Adrenergic Drugs
Name 2 centrally-acting adrenergic drugs that are alpha2-adrenergic receptor stimulators (blockers).
Clonidine (Catapres) and methyldopa
What is the suffix for ACE inhibitors?
"-pril" (i.e., captopril, enalapril, lisinopril)
What is the suffix for angiotensin II receptor blockers (ARBs)?
"-sartan" (i.e., losartan, valsartan)
What is the suffix for calcium channel blockers?
"-dipine" (i.e., amlodipine, nifedipine)
NOTE: One calcium channel blocker that is well known is "verapamil".
Name a drug that is a vasodilator.
Hydralazine
How do centrally acting adrenergic drugs work?
- Decrease norepinephrine production
- Reduce renin activity in the kidneys
What conditions do ACE inhibitors treat?
- Heart failure
- HTN
What is the MOA of ARBs?
They block vasoconstriction and the secretion of aldosterone.
**This is why these drugs are beneficial in patients with HTN and heart failure.
What are calcium channel blockers primarily used for?
HTN and angina
What is the MOA of vasodilators?
They directly relax arteriolar or venous smooth muscle (or both), resulting in decreased SVR, decreased afterload, and peripheral vasodilation.
What adverse effects should the nurse watch for with the alpha2-adrenergic receptor stimulators (blockers)?
- Orthostatic hypotension
- Fatigue
- Dizziness
Name 2 adverse effects associated with ACE inhibitors.
- Dry, nonproductive cough
- Angioedema (rare)
Who should not be prescribed ARBs?
Women who are pregnant or breastfeeding.
What is the MOA of calcium channel blockers?
Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction.
Name some adverse effects associated with hydralazine.
- Dizziness
- Headache
- Tachycardia
- Anxiety
Name 2 adrenergic drugs that are peripherally acting alpha1 blockers.
Doxazosin and prazosin
What are the primary effects of ACE inhibitors?
- Prevent sodium and water resorption in the kidneys, thereby decreasing the volume of blood (decreases systemic vascular resistance or SVR)
Name some of the most common adverse effects of ARBs.
- hypoglycemia
- hyperkalemia (less likely to occur than with the ACE inhibitors)
What are common adverse effects of calcium channel blockers?
- flushing
- nausea
- constipation
What conditions do the peripherally acting alpha1 blockers treat (what condition do they treat that sets them apart from the other antihypertensive drugs)?
- HTN
- BPH!
What lab values need to be monitored with a patient taking an ACE inhibitor?
- Serum creatinine
- Potassium levels
What should the nurse educate a patient about who was recently prescribed an ARB?
ARBs are tolerated best when taken with food (absorption of the drug is more gradual and effective).
What should the nurse teach a patient who is taking a calcium channel blocker?
1. Increase fluid and fiber intake to prevent constipation.
2. Avoid hot tubs and saunas. They increase vasodilation and increase the occurrence of orthostatic hypotension.
3. Report the occurrance of any palpitations to the provider.
4. Verapamil should NOT be taken with grapefruit juice, because it will decrease the metabolism of this drug.
What is the suffix for the adrenergic drug class "Beta Blockers"?
"-lol"
What is the MOA for beta blockers?
They reduce the heart rate (this reduces the workload on the heart and decreases oxygen demand).
Name a disease that is a contraindication to the use of beta blockers.
Asthma and other chronic respiratory diseases (due to beta2-blocking properties)
What is a common adverse effect with beta blockers?
Sexual dysfunction
What should patients be cautioned about when taking adrenergic drugs?
The drugs can cause additive CNS depression when taken with alcohol, benzodiazepines, or opioids.