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NURS 320 > Exam 1: Chapter 19: Adrenergic Blocking Drugs > Flashcards

Exam 1: Chapter 19: Adrenergic Blocking Drugs Flashcards

1
Q

Adrenergic Blockers

A

binds to adrenergic receptors, but inhibit stimulation of SNS

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2
Q

Adrenergic blockers are also known as

A

adrenergic antagonists
sympatholytics
alpha blockers, beta blockers or alpha-beta blockers

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3
Q

Adrenergic blockers are classified by the

A

type of adrenergic receptor they block (alpha 1 and 2 receptors and beta 1 and 2 receptors)

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4
Q

Alpha Blockers: Drug Effects

A

Vasodilation (arterial and venous)
Reduced peripheral vascular resistance and BP
Miosis (pupillary constriction)
Reduced smooth muscle tone (bladder and prostate)

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5
Q

How can alpha blockers affect benign prostatic hyperplasia?

A

it affects receptors on prostate gland and bladder which decreases resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of BPH

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6
Q

Indications for Alpha Blockers

A

used to control and prevent hypertension in patients with preochromocytoma

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7
Q

Phentolamine (Regitine)

A

drug of choice

alpha blocker

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8
Q

Phentolamine is used to

A
  • quickly reverse potent vasoconstrictive effects of extravasated vasopressors such as norepinephrine or epinephrine
  • restores blood flow and prevents tissue necrosis
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9
Q

Phentolamine is contraindicated in

A

hypersensitivity
myocardial infarction
coronary artery disease

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10
Q

Alpha Blockers: Most Common Adverse Effects (more on slide 7 of powerpoint)

A

Orthostatic Hypotension
Dizziness, Headache
Constipation
Dry mouth

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11
Q

Common Alpha Blockers (more on powerpoint)

A

phentolamine
prazosin
tamsulosin

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12
Q

Tamsulosin (Flomax)

A

alpha blocker used primarily to treat BPH

is exclusively indicated for male patients

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13
Q

Contraindications for Tamsulosin

A

known drug allergy

concurrent use of erectile dysfunction drugs

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14
Q

Adverse Effects of Tamsulosin

A

headache, abnormal ejaculation, rhinitis and others

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15
Q

Beta blockers

A

block stimulation of beta receptors in SNS
compete with norepinephrine and epinephrine
can be selective or nonselective

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16
Q

Nonselective beta blockers

A

block both beta 1 and beta 2 receptors

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17
Q

Beta 1 receptors

A

located primarily on the heart

beta blockers selective for these receptors are called cardioselective beta blockers

18
Q

Beta 2 receptors

A

located primarily on smooth muscle of bronchioles and blood vessels

19
Q

Cardioselective beta blockers (beta 1): MOA

A
  • Reduce SNS stimulation of the heart
  • Decrease heart rate
  • Prolong sinoatrial (SA) node recovery
  • Slow conduction rate through the AV node
  • Decrease myocardial contractility, thus reducing myocardial oxygen demand
20
Q

Nonselective beta blockers (beta1 and beta2): MOA

A
  • Cause same effects on heart as cardioselective beta blockers
  • Constrict bronchioles, resulting in narrowing of airways and shortness of breath
  • Produce vasoconstriction
  • Other effects
21
Q

Beta blockers: Indications

A

Angina (decreases demand for myocardial oxygen)
Cardioprotective (inhibits stimulation from circulation catecholamines)
Dysrhythmias (Class II antidysrhythmic)
Migraine headache (lipophilicity allows entry into CNS)
Antihypertensive
Heart failure
Glaucoma (topical use)

22
Q

Alpha-Blockers: Contraindications

A
  • Drug Allergies
  • Peripheral vascular disease
  • Hepatic/renal disease
  • Coronary artery disease
  • Peptic ulcer
  • Sepsis
23
Q

Beta-Blockers: Contraindications

A 
Drug Allergies
Uncompensated Heart Failure
Cardiogenic Shock
Heart Block or bradycardia
Pregnancy
Severe Pulmonary disease
Raynaud’s disease
24
Q

Beta-Blockers: Common Adverse Effects (more on powerpoint)

A 
Bradycardia
Depression
Constipation
Impotence
Fatigue
25
Q

How does beta blockers impact hypoglycemia?

A
  • nonselective beta blockers may interfere with normal responses to hypoglycemia (tremor, tachycardia, nervousness)
  • may mask S&S of hypoglycemia
  • use with caution in patients with diabetes mellitus
26
Q

Atenolol

A
  • cardioselective beta blocker

- commonly used to prevent future heart attacks in patients who have had one.

27
Q

What are other indications for atenolol?

A
  • hypertension and angina

- management of thyrotoxicosis to help block the symptoms of excessive thyroid activity

28
Q

Carvedilol

A

nonselective beta blocker, an alpha 1 blocker, a calcium channel blocker and possible an antioxident

29
Q

Carvedilol: Uses

A

heart failure, hypertension and angina

30
Q

Carvedilol: Action

A

slows progression of heart failure and to decrease the frequency of hospitalization in patients with mild to moderate heart failure

31
Q

Carvedilol is most commonly added to

A

digoxin, furosemide, and angiotensin-converting enzyme inhibitors when used to treat heart failure

32
Q

Esmolol

A

very strong short-acting beta 1 blocker

administered IV

33
Q

Primary use of esmolol

A

acute situations to provide rapid temporary control of the ventricular rate in patients with supraventricular tachydysrhythmias

34
Q

Cardioselective Beta Blockers include

A 
acebutolol
atenolol
metoprolol
esmolol
(more on powerpoint)
35
Q

Nonselective Beta Blockers include

A 
carvedilol
labetalol
propranolol
timolol
(more on powerpoint)
36
Q

Adrenergic-Blocking Drugs: Nursing Implications

A

-Assess for history of COPD, hypotension, cardiac dysrhythmias, bradycardia, heart failure or other cardiovascular problems
-Advise patients to never stop these medications abruptly
-Advise patients to report constipation or the development of urinary hesitancy or bladder distention
(More on powerpoint)

37
Q

Alpha blockers may precipitate

A

hypotension

38
Q

Some beta blockers may precipitate

A

bradycardia, hypotension, heart block, heart failure and bronchoconstriction

39
Q

Possible drug interactions may occur with

A 
Antacids (aluminum hydroxide type)
Antimuscarinics/anticholinergics
Diuretics and cardiovascular drugs
Neuromuscular blocking drugs
Oral hypoglycemic drugs
40
Q

Monitor for therapeutic effects

A
  • Decreased chest pain in patients with angina
  • Return to normal BP and HR
  • Other specific effects, depending on the use
41
Q

Beta Blocking Drugs: Nursing Implications

A
  • Rebound hypertension or chest pain may occur if this medication is discontinued abruptly
  • Inform patients that they may notice a decrease in tolerance for exercise (dizziness and fainting may occur with increased activity), and have patients notify the physician if these problems occur
42
Q

The nurse should inform patients to report the following to their physician when taking beta-blocking drugs:

A 
Weight gain of more than 2 pounds in 1 day or 5 pounds in 1 week
Edema of the feet or ankles
Shortness of breath
Excessive fatigue or weakness
Syncope or dizziness

NURS 320 (28 decks)

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