart
failure
MI- core
measures; used
to prevent re-
infarction
Adverse: Hypotension
Heart Failure
Bradycardia
bronchospasm
fatigue,
weakness
erectile
dysfunction
Oral (Regular or ER)
IV
Taper if D/C after
long-time use
Monitor BP, pulse,
ECG, and blood
glucose (does not
block sweating, a
sign of
hypoglycemia)
Give with food to
↑absorption
Preferred but caution
in those with lung,
thyroid disease

Question 10

Metoprolol/
Atenolol Class

Answer 10

Beta 1 Selective
Adrenergic
Blocking Agents.
↓BP, ↓ HR;
↓ excitability,
workload, O2
consumption of
heart
Preferred in patients
with Asthma / COPD:
Do not block Beta 2
receptors, so do not
block
bronchodilation
(important for those
with lung disease or
allergic rhinitis)