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39 Cards in this Set
- Front
- Back
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Adrenergic blockers |
-bind to adrenergic receptors but inhibit or block stimulation of the sympathetic nervous system -have the opposite effect of adrenergic drugs -inhibit(lyse) sympathetic stimulation |
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also known as |
adrenergic antagonists sympatholytics a-blockers, b-blockers, and a-b-blockers |
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classified by the type of the adrenergic receptor they block |
a1 and a2 receptors b1 and b2 receptors |
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a- blcokers effects and indication |
-cause both arterial and venous dilation, reducing peripheral vascular resistance and BP -treats hypertension -effect on receptors on prostate gland and bladder decreases resistance to urinary outflow, thus reducing urinary obstruction and relieving the effects of benign prostatic hyperplasia(BPH) |
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a-blockers - phenochromocytoma |
-used to control and prevent hypertension in patients with pheochromocytoma -abnormality in adrenal gland, overproduces epi and norepineprhine -blood pressuer will go sky high |
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other indications for a-blcokers |
-raynaud's disease, acrocyanosis, and frostbite |
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Phentolamine |
-quickly reverses the potent vasoconstrictive effects of extravasated vasopressors such as norepinephrine or epinephrine -restores blood flow and prevents tissue necrosis |
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a-blockers cardio adverse effecsts |
-palpitations, orthostatic hypotension, tachycardia, edema, chest pain |
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a-blockers central nervous system adverse effects |
dizziness, headache, anxiety, depression, weakness, numbness, fatigue |
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GI effects |
n/v/d, constipation, abomdinal pain |
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other effects |
incontinence, dry mouth, pharyngitis |
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common a-blockers |
usually end in SIN -alfuzosin hydrochloride -phentolamine mesylate -prazosin hydrochlroide teraosin hydrochloride -tamsulosin -doxasin mesylate |
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tamsulosin |
-ablocker used to treat BPH
-contraindications: known drug allergy and concurrent use of erectile dysfunctional drugs such as sildenafil(can severely reduce bp) -adverse effectS: headache, abnormal ejaculation, rhinitis, and others |
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Phentolamine |
-a-blocker that reduces systemic vascular resistnace and is sometimes used to treat hypertension -establish a diagnosis of pheochromocytoma -most commonly used to treat the extravasation of vasoconstricting drugs such as norepinephrine, epinephrine, and dopamine -contraindicated in known hypersensitivity, MI and coronary artery disease |
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beta blockers |
-block stimulation of b-receptors in SNS -complete with norepinephrine and epi -can be selective or nonselective |
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can be selective or nonselective |
-cardioselevetive B blockers or b1-blocking drugs -nonselective B blockers block both b1-receptors and b2-receptors |
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b2 receptors located on |
smooth muscles of the bronchioles and blood vessels |
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b1 receptors located |
primarily on the heart |
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cardioselective B-blockers mechanism of action |
-reduce SNS stimulation of the heart -decrease HR -prolong SA node recovery -slow conduction rate through the AV node -decrease myocardial contractility, thus reducing myocardial oxygen demand |
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nonselective B-blockers(b1 and b2) mechanism of action |
-cause same effects on heart as do cardioselective b-blockers -constrict bronchioles, resulting in narrowing of airways and SOB -produce vasocontrction of blood vessels -other effects |
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b-receptors: indications - |
-Angina, MI, hypertension - decrease demand for myocardial oxygen -Cardioprotective- inhibit stimulation from circulation catecholamines -Dysrhythemias -Glaucoma(topical use) -Migraine headache - lipophilicity allows entry into CNS |
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b-blockers cardio effects |
AV block, bradycardia, heart failure |
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CNS effects b blockers |
dizziness, fatigue, depression, drowsiness, unusual dreams |
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GI effects b blockers |
-n/v/d, constipation |
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Hematologic effects b blocckers |
agranulocytosis, thrombocytopenia |
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metabolic b blocker effects |
hyperglycemia, hypogylcemia, dyslipidemia |
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other effects b blockers |
ereticle dysfunction, alopecia, bronchospasm, wheezing, dry mouth |
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nonselective B blockers effects |
-may interefere w/ normal responses to hypoglycemia(tremors, tachycardia, nervousness) -may mask signs and symptoms of hypocglycemia -use with caution in patients with diabetes mellitus |
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Atenolol |
-cardioselective B-blocker -comonly usd to prevent future heart attacks in patients who have had one heart attack -hypertension and angine -management of thryotoxicosis to help block the symptoms of excessive thyroid activity -available for oral use -metoprolol for oral use and IV |
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OLOL ending |
beta blockers |
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Carvedilol |
-nonselective B-blocker and a1-blocker, a calcium channel blocker, and possibly an antioxidant -uses: heart failure, hypertension, angina -slows progession of heart failure and decreases the frequency of hospitalization in patients w/ mild to moderate(class 2 or 3) heart failure -most commonly added to digoxin, furosemide, and angiotension-converting enzyme inhibitors when used to treat heart failure |
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nursing implications |
-a-blockers may precipitate hypotension -some b-blockers may preceipitate bradycardia, hypotension, heart block, heart failure and bronchoconstriction |
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possible drug interactions |
-antacids -antimuscarinics or anticholinergics -diuretics and cardiovascular drugs -neuromuscular blocking drugs -oral hypoglycemic drugs |
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inform patietns to report |
constiptation of the development of urinary hesistancy or bladder distentension
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teaching |
-change positions slowly to prevent postural hypotension -avoid caffiene-causes irritability -avoid alcohol and hazardous activities till blood levels become stable -notify physician if palpitations, dyspneam nausea or vomiting occurs |
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monitor for therapeutic effects |
-decreased chest pain in patients with angina -return to normal BP and HR -other specific effects, depending on use |
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what can occur if b-blockers are discountined abruptly |
rebound hypertension and chest pain
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teaching patients b-blockers |
-notify physican if they become ill and are unable to take med -they may notice a decreased in tolerancce for exercise(dizziness and fainting may occur with increased activity) , and have patients notify their physicans if these problems occur |
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inform patients to report the following to their physicians: |
-weight gain of more than 1kg in 24 hours or 2.3kg in one week -edema of the feet or ankles -SOB -excessive fatigue or weakness -syncope or dizziness |
