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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
How does beta blockers impact hypoglycemia?
- 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
Atenolol
- cardioselective beta blocker | - commonly used to prevent future heart attacks in patients who have had one.
27
What are other indications for atenolol?
- hypertension and angina | - management of thyrotoxicosis to help block the symptoms of excessive thyroid activity
28
Carvedilol
nonselective beta blocker, an alpha 1 blocker, a calcium channel blocker and possible an antioxident
29
Carvedilol: Uses
heart failure, hypertension and angina
30
Carvedilol: Action
slows progression of heart failure and to decrease the frequency of hospitalization in patients with mild to moderate heart failure
31
Carvedilol is most commonly added to
digoxin, furosemide, and angiotensin-converting enzyme inhibitors when used to treat heart failure
32
Esmolol
very strong short-acting beta 1 blocker | administered IV
33
Primary use of esmolol
acute situations to provide rapid temporary control of the ventricular rate in patients with supraventricular tachydysrhythmias
34
Cardioselective Beta Blockers include
``` acebutolol atenolol metoprolol esmolol (more on powerpoint) ```
35
Nonselective Beta Blockers include
``` carvedilol labetalol propranolol timolol (more on powerpoint) ```
36
Adrenergic-Blocking Drugs: Nursing Implications
-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
Alpha blockers may precipitate
hypotension
38
Some beta blockers may precipitate
bradycardia, hypotension, heart block, heart failure and bronchoconstriction
39
Possible drug interactions may occur with
``` Antacids (aluminum hydroxide type) Antimuscarinics/anticholinergics Diuretics and cardiovascular drugs Neuromuscular blocking drugs Oral hypoglycemic drugs ```
40
Monitor for therapeutic effects
- Decreased chest pain in patients with angina - Return to normal BP and HR - Other specific effects, depending on the use
41
Beta Blocking Drugs: Nursing Implications
- 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
The nurse should inform patients to report the following to their physician when taking beta-blocking drugs:
``` 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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