ADRENERGIC DRUGS
xv. What other class of drugs should not be taken with these BPH drugs?
-- Do not take erectile dysfunction meds
iv. Where are Dopaminergic receptors located?
- Brain
-Kidney
-RAAS (he system of hormones, proteins, enzymes and reactions that regulate your blood pressure and blood volume on a long-term basis)
v. What happens if Dopamine binds to a Dopaminergic receptor?
-Dilation of cerebral arteries, coronary arteries, renal arteries, and mesenteric arteries.
i. What autonomic response can you expect if Adrenergic receptors are stimulated?
-Sympathetic Nervous System Activated (Fright)!!!!
-Constriction of blood vessels.
- Pupil dilation
- Increased cardiac output to brain, heart, skeletal muscles.
- Increased respirations and O2 consumption
- Increased mental activity
vi. What are the names of 3 exogenous catecholamine drugs?
- Norepinephrine
-Epinephrine
-Dopamine
xiii. When is it appropriate to use an adrenergic blocking drug?
- BPH (Benign Prostatic Hyperplasia: enlarged prostate).
- Pts with increased alpha-adrenergic agonist activity: Raynard’s disease and Frostbite
- Extravasation (unintentional leakage of vesicant fluids or medications from the vein into surrounding tissue).
- Cardiovascular indications: HTN
xvi. What is Phentolamine used for?
Phentolamine
-Alpha blockers
- Reduces PVD (peripheral vascular disease)
-Used for: Treating extravasation of: Vasoconstricting drugs, High BP from pheochromocytoma, and Diagnosing pheochromocytoma
xvii. What are common adverse effects of adrenergic blocking drugs?
-Bronchospasm
-HF
- prolonged hypoglycemia
- bradycardia
-heart block
- intermittent claudication
-Raynaud’s phenomenon
- Neurological reactions include depression, fatigue, and nightmares.
iii. What are the individual adrenergic receptors?
-Alpha 1 (vasoconstriction, increased peripheral resistance (blood flow), increased BP, Mydriasis, and increased bladder sphincters
-Alpha 2 (Inhibits norepinephrine release, inhibits acetylcholine release, inhibits insulin release).
-Beta 1 (Increased HR, Increased lipolysis, increased myocardial contractility, increased renin).
-Beta 2 (vasodilation, decreased peripheral resistance, bronchodilatation, increased glycogenolysis (muscle, liver), increased Glucagon release, relaxes uterine smooth muscle).
viii. What are important nursing considerations when a patient is receiving an exogenous catecholamine drug?
- These drugs have many interactions with lots of other drugs.
- These drugs are used in emergency situation in a controlled setting with resuscitative equipment.
- These drugs are used to raise BP when the pts BP is very low and incompatible with life.
- Hypotension can occur as result of: Hypovolemic shock, Cardiogenic shock, Septic shock, Anaphylactic shock.
- These drugs are given IV (large vessel and large catheter) and need to titrated to the desired therapeutic response (BP,HR,etc).
- The nurse will be responsible for monitoring the vital signs closely including oxygen saturation.
- The nurse will monitor ABG, lactate levels
-The nurse will monitor urine output (greater than 30 mL/h)
- The nurse will monitor the IV site when an adrenergic drug is infusing.
-Black box warning for tissue damage with extravasation
-Collaborate with pt and family regarding discharge.
ix. What are the names of 2 alpha agonists drugs and when and why are these drugs used?
- Midodrine:
-Alpha 1 (selective)
-Used for orthostatic hypotension
- Phenylephrine
-Alpha 1
-Vasoconstriction
x. What are the names of 3 beta agonists drugs and how are they used?
-Dobutamine
Beta 1 (selective)
Increases cardiac output and strength of contraction
Used for: short term treatment of HF and Cardiac surgical procedures that go bad.
-Norepinephrine
Alpha 1 and Beta 1 (predominately alpha 1)
Used for: treat hypotension and shock
xiv. What are the names of 3 adrenergic blocking drugs that are used to treat BPH?
- Tamsulosin
- Terazosin
- Alfuzosin