Adrenergic Agonists and Antagonist

Fill in the blanks:

Adrenergic agonists stimulate the _________________ nervous system by mimicking ________________________ and __________________________.

Sympathetic, epinephrine, and norepinephrine

What are the (3) main adrenergic receptors that we will be studying and where are they located?

Alpha 1 - located in blood vessels, eyes, bladder, and prostate

Beta 1 - primarily in the heart but can be found in the kidneys (Think...you have 1 heart)

Beta 2 - in the lungs and GI tract (Think..you have 2 lungs)

What s/s should be expected when Alpha 1 receptors are stimulated?

Increased cardiac contractility

Vasoconstriction

Dilates pupil

Relaxes the bladder

Contracts the prostate

What are the effects of adrenergic agonists at Alpha 1 receptors?

-Heart

-Bronchi

-GI tract

-Urinary bladder relaxation

-Ciliary eye muscles - dilation of pupil (mydriasis)

-Decreased salivary gland secretion - dry mouth

-Increased urinary sphincter contraction

What are the effects of adrenergic agonists at Beta 1 recepeptors?

-Increases cardiac contractility (force of contraction) and heart rate

-Increases renin secretion > increasing blood pressure

What are the effects of adrenergic agonists at Beta 2 receptors?

- Decreased GI tone and motility (relax)

-Broncho dilation

-Increases blood flow in skeletal muscles

-Relaxes smooth muscles of uterus

-Activates liver glycogen lysis - increases blood sugar

True/False:

IV adrenergic agonists are high-alert medications.

True, bc they can cause significant harm if a medication error occurs

What (2) enzymes inactivate and reuptake norepinephrine?

-MAO - inside the neuron

-COMT- outside the neuron

Why is epiepheren considered to be nonselective?

Because it stimulates alpha 1, beta 1, and beta 2

What is the "action" of epinephrine?

Activate sympathetic nervous system by increased blood pressure, increasing heart rate, and promoting bronchdilation

What conditions does epinephrine treat?

- Anaphylaxis,, anaphylactic shock

-Broncho spasms, status asthmaticus

-Cardiogenic shock, cardiac arrest, cardiac resuscitation

-Angioedema

What are side effects and adverse reactions of epinephrine?

-GI disturbances

-Sweating, headache, insomnia, dizziness, agitation, anxious

-Hyperglycemia

-Palpitations, cardiac dysrhythmia

-Tachycardia

-Hypertension

When is epinephrine contraindication and used cautiously?

Contraindicated:

-Tachycardia Glaucoma, and Labor

Caution:

Hypertension, enlarged prostate, diabetes mellitus

Which medications can cause an interaction with epinephrine?

MAOIs tricyclic antidepressants bc they intensify and prolong the effect

Beta Blockers bc they block the effect

Digoxin bc it can increase the risk of dysthythmia

What should you assess for when a pt is taking an adrenergic agonists?

-VS

-Medication and medical hx

-Current symptoms

-Baseline glucose level (need to know what the pt's normal is)

T/F:

The 1/2 life of epinephrine (IV) is less than 5 minutes

True

How often can you administer epinephrine?

Every 3-5 minutes.

Normally administered 1mg IV over 1 minute

T/F:

When giving adrenergic agonists to a pt, you should offer food to avoid N/V?

True

After injecting an EpiPen, you should massage the site for how long to promote absorption?

10 seconds

What EpiPen side effects should be reported to the HCP?

-Palpitations

-Rash

-itching

-Flushing

-Chest pain

-Irregular heart beat

-Numbness of fingers and toes

Nonselective beta blockers should be used with extreme caution with pt's that have which conditions?

COPD and asthma

What are nursing interventions for Adrenergic agonists?

-Monitor BP, HR, and urine output

-Monitor IV site for filtration

-Client should be on cardiac monitor while giving IV

-Monitor BS in diabetic patients

-Monitor for adverse reactions (HTN, irregular HR, and tachycardia)

T/F:

Propanolol doesn't have many side effects

False, it has many side effects bc it is a non-selective beta blocker

T/F:

You can stop using beta blockers abruptyly

False, you should be tapered off over a 1-2 week period to prevent tachycardia

What is atenolol used to treat?

Acute MI, HTN, angina, and prophylaxis

How does atenolol work on the body?

It's a selective beta 1 blocker, decrease outflow to the periphery, and suppresses renin-angiotensin system (RAAS response)

What should you teach a pt about adrenergic agonists?

-Side effects that should be reported immediately

-Avoid cold meds and diet pills bc they can increase BP

- Don't use when breastfeeding

-Nasal sprays should only be used 3-5 days

-How to properly use medication

-Advise if EpiPen is being used more than 2x's/week

- Do not use EpiPen if particles are pink or brown

Beta blockers are useful in treating what?

mild to moderate HTN, angina, heart failure, and MI

What drugs (when given concurrently) increase the absorption of atenolol?

Atropine and other anticholinergics

Why shouldn't NSAIDs be used with Atenolol?

Bc they decrease the hypotensive effect

When giving a pt a adrenergic agonists, you should withhold the medication is the patient's apical pulse is less than _____ bpm?

Less than 60 bpm

A patient is given epinephrine, an adrenergic agonists, the nurse should monitor the pt for what condition?

Increased BP

3 multiple choice options

The nurse realizes that beta1 receptor stimulation is differentiated from beta 2 stimulation, in that beta 1 stimulation leads to which conditions?

Increased myocardial contractility

3 multiple choice options