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NURS 320 > Exam 1: Chapter 18: Adrenergic Drugs > Flashcards

Exam 1: Chapter 18: Adrenergic Drugs Flashcards

1
Q

Adrenergic Drugs

A
  • drugs that stimulate the SNS

- aka adrenergic agonists and sympathomimetics

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2
Q

Characteristics of Adrenergic drugs

A

mimics the effects of SNS neurotransmitters (catecholamines)

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3
Q

Endogenous Catecholamines include

A

norepinephrine
dopamine
epinephrine

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4
Q

Adrenergic receptors

A
  • located throughout the body

- are receptors for the sympathetic neurotransmitters

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5
Q

Adrenergic recptors include

A
  • alpha-adrenergic receptors
  • beta-adrenergic receptors
  • dopaminergic receptors: responds only to dopamine
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6
Q

Alpha 1 Adrenergic Receptors are located on

A

postsynaptic effector cells (the cell, muscle or organ that the nerve stimulates)

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7
Q

Alpha 2 Adrenergic Receptors

A
  • located on presynaptic nerve terminals (the nerve that stimulates the effector cells)
  • controls the release of neurotransmitters
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8
Q

Alpha-Adrenergic Agonist Responses

A

Vasoconstriction

CNS stimulation

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9
Q

All beta-adrenergic receptors are located on

A

postsynaptic effector cells

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10
Q

Beta 1 Adrenergic Receptors are located

A

primarily in the heart

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11
Q

Beta 2 Adrenergic Receptors are located in

A

smooth muscle of the bronchioles, arterioles and visceral organs

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12
Q

Beta 3 Adrenergic Receptors are located in

A

human urothelium muscle and detrusor muscle

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13
Q

Beta-Adrenergic Agonist Responses

A

Bronchial, GI and uterine smooth muscle relaxation
Glycogenolysis
Cardiac Stimulation

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14
Q

Dopaminergic Receptors

A

stimulated by dopamine

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15
Q

Dopaminergic Receptors causes

A

dilation of the following blood vessels, resulting in INCREASED blood flow (renal, mesenteric, coronary and cerebral)

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16
Q

Catecholamines

A

substances that can produce a sympathomimetic response

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17
Q

Synthetic Catecholamines include

A

dobutamine and phenylephrine

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18
Q

Direct-acting sympathomimetics: MOA

A

binds directly to the receptor and causes a physiologic response

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19
Q

Indirect-acting sympathomimetic: MOA

A
  • Causes release of catecholamine from storage sites (vesicles) in nerve endings
  • Catecholamine then binds to receptors and causes a physiologic response
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20
Q

Mixed-acting sympathomimetic: MOA

A

-Directly stimulates the receptor by binding to it

AND

-Indirectly stimulates the receptor by causing the release of stored neurotransmitters from vesicles in the nerve endings

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21
Q

Alpha-Adrenergic Receptors: Drug Effects

A

Vasoconstriction of blood vessels
Relaxation of GI smooth muscles (decreased motility)
Constriction of bladder sphincter
Contraction of uterus
Male ejaculation
Contraction of pupillary muscles of the eye (dilated pupils)

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22
Q

Stimulation of beta 1 adrenergic receptors on the myocardium, AV node and SA node results in

A

cardiac stimulation:
increased force of contraction
increased heart rate
increased conduction through AV node

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23
Q

Stimulation of beta 2 adrenergic receptors on the airways results in

A

bronchodilation (relaxation of the bronchi)

24
Q

Other effects of beta 2 adrenergic stimulation includes

A

Uterine relaxation
Glycogenolysis in the liver
Increased renin secretion in the kidneys
Relaxation of GI smooth muscles (decreased motility)

25
Q

Adrenergic Drugs: Indications

A
  • Treatment of asthma and bronchitis (terbutaline can also be used to stop premature labor causing relaxation of uterine smooth muscle)
  • Treatment of nasal congestion
  • Ophthalmic Treatment
  • Cardiovascular
26
Q

How can adrenergic drugs be used to treat asthma and bronchitis?

A

includes bronchodilators: drugs that stimulate beta 2 adrenergic receptors of smooth muscles, causing relaxation resulting in bronchodilation

27
Q

How can adrenergic drugs be used to treat nasal congestion?

A
  • intranasal application causes constriction of dilated arterioles and reduction of nasal blood flow, thus decreasing congestion
  • alpha-1-adrenergic receptors
28
Q

How can adrenergic drugs be used for ophthalmic treatments?

A
  1. temporary relief of conjunctival congestion (eyes) (alpha-adrenergic receptors)
  2. reduction of IOP and dilation of pupils: treatment of open-angle glaucoma (alpha adrenergic receptors)
29
Q

How can adrenergic drugs be used to treat cardiovascular problems?

A
  • aka cardioselective sympathomimetics
  • used to support the heart during cardiac failure or shock
  • various alpha and beta receptors affected
30
Q

Dobutamine (Dobutrex)

A
  • Beta1-selective vasoactive adrenergic drug that is structurally similar to the naturally occurring catecholamine dopamine
  • Given IV, through continuous infusion
31
Q

Dobutamine stimulates

A
  • beta1 receptors on heart muscle (myocardium)
  • increases cardiac output by increasing contractility (positive inotropy), which increases the stroke volume, especially in patients with heart failure
32
Q

Dopamine (Intropin)

A

-Naturally occurring catecholamine
neurotransmitter
-Potent dopaminergic as well as beta1- and alpha1-adrenergic receptor activity

33
Q

Low dosages of dopamine can

A

dilate blood vessels in the brain, heart, kidneys, and mesentery which increases blood flow to these areas (dopaminergic receptor activity)

34
Q

Higher infusion rates of dopamine can

A

improve cardiac contractility and output (beta 1 adrenergic receptor activity)

35
Q

Highest doses of dopamine can cause

A

vasoconstriction (alpha 1 adrenergic receptor activity)

36
Q

Epinephrine (Adrenalin)

A
  • Endogenous vasoactive catecholamine
  • Prototypical nonselective adrenergic agonist
  • Administered in emergency situations
  • One of the primary vasoactive drugs used in advanced cardiac life support protocols
37
Q

Epinephrine acts directly on

A

both the alpha and beta adrenergic receptors of tissues innervated by the SNS

38
Q

Norepinephrine (Levophed)

A
  • Stimulates alpha-adrenergic receptors
  • Causes vasoconstriction
  • Direct-stimulating beta-adrenergic effects on the heart (beta1-adrenergic receptors)
  • No stimulation to beta2-adrenergic receptors of the lung
39
Q

Norepinephrine is used to treat

A

hypotension and shock

40
Q

Norepinephrine is administered by

A

continuous infusion

41
Q

Phenylephrine (Neo-Synephrine)

A

Works almost exclusively on the alpha-adrenergic receptors

42
Q

Phenylephrine is used for

A
  • Primarily for short-term treatment to raise blood pressure in patients in shock
  • Control of supraventricular tachycardias
  • Vasoconstriction in regional anesthesia
  • Topical ophthalmic drug
  • Nasal decongestant
43
Q

Adverse Effects on the CNS of Alpha Adrenergic Drugs

A

headache, restlessness, excitement, insomnia and euphoria

44
Q

Adverse Effects on the Cardiovascular System of Alpha Adrenergic Drugs

A

Palpitations (dysrhythmias)
Tachycardia Vasoconstriction
Hypertension
Chest pain

45
Q

Other Adverse Effects of Alpha Adrenergic Drugs

A 
Loss of appetite
Dry mouth
Nausea
Vomiting
Taste Changes (rare)
46
Q

CNS Effects of Beta Adrenergic Drugs

A

Mild tremors
Headache
Nervousness
Dizziness

47
Q

Cardiovascular Effects of Beta Adrenergic Drugs

A

Increased Heart Rate
Palpitations (dysrhythmias)
Fluctuations in BP
Chest pain

48
Q

Other Adverse Effects of Beta Adrenergic Drugs

A

Sweating
N/V
Cramps

49
Q

Interactions: Adrenergic Drugs

A 
anesthetic drugs
tricyclic antidepressants
MAOIs
antihistamines
thyroid preparations
adrenergic antagonsts
50
Q

Nursing Implications for Adrenergic Drugs

A

Older adults and pediatrics may react with increased sensitivity to adrenergic drugs

51
Q

Nursing Implications for patients with chronic lung disease taking adrenergic drugs

A
  • Instruct patients to avoid factors that exacerbate their condition
  • Encourage fluid intake (up to 3000 mL/day) if permitted
  • Educate patients about proper dosing, use of equipment (metered-dose inhaler [MDI], spacer, nebulizer), and equipment care
52
Q

Salmeterol is indicated for

A

prevention of bronchospasms, NOT management of acute symptoms

53
Q

Administering two adrenergic drugs together may

A

precipitate severe cardiovascular effects such as tachycardia or hypertension

54
Q

Monitor for therapeutic effects (cardiovascular uses)

A 
decreased edema
increased urinary output
return to normal vital signs
improved skin color and temperature
increased LOC
55
Q

Monitor for therapeutic effects (asthma)

A
  • Return to normal respiratory rate
  • Improved breath sounds, fewer crackles
  • Increased air exchange
  • Decreased cough
  • Less dyspnea
  • Improved blood gases
  • Increased activity tolerance

NURS 320 (28 decks)

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