Chapter 15

Question 1

A drug that binds to a receptor and causes a reaction.

Answer 1

Agonist

Question 2

A drug that blocks a receptor site and prevents an action.

Answer 2

Antagonist

Question 3

Anything that mimics the SNS (epinephrine, norepinephrine)

Answer 3

Adrenergic

Question 4

A drug that binds to certain receptors.

Answer 4

Selective

Question 5

A drug that binds to all receptors.

Answer 5

Non-selective

Question 6

2 alpha receptors and 2 beta receptors.

Answer 6

Receptors

Question 7

What happens to the blood when an agonist drug binds to alpha 1 receptors?

Answer 7

Vasoconstriction
Increased BP
Increased HR

Question 8

What happens to the eyes when an agonist drug binds to alpha 1 receptors?

Answer 8

Mydriasis (pupil dilation)

Question 8

What happens to the bladder when an agonist drug binds to alpha 1 receptors?

Answer 8

Relaxation

Question 9

What happens to the prostate when an agonist drug binds to alpha 1 receptors?

Answer 9

Contraction

Question 10

What happens to the blood when an agonist drug binds to alpha 2 receptors?

Answer 10

Decreased blood pressure (decreased norepinephrine)

Question 11

What happens to the GI when an agonist drug binds to alpha 2 receptors?

Answer 11

Decreased GI tone and motility

Question 12

What happens to the heart when an agonist drug binds to beta 1 receptors?

Answer 12

Increased contraction/ HR

Question 13

What happens to the kidneys when an agonist drug binds to beta 1 receptors?

Answer 13

Increased renin secretion
Increased angiotensin
Increased BP

Question 14

What happens to the GI when an agonist drug binds to beta 2 receptors?

Answer 14

Decreased GI tone and motility

Question 15

What happens to the lungs when an agonist drug binds to beta 2 receptors?

Answer 15

Bronchodilation

Question 16

What happens to the uterus when an agonist drug binds to beta 2 receptors?

Answer 16

Relaxation of uterine smooth muscle

Question 17

What happens to the liver when an agonist drug binds to beta 2 receptors?

Answer 17

Activation of glycogenolysis
Increased blood sugar

Question 18

Catecholamines?

Answer 18

Chemical structure of a substance.
Either endrogenous or synthetic
Produce sympathomimetic response
Ex. epinephrine, norepinephrine, dopamine

Question 19

Non-catecholamines?

Answer 19

Stimulate the adrenergic receptors. Longer duration of action than the endogenous or synthetic catecholamines.
Ex. phenylephrine and albuterol

Question 20

What is the action of epinephrine?

Answer 20

• Non-selective adrenergic agonist
• Alpha 1: Increase BP
• Beta 1: Increase HR
• Beta 2: Bronchodilation

Question 21

How can epinephrine be given?

Answer 21

Subcutaneously, IV, topical, inhalation, intracardiac
NO ORAL

Question 22

What lab interactions are associated with epinephrine administration?

Answer 22

Increased blood glucose

Question 23

Side effects/ adverse reactions of epinephrine?

Answer 23

Restlessness, sweating, hyperglycemia, MI, hypertension, tremor, oliguria, decreased secretions

Question 24

What should be monitored after epinephrine administration?

Answer 24

Monitor BP, pulse, urine output, blood sugar, diet pills, cold medications (as these have stimulants)

Question 25

How does albuteral interact with receptors?

Answer 25

- Selective however affects B1 receptors to some degree

Question 26

Side effects/ adverse reactions to albuterol?

Answer 26

Tremors, nervousness, restlessness, dizziness, reflex tachycardia, cardiac dysrhytmias

Question 27

What drug interaction should be monitored when a patient is administered albuterol?

Answer 27

May increase effect with other sympathomimetics.

Question 28

What are dopamine receptors? What is important?

Answer 28

Can only be stimulated by dopamine Found in kidneys, coronary arteries, cerebral arteries Stimulation causes vessels to dilate and blood flow to increase

Question 29

What do adrenergic alpha blockers do?

Answer 29

Block alpha and beta receptor sites - Alpha blockers

Question 30

What do alpha blockers do?

Answer 30

Selective (block alpha 1) Non-selective (block alpha 1 and 2)

Question 31

What do adrenergic beta blockers do?

Answer 31

Selective (block beta 1) Non-selective (block beta 1 and 2)

Question 32

What are the effects of adrenergic alpha blockers?

Answer 32

- Vasodilation=decreased BP= reflex tachycardia - Pupil constriction - Reduces contraction of smooth muscles in bladder

Question 33

What is the effect of adrenergic beta blockers?

Answer 33

Beta 1= reduces cardiac contractility, decreases HR Beta 2= bronchoconstriction, contracts uterus, inhibits glycogenolysis All beta blockers decrease BP and HR

Question 34

What do beta 1 blockers affect?

Answer 34

The heart

Question 35

What do beta 2 blockers affect?

Answer 35

Lungs

Question 36

What is the contraindication of propanolol a nonselective beta blocker?

Answer 36

- Blocks beta 1 = decrease BP and pulse - Blocks beta 2 = bronchoconstriction Contraindication for patients with COPD and asthma

Question 37

What should be monitored when giving an adrenergic blocker?

Answer 37

1. Monitor BP before administration 2. Non-selective BB will lower BP and HR and cause bronchoconstriction 3. Ashmatics should take a selective BB 4. Monitor for falls (ortho-hypotension) 5. Take medication at the same time every day 6. Taper medications 7. Monitor blood sugar (will mask signs of hypoglycemia except sweating)

Question 38

The nurse is teaching a client who is taking metoprolol. Which should the nurse consider the highest priority in teaching side effects/adverse effects? A. Report any complaints of stuffy nose. B. Instruct the client how to take a pulse. C. Check urine output and bladder distention. D. Warn of possible impotence and decreased libido.

Answer 38

C. Check urine output and bladder distention.

Question 39

The nurse will monitor the client taking albuterol for which conditions? (Select all that apply) A.Palpitations B.Hypertension C.Hypoglycemia D.Bronchospasm E.Uterine contractions

Answer 39

A.Palpitations B.Hypertension D.Bronchospasm

Question 40

Nadolol is prescribed for a client. The nurse realizes that this drug is a non-selective beta- adrenergic blocker and that this drug classification is contraindicated for clients with which condition? A.Hypothyroidism B.Angina pectoris C.Bronchial asthma D.Liver dysfunction

Answer 40

C.Bronchial asthma

Question 41

The client is given epinephrine, an adrenergic agonist. The nurse should monitor the client for which condition? A.Decreased pulse B.Pupil constriction C.Bronchial constriction D.Increased blood pressure

Answer 41

D.Increased blood pressure

Question 42

A client is prescribed metoprolol to treat hypertension. It is important for the nurse to monitor the client for which condition? (Select all that apply) A.Bradycardia B.Hypotension C.Ankle edema D.Decreased respirations E.Increased respirations

Answer 42

A.Bradycardia B.Hypotension C.Ankle edema