Pharm Exam 2, (Anti)Adrenergics Flashcards
Adrenergic Drugs
Drugs that stimulate the sympathetic nervous system
Mimic the actions of norepinephrine, epinephrine, and dopamine
Not given orally
able to treat: Asthma Anaphylaxis Cardiac arrest Nasal decongestant Conjunctival congestion Premature labor Heart failure Cardiac contractility
Adrenergic Drug Action
Action Acts on alpha and beta receptors to produce desired effect Found through out the body Acts on dopamine receptors (only will respond to dopamine) Renal Mesenteric Coronary Cerebral
alpha adrenergic receptor stimulation on smooth muscle
Vasoconstriction of blood vessels Relaxation of GI smooth muscles Contraction of the uterus and bladder Male ejaculation Decreased insulin release Dilation of the pupils (Mydriasis)
B1 adrenergic receptor stimulation on myocardium, AV/SA node
Increased force of contraction (positive inotropic effect)
Increased heart rate (positive chronotropic effect)
Increased conduction through the AV node (positive dromotropic effect)
B2 adrenergic receptor stimulation on airways
Bronchodilation (relaxation of the bronchi)
Uterine relaxation
Glycogenolysis in the liver
Increased renin secretion in the kidneys
albuterol (Proventil, Ventolin, Volmax)
SABA (short-acting beta2 agonist) Oral Inhaled, 2 puffs q 4-6 hours “Rescue medication” Treatment of...? Asthma What it does? bronchodilator
levalbuterol (Xopenex)
Does not cause excitation like albuterol “Rescue medication” Treatment of...? Asthma What it does? Bronchodilator
salmeterol (Serevent)
Long term treatment of asthma Treatment of...? Asthma What it does? Bronchodilator
ephinephrine (Adrenalin)
Acute asthma only not controlled by albuterol Treatment of...? Asthma What it does? Bronchodilator
IM “epipen” IV (monitor carefully!) Treatment of...? Anaphylaxis Shock What it does? Vasoconstriction Increased blood pressure Cardiac stimulation Dilation of bronchioles
Treatment of...? Cardiac arrest Prolonged anesthetic effect if given locally What it does? Restoration of cardiac rhythm
pseudoephedrine (Sudafed, Afrin)
Treatment of...? Nasal congestion What it does? Vasoconstriction of the mucosa Reduction of nasal secretions Rebound effect
tetrahydrozoline (Murine, Visine)
tetrahydrozoline (Murine, Visine)
terbutaline (Brethine, Bricanyl)
Treatment of…?
Premature labor
What it does?
Relaxes smooth muscle of the uterus
dobutamine (dobutrex)
Treatment of…?
Heart failure
What it does?
Increases cardiac output by increasing contractility which increases stroke volume
dopamine (Intropin)
Treatment of…?
Cardiac contractility
What it does?
High doses- improves contractility and output
Low doses- vasodilation in brain, heart, kidneys, and mesentery which increases blood flow
norepinephrine (Levophed)
Directly metabolized to dopamine Treatment of...? Hypotension Shock What it does? Vasoconstriction
AR Adrenergic Drugs
Cardiovascular Vasoconstriction, hypertension, tachycardia, palpitations, dysrhythmias Central nervous system Headache, restlessness, excitement, insomnia, euphoria, nervousness, dizziness Respiratory system Bronchodilation Gastrointestinal Nausea, vomiting, anorexia
Contraindications of Adrenergic Drugs
Severe hypertension
Resulting in hemorrhage of the brain and other parts of the body
Adrenergic RN Implications
Vital signs including blood pressure and heart rate Cardiac dysrhythmias Hypertension Renal, hepatic, and cardiac function Inhalation Education on how to use inhaler Monitor for therapeutic effects Use pump to administer IV preparations Slow infusion Cardiac monitor
Adrenergic Drug Drug Interactions
DO NOT give with
Digoxin- cardiac dysrhythmias
Anesthetic drugs- cardiac dysrhythmias
Tricyclic antidepressants- acute hypertensive crisis
MAO inhibitors- life threatening hypertensive crisis
Adrenergic Toxicity
Lower the blood pressure using rapid acting sympatholytic drug
esmolol (Brevibloc) or another beta blocker
Adrenergic-Blocking Drugs
Inhibit sympathetic nervous system stimulation
used to treat:
a-Blockers
Hypertension
Benign prostatic hyperplasia (BPH)
b-Blockers Blocks norepinephrine and epinephrine Hypertension Tachycardia Angina Myocardial infarction Post myocardial infarction Migraine
phentolamine (Regitine)
Treatment of...? Hypertension a- adrenergic drug extravasation What it does? Vasodilation of the vessels
prazosin (Minipress)
Treatment of...? Benign prostatic hyperplasia What it does? Relaxes and dilates vasculature around the prostate Relieves impaired urinary flow Lowers blood pressure
a-Blockers
Adverse Reactions Orthostatic hyp0tension Nursing Implications Vital signs Fall risk Toxicity Emesis/gastric lavage Followed by activated charcoal
ergotamine (Ergostat)
phenoxybenzamine (Dibenzyline)
tolazoline (Priscoline)
atenolol (Tenormin)
Treatment of…?
Hypertension
Angina
Acute myocardial infarction
esmolol (Brevibloc)
Treatment of…?
Supraventricular Tachydysrhythmias (SVT)
Intra & postoperative hypertension
metoprolol (Lopressor)
Drug of choice if asthmatic or diabetic (but be careful!)
Treatment of…?
Hypertension
Myocardial infarction
propranolol (Inderal)
Do not give to asthmatic Careful if diabetic Treatment of...? Angina Hypertension Migraine
b-Blockers
Nursing Implications Do not give if HR <60 If diabetic, monitor blood sugars Do not coadminister with insulin (lowers blood sugar) Patient education Impotence Do not stop taking drug, needs to be tapered Can cause rebound hypertension Emergency!
acebutolol (Sectral)
carvedilol (Coreg)
labetalol(Normodyne)
sotalol (Betapace)
