Adrenergic Agonists and Blockers

Question 1

Adrenergic Agonists affect the

Answer 1

sympathetic nervous system (fight or flight)

Question 2

What effects do adrenergic agonists have on the body?

Answer 2

• Mydriasis
• Bronchodialysis
• Increased HR
• Vasoconstriction
• Relaxation of the bladder
  
  • decreased motility of GI
• Relaxation of the Uterus
  
  • fluid retention
• Relaxation of the Uterus
  
  • decreased contraction

Question 3

Beta₁ receptors are located primarily in the

Answer 3

1. heart

Question 4

Stimulation of the Beta₁ receptors cause

Answer 4

• increased cardiac contractility (P)
• increased renin secretion (inc. BP and vasoconstriction)

Question 5

Beta₂ receptors are found mostly in

Answer 5

smooth muscles of the

1. lungs
2. GI tract
3. uterine muscle

Question 6

Stimulation of the Beta₂ receptors results in

Answer 6

• bronchodilation
• decreases GI motility and tone (constipation)
• increases blood flow to skeletal muscles
• decreases uterine tone (urine rtn.)
• activates liver glycogenolysis (inc. serum blood glucose)

Question 7

What are the effects of dopaminergic receptor sites?

Answer 7

• vasodilation
  
  • increases blood flow

Question 8

What classification is Epinephrine (adrenalin)?

Answer 8

Non-selective: works on ALL receptor sites

primarily alpha₁, beta_1, and beta₂

Question 9

What is the action/effect of epinephrine

Answer 9

• alpha₁ increases blood pressure, contractility (inotropic.)
• beta₁ increases HR (vasoconstriction)
• beta₂ promotes bronchodilation

Question 10

What are the contraindications for epinephrine

Answer 10

• cardiac dysrhythmias
• hypertension
• hyperthyroidism
• pregnancy
• closed angle glaucoma
• shock

Question 11

What are some uses of epinephrine

Answer 11

• anaphylaxis, anaphylactic shock
• bronchospasms
• cardiogenic shock, cardiac arrest

Question 12

What are the side effects/adverse reactions of epinephrine?

Answer 12

• cardiac dysrhythmias
• flushing
• reflex tachycardia
• IOP
• decreased renal perfusion
  
  • due to vasoconstriction
• HA, anxiety, fear, palpatations,

Question 13

What types of drugs interact with epinephrine?

Answer 13

• beta-blockers
  
  • decreases epinephrine action
• digoxin
  
  • causes cardiac dysrhythmias

Question 14

What are the nursing interventions for epinephrine?

Answer 14

• Never give orally
• Monitor BP, P, and urine output
• Report tachycardia, palpitations, tremors, dizziness, hypertension
• Monitor IV site for infiltration
• Avoid cold medications and diet pills if hypertensive, diabetic, CAD, or dysrhythmias
• Avoid adrenergics when nursing infants
• Avoid continuous use of adrenergic nasal sprays

Question 15

What classification is albuterol

Answer 15

Selective

Acts on beta2 adrenergic receptors

promotes bronchodilation

Question 16

Alpha₁ receptors cause

Answer 16

• increased cardiac contractility
• vasoconstriction
• dilated pupils - mydriasis
• decreased salivary gland secretion
• increased bladder relaxation and urinary sphincter

Question 17

Alpha₂ receptors cause

Answer 17

• inhibit norepinephrine release (vasodilation)
• decreased GI motility and tone

Question 18

For what is albuterol used?

Answer 18

Treat bronchospasm, asthma, bronchitis, COPD

Question 19

Albuterol can be used cautiously with

Answer 19

• Severe cardiac disease
• Hypertension
• Hyperthyroidism
• Diabetes mellitus
• Pregnancy

Question 20

Albuterol can be given by which routes?

Answer 20

• orally
• inhalation
  
  • Nebulizer is by far the fastest route of admin

Question 21

Epinephrine can be administered by what routes?

Answer 21

• Subq
• IV
• Topically
• Inhalation
• Intercardiac
• Instillation

Question 22

Side effects/ adverse reactions of albuterol include

Answer 22

• Tremors
• nervousness
• restlessness
• dizziness
• reflex tachycardia
• hallucinations
• cardiac dysrhthmias

Question 23

What is the effect of alpha₁ adrenergic blockers?

Answer 23

• Vasodilation
• decreased BP
• pupil constriction (miosis)
• reflex tachycardia
• suppresses ejaculation
• reduces contraction of smooth muscles in bladder neck and prostate.

Question 24

What is the effect of beta₁ blockers

Answer 24

• Reduces cardiac contractility
• Decreases pulse

Question 25

What is the effect of beta₂ blockers

Answer 25

* Bronchoconstriction * Contracts uterus * Inhibits glycogenolysis

Question 26

What are the uses of alpha blockers?

Answer 26

* Decrease symptoms of * BPH - benign prostatic hypertrophy * Terazosin * PVD - peripheral vascular disease

Question 27

What are the uses for beta blockers?

Answer 27

* Hypertension * Angina pectoris * HF * MI

Question 28

Contraindications for beta blockers include

Answer 28

* COPD * asthma * 2^nd and 3^rd degree heart block

Question 29

Side effects of nonselective beta-blockers include

Answer 29

* bronchoconstriction * weight gain * impotence * decreased libido * reversible alopecia

Question 30

Side effects of selective beta blockers include

Answer 30

* Bradycardia * Hypotension * fainting * fatigue * mental depression * etc - see slide 20

Question 31

What assessments should be done before administering adrenergic agonists?

Answer 31

* Baseline VS * Complete Drug Hx * Determine Health Hx * contraindications * cardiac dysrhythmias * narrow-angle glaucoma * cardiogenic shock * Determine baseline glucose level

Question 32

What are some nursing interventions and teaching for adrenergic agonists

Answer 32

* Monitor IV sites for extravasation * Monitor ECG * Monitor I&O * Avoid use with OTC cold and diet pills with hypertension and DM * Avoid continuous use of nasal sprays - rebound nasal congestion * Do Not Stop use abruptly * Report side effects * rapid HR, palpitations, Irregular HB * rash, itching, flushing * chest pain * numbness of fingers and toes

Question 33

What are some assessments that should be done before administering adrenergic blockers

Answer 33

* Baseline VS and ECG * Report if pt taking diuretics, NSAIDs, digoxin, MAOIs, or CNS depressants * Health Hx * Depression * peptic ulcer * heart failure

Question 34

What are some nursing interventions and patient teaching for adrenergic neuron blockers?

Answer 34

* Monitor VS (teach) * Report excessive dizziness, lightheadedness, early morning insomnia, mental depression or chest pain * Assist with ambulation * Note complaints of stuffy nose * Adhere to drug regimen * Teach to rise slowly * Inform of possible mood changes * May cause impotence/decreased libido * Do not drive before effects are known

Question 35

What is the drug class and mechanism of action for propranolol?

Answer 35

* beta-adrenergic blocker * acts on beta₁ and beta₂ receptors

Question 36

For what is propranolol used

Answer 36

* Hypertension * dysrhythmia * angina pectoris * Prevention of migraine and MI

Question 37

What is the route of administration for propranolol?

Answer 37

PO

Question 38

What are the drug class and mechanism of action for metoprolol?

Answer 38

* beta-adrenergic blocker * acts on the beta₁ receptor

Question 39

For what is metoprolol used to treat?

Answer 39

* Hypertension * Heart Failure

Question 40

What is the route of administration for metoprolol?

Answer 40

PO - hypertension IV - MI

Question 41

What are the drug class and mechanism of action for atenolol?

Answer 41

* Beta-adrenergic blockers * Acts on beta₁ receptors

Question 42

For what is atenolol used to treat?

Answer 42

* Hypertension * angina * MI * HF

Question 43

What is the route of administration for atenolol?

Answer 43

PO

Question 44

What are the drug class and action of terazosin?

Answer 44

* Alpha-adrenergic blocker * acts on alpha₁ receptors

Question 45

For what is terazosin used to treat?

Answer 45

* Hypertension * BPH - benign prostatic hypertrophy