Chapter 15: Epinephrine & Atenolol

Adrenergic agonists

Drugs that stimulate the sympathetic nervous system

• Pupils dilate, increased HR/BP, bronchodilation, bladder/intestine relaxes

Adrenergic antagonist drugs

 Block the effects of adrenergic neurotransmitters

• Indirectly inhibiting the release of neurotransmitters epi and norepi

Epinephrine drug class

Sympathomimetic/Adrenergic agonists

Epinephrine mechanism of action

• Alpha 1

• Beta 1

• Beta 2

Alpha 1

Increases BP

Beta 1

Increases HR

Beta 2

Promotes bronchodilation

Epinephrine uses

• Anaphylaxis

• Anaphylactic shock

• Asthma exacerbation

• Cardiac arrest

• Bronchospasms

• Cardiogenic shock

• Status asthmaticus

Epinephrine side effects

• Hyperglycemia/hypoglycemia

• Oliguria (decreased urine output)

• Paresthesia

Heart/BVs

• Cardiac dysrhythmias

• Palpitations

• Tachycardia

• HTN

Nervous System

• Dizziness

• Restlessness

• Headache

• Agitation

• Tremors

Epinephrine adverse effects

• Dyspnea

• Injection site reaction

• Renal insufficiency

• Tachycardia

• Palpitations

• MI

Epinephrine life-threatening adverse effects

• Dysrhythmias

• Pulmonary edema

Atenolol drug class

beta 1-adrenergic blocker

• beta 1 controls heart

Atenolol uses

• Lowers BP of HTN

• Reduces angina pectoris

• Treats/prevents MI

• Manages arrythmias

Atenolol mechanism of action

• Decreases sympathetic outflow to the periphery 

• Suppresses renin-angiotensin-aldosterone system

Atenolol side effects

Neurological

• Drowsiness

• Dizziness

• Depression

• Headache

• Fatigue

Gastrointestinal

• Nausea

• Diarrhea

Circulatory

• Edema

• Cool extremities

Atenolol adverse effects

• Dyspnea

• Orthostatic hypotension

• Tachycardia/Bradycardia

• Chest pain

• Heart failure

Atenolol nursing considerations

• Tell patients to sit up slowly then wait for a few mins before getting up (d/t orthostatic hypotension)

• DO NOT take with other BP meds or NSAIDs

  • May cause rebound hypertension

• Not safe for pregnant women

Atenolol patient education

• Teach how to take their own BP using a BP cuff

  • (for all antihypertensives)

• DO NOT abruptly stop

  • Rebound hypertension too