Term
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Definition
| aka sympatholytics because they "lyse" or inhibit SNS stimulation |
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Term
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Definition
1. cause both arterial and venous dilation, reducing peripheral vascular resistance and BP
2. used to treat hypertension
3. effect on receptors on prostate gland and bladder decrease resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of BPH
4. used to control and prevent hypertension in pts with pheochromocytoma
5. Phentolamine - quickly reverses the potent vasoconstrictive effects of extravasated vasopressors such as norepinephrine or epinephrine and it restores the blood flow and prevents tissue necrosis |
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Term
| Common Alpha Blockers list |
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Definition
phenoxybenzamine HCl (Dibenzyline)
phentolamine (Regitine)
prazosin (Minipress)
tolazoline (Priscoline) |
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Term
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Definition
1. Block stimulation of beta receptors in SNS
2. compete with norepinephrine and epinephrine
3. can be selective or nonselective
4. nonselective beta blockers block both beta 1 and beta 2 receptors
5. located primarily on the heart
6. beta 1 blockers selective for these receptors are called cardioselective beta blockers
7. Beta 2 receptors are located primarily on the smooth muscle of the bronchioles and blood vessels |
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Term
A 32 year old pt has type II diabetes mellitus controlled with hypoglycemics.
Physician orders a nonselective beta blocker for treatment of essential tremors
Are there any concerns regarding this new drug order? |
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Definition
| Yes. Nonselective beta blockers may mask the tachycardia that occurs when a pt is hypoglycemic due to the action of insulin or sulfonylureas, and hypoglycemic effects of these two antidiabetic drugs may be enhanced |
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Term
| A pt in intensive care unit is receiving a beta blocker for treatment of severe hypertension. What beta-blocker will be used, and why is it used in this situation? |
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Definition
| Labetalol (Normodyne) blocks both alpha and beta adrenergic receptors and is used in the treatment of severe hypertension and hypertensive emergencies to quickly lower the BP before permanent damage is done |
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Term
A 78 year old man receiving tamsulosin for treatment of BPH. He has residual weakness from a previous stroke and sometimes has difficulty walking steadily.
What safety measures should be taught to this pt? |
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Definition
| Because tamsulosin may cause orthostatic hypotension, the pt must be taught how to rise slowly from lying or sitting position to prevent injury from falls. in additon, the drug should also be used with caution when driving or engaging in other activities requiring alertness because the adverse effects of this drug include blurred vision, dizziness, and drowsiness |
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Term
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Definition
Angina - decreases demand for myocardial oxygen
Cardioprotective - inhibits stimulation from circulating catecholamines
Dysrhythmias - Class II antidysrhythmic
Migraine headache - lipophilicity allows entry into CNS
antihypertensive
heart failure
glaucoma (topical use) |
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Term
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Definition
acebutolol (Sectral)
carvedilol (Coreg)
labetalol (Normodyne)
metoprolol (Lopressor)
atenolol (Tenormin)
esmolol (Brevibloc)
sotalol (Betapace)
Propranolol (Inderal) |
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Term
| Nursing Implications assessment |
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Definition
| Assess for allergies and history of COPD, hypotension, cardiac dysrhythmias, bradycardia, HF, or other cardiovascular problems---any preexisting condition that might be exacerbated by the use of these drugs might be a contraindication |
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Term
| Nursing Implications card 2 |
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Definition
1. Remember - alpha blockers may precipitate hypotension
2. Remember - some beta blockers may precipitate bradycardia, hypotension, heart block, HF, and bronchoconstriction |
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Term
| Nursing Implications Card 3 |
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Definition
1. Avoid OTC meds b/c of possible interactions
2. Possible drug interactions may occur with antacids, antimuscarinics/anticholinergics; diuretics and cardiovascular drugs; neuromuscular blocking drugs; oral hypoglycemic drugs |
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Term
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Definition
1. encourage pts to take meds as prescribed
2. instruct pts that these meds should never be stopped abruptly
3. pts should report constipation or the development of urinary hesitancy or bladder distension |
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Term
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Definition
1. teach pts to change positions slowly to prevent or minimize postural hypotension
2. instruct pts to avoid caffeine (excessive irritability)
3. avoid alcohol and hazardous activities until blood levels become stable
4. notify dr if palpitations, dyspnea, nausea, or vomiting occurs |
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Term
| Nursing Implications 6 - therapeutic effects |
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Definition
1. Monitor for adverse effects
2. Therapeutic effects
a. decreased chest pain in pts with angina
b. return to normal BP and HR
c. other specific effects depending on use |
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Term
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Definition
1. rebound hypertension or chest pain may occur if this med is discontinued abruptly
2. notify dr if they become ill and unable to take meds
3. they may notice a decrease in tolerance for exercise (dizziness and fainting may occur with increased activity) notify dr if these occur |
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Term
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Definition
Report the following to dr
1. weight gain of more than 2 lbs in 1 day or 5 lbs in 1 week
2. edema of the feet or ankles
3. shortness of breath
4. excessive fatigue or weakness
5. syncope or dizziness |
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Term
| Explain the purpose of propranolol order |
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Definition
| Beta blockers are considered to be cardioprotective b/c they inhibit the stimulation of the myocardium by circulating catecholamines (which are released during myocardial muscle damage such as that cause by an MI. |
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Term
| Pt has MI and is prescribed propranolol. after going home for 1 week he is called by the nurse and reports he is feeling more and more short of breath even though resting. What could be causing the problem and what do you expect may happen as a result? |
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Definition
| Propanolol is nonselective beta blocker and blocks receptors in the lungs as well as heart. Bronchoconstriction results and should not be used in pts with asthma. a cardioselctive beta blocker such as atenolol or metroprolol should be given instead. |
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Term
| What is a common adverse effect of beta blockers? |
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Definition
| Impotence... but do not stop meds abruptly if this happens. Pt should be weaned off and then prescribed something else. Abrupt discontinuation can cause rebound hypertension or chest pain. |
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Term
A. Alpha blocker
B. beta blocker
1. prolonged sinoatrial node recovery
2. decreased peripheral vascular resistance due to vasodilation
3. slowed conduction through the AV node of the heart
4. pupillary constriction
5. inhibition of catecholamines
6. reduced smooth muscle tone in the bladder
7. decreased heart rate
8. constriction of bronchial smooth muscle (narrowed airways) |
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Definition
1. B
2. A
3. B
4. A
5. B
6. A
7. B
8. B |
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Term
| General issues regarding beta blockers |
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Definition
1. bradycardia
2. bronchospasm
3. masking symptoms of hypoglycemia
4. depression
5. sexual dysfunction |
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Term
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Definition
| Interupt stimulation of the SNS at the alpha1 adrenergic receptors. More specifically, alpha blockers work either by direct competition with norepinephrine or by a noncompetitive process. Alpha blockers have a greater affinity for the alpha-adrenergic receptor than norepinephrine does and therefore can chemically displace norepinephrine molecules from the receptor. Adrenergic blockage leads to vasodilation, reduced blood pressure. |
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Term
| Alpha blockers used to treat BP |
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Definition
| doxazosin, prazosin, and terazosin |
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Term
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Definition
alpha blocker
1. reduces peripheral vascular resitance
2. used to treat hypertension
3. treat high BP caused by pheochromocytoma
4. also used to diagnose pheochromocytoma (tumor that secretes catecholamine)
5. only injectable
6. most commonly used to treat extravasation of vasoconstricting drugs
7. epinephrine and ephedrine can counteract the desired effects |
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Term
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Definition
| block the SNS stimulation of beta andrenergic receptors by competing with norepinephrine and epinephrine. The beta blockers can be selective or nonselective |
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Term
| Beta blockers used to treat BP |
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Definition
usually used in angina, cardioprotective, and conduction of heart
carvedilol and metoprolol most successful antihypertensives |
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Term
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Definition
beta blocker
1. cardioselective beta blocker
2. used to prevent heart attack in pts who have had a heart attack
3. hypertension and angina and management of thyrotoxicosis to plock the symptoms of excessive thyroid activity. |
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Term
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Definition
beta blocker
1. very strong, short acting
2. used for acute situation to provide temporary control of ventricular rate in pts with supraventricular tachydysrhythmias
3. only IV |
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Term
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Definition
beta blocker
1.fave of drs for treatment after MI
2. increased survival in pts
3. oral and injectable |
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Term
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Definition
beta blocker
1. nonselective beta blocker
2. uses for pts after MI and for treatment of tachydysrhythmias associated with cardiac glycoside intoxication and fro treatment of hypertrophic subaortic stenosis, pheochromocytoma, thyrotoxicosis, migraines, tremor
oral and injectable |
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Term
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Definition
agonists - drugs with specific recepttor affinity that mimic natural chemicals - compete for receptors
antagonists - drugs that bind to specific receptors and inhibit or block the response |
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