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Flashcards in Adrenergic Drugs Deck (32):
0

Dobutamine
(Functional Classification)

Adrenergic direct-acting Beta1-agonist, cardiac stimulant

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Dobutamine
(Chemical Classification)

Catecholamine

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Dobutamine
(Mechanism of Action)

Causes increased contractility, increased cardiac output without marked increase in heart rate by acting on Beta1-receptors in heart; minor alpha and beta2 effects

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Dobutamine
(Uses)

Cardiac decompensation due to organic heart disease or cardiac surgery

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Dobutamine
(Contraindications)

Hypersensitivity, idiopathic hypertrophic subaortic stenosis

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Dobutamine
(Side Effects)

CNS: Anxiety, headache, dizziness, fatigue
CV: palpitations, tachycardia, hyper/hypotension, PVCs, angina
ENDO: hypokalemia
GI: heartburn, nausea, vomiting
MS: muscle cramps (leg)
RESP: dyspnea

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Dobutamine
(Nursing Considerations)

ASSESS:
-HYPOVOLEMIA; if present, correct first; administer cardiac glycoside before DOBUTamine
-OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
-HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses; report if extremities become cold or mottled or if peripheral pulses decrease
-ECG during administration continuously; if BP increases, product is decreased; CVP or PCWP, cardiac output during inf; report changes
-Serum electrolytes, urine output
-SULFITE SENSITIVITY, which may be life threatening

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Dobutamine
(Overdose Treatment)

Administer a Beta1-adrenergic blocker; reduce IV or discontinue, ensure oxygenation/ventilation; for severe tachydysrhythmias (ventricular), give lidocaine or propranolol

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Dopamine
(Functional Classification)

Adrenergic

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Dopamine
(Chemical Classification)

Catecholamine

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Dopamine
(Mechanism of Action)

Causes increased cardiac output; acts on beta1- and alpha-receptors, causing vasoconstriction in blood vessels; low dose causes renal and mesenteric vasodilation; beta1 stimulation produces inotropic effects with increased cardiac output

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Dopamine
(Uses)

Shock, increased perfusion, hypotension, cardiogenic/septic shock

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Dopamine
(Contraindications)

Hypersensitivity, ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypovolemia

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Dopamine
(Side Effects)

CNS: Headache, anxiety
CV: Palpitations, Tachycardia, Hypertension, Ectopic Beats, Angina, Wide QRS Complex, peripheral vasoconstriction, hypotension
GI: Nausea, Vomiting, Diarrhea
INTEG: necrosis, tissue sloughing with extravasation, GANGRENE
RESP: dyspnea

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Dopamine
(Nursing Considerations)

ASSESS:
-Hypovolemia; if present, correct first
-OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
-HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses
-I&O ratio: if urine output decreases without decrease in BP, product may need to be reduced
-ECG during administration continuously; if BP increases, product should be decreased; PCWP, CVP during inf
-BP, pulse q5min
-Paresthesias and coldness of extremities; peripheral blood flow may decrease
-Inj site: tissue sloughing; if this occurs, administer phentolamine mixed with NS

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Dopamine
(Overdose Treatment)

Discontinue IV, may give a short-acting alpha-adrenergic blocker

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Epinephrine
(Functional Classification)

Bronchodilator nonselective adrenergic agonist, vasopressor

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Epinephrine
(Chemical Classification)

Catecholamine

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Epinephrine
(Mechanism of Action)

Beta1- and Beta2-agonist causing increased levels of cAMP, thereby producing bronchodilation, cardiac, and CNS stimulation; high doses cause vasoconstriction via alpha-receptors; low doses can cause vasodilation via Beta2-vascular receptors

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Epinephrine
(Uses)

Acute asthmatic attacks, hemostasis, bronchospasm, anaphylaxis, allergic reactions, cardiac arrest, adjunct in anesthesia, shock

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Epinephrine
(Contraindications)

Hypersensitivity to sympathomimetics, closed-angle glaucoma, nonanaphylactic shock during general anesthesia

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Epinephrine
(Side Effects)

CNS: Tremors, Anxiety, insomnia, headache, Dizziness, confusion, hallucinations, CEREBRAL HEMORRHAGE, weakness, drowsiness
CV: Palpitations, Tachycardia, hypertension, Dysrhythmias, increased T wave
GI: Anorexia, Nausea, Vomiting
MISC: sweating, dry eyes
RESP: Dyspnea

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Epinephrine
(Nursing Considerations)

ASSESS:
-ASTHMA: auscultate lungs, pulse, BP, respirations, sputum (color, character); monitor pulmonary function studies before and during treatment
-ECG during administration continuously; if BP increases, decrease dose; BP, pulse q5min after parenteral route; CVP, ISVR, PCWP during inf if possible; inadvertent high arterial BP can result in angina, aortic rupture, cerebral hemorrhage
-Inj site: tissue sloughing; administer phentolamine with NS
-SULFITE SENSITIVITY; may be life-threatening
-Cardiac status, I&O; blood glucose in diabetes
-ALLERGIC REACTIONS, BRONCHOSPASMS: withhold dose, notify prescriber

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Epinephrine
(Overdose Treatment)

Administer alpha-blocker and beta-blocker

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Norepinephrine (Levophed)
(Functional Classification)

Adrenergic

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Norepinephrine (Levophed)
(Chemical Classification)

Catecholamine

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Norepinephrine (Levophed)
(Mechanism of Action)

Causes increased contractility and heart rate by acting on beta-receptors in heart; also acts on alpha-receptors, thereby causing vasoconstriction in blood vessels; BP is elevated, coronary blood flow improves, and cardiac output increases

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Norepinephrine (Levophed)
(Uses)

Acute hypotension, shock

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Norepinephrine (Levophed)
(Contraindications)

Hypersensitivity to this product or cyclopropane/halothane anesthesia; ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypotension, hypovolemia

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Norepinephrine (Levophed)
(Side Effects)

CNS: Headache, anxiety, dizziness, insomnia, restlessness, tremor, CEREBRAL HEMORRHAGE
CV: Palpitations, Tachycardia, Hypertension, Ectopic Beats, Angina
GI: Nausea, Vomiting
GU: decreased urine output
INTEG: necrosis, tissue sloughing with extravasation, GANGRENE
RESP: dyspnea
SYST: ANAPHYLAXIS

30

Norepinephrine (Levophed)
(Nursing Considerations)

ASSESS:
-I&O ratio; notify prescriber if output <30ml/hr
-BP, pulse q2-3min after parenteral route, ECG during administration continuously; if BP increases, product is decreased, CVP or PWP during inf if possible
-Paresthesias and coldness of extremities; peripheral blood flow may decrease
-EXTRAVASATION: inj site: tissue sloughing
-sulfite sensitivity, which may be life-threatening

31

Norepinephrine (Levophed)
(Overdose Treatment)

Administer fluids, electrolyte replacement