exam 2: Adrenergic Agonists (alpha & beta)

what classification is also known as sympathomimics and activate receptors in sympathetic nervous system to induce fight or flight

adrenergic agonists

• Increase muscle strength, blood pressure, breathing, alertness triggered by fear anxiety

• Catecholamines: epinephrine, dopamine, dobutamine, isoproterenol, norepinephrine

• Noncatecholamines: albuterol, ephedrine

• Nursing: give IV-continuous infusion (use IV pump, titrate dose based upon BP)

  • Monitor EKG,BP,CP, urine output

  • Diabetes- hyperglycemia (epinephrine, isoproterenol, albuterol)

• Effective: UOP > 30 mL/hr, SBP > 90 mmHG, improved mental status

• AE: hypertensive crisis ( a1: cerebral hemorrhage & monitor EKG, BP)

  • Cardiac complications (b1: dysrhythmia, angina & monitor urine output, EKG, BP, angina

  • Necrosis ( a1: vasoconstriction (extravasation), GIVE: phentolamine (alpha blocker)

• Interactions: MAOIs, tricyclic, general anesthesia, alpha/beta blocker

what classification

adrenergic agonists

impacts vascular tissue & smooth muscle

• ↑ Force of heart contraction

• Vasoconstriction à ↑ BP

• Dilate pupils (mydriasis)

• ↓ GI secretions

• ↑ bladder & prostate contraction

alpha 1 adrenergic agonists

 impacts sympathetic nerve endings

• ↓ Norepinephrine release

• Vasodilation -> ↓ BP

• ↓ GI motility

alpha 2 adrenergic agonist

 impacts heart

• ↑ Heart Rate

• ↑ Force of heart contraction

• ↑ BP

• ↑ renin secretion

beta 1 adrenergic agonist

impacts smooth muscle of lungs, uterine muscles, arterioles

• Dilates bronchioles

• GI & Uterine relaxation

• ↑ Blood sugar (glycogenolysis)

beta 2 adrenergic agonist

• Renal vasodilation →  ↑ renal perfusion 

dopamine agonist

what receptors does epinephrine activate

alpha 1, beta 1, beta 2

• Vasoconstriction

• Treatment of: Anaphylactic shock, Slows absorption of local anesthesia ,Manages superficial bleeding, Decreased congestion (nasal mucosa) , Increased BP

what receptor

alpha 1

• Bronchodilation

• Treatment of: asthma

what receptor

beta 2

• Increased HR, myocardial contractility, rate of conduction through AV node, cardiac output, tissue perfusion

• Treatment of: AV block, HF, shock, cardiac arrest

what receptor

beta 1

• Benefits: renal blood vessel dilation causing more urine output

• Treatment: shock, HF, acute kidney injury

what type of dopamine dose

low dose

• Benefits: renal blood vessel dilation, increase HR, contractility, AV node conduction

• Treatment: shock, HF

• receptor activated: dopamine & beta 1

what type of dopamine dose

Moderate dose

• Benefits: renal blood vessel dilation, increased HR, contractility, AV node conduction, vasoconstriction, mydriasis

• Treatment: shock, HF

• receptor activated: dopamine, beta 1, alpha 1

what type of dopamine dose

High dose

• Benefits: increased HR, myocardial contraction, cardiac output, AV node conduction

• Treatment: heart failure

• receptor activated: beta 1

dobutamine

norepinephrine activates what receptors

alpha 1 & beta 1

isoproterenol activates what receptor

beta 1 & 2

albuterol activates what receptor

beta 2

ephedrine activates what receptors

alpha 1, beta 1 & 2

phenylephrine activates what receptor

alpha 1

clonidine, guanfacine, & methyldopa are classified as what

centrally acting alpha 2 agonists

• Benefits: HTN, severe pain, ADHD

• Effects: bradycardia, decreased cardiac output, vasodilation

• AE: drowsiness/ sedation, xerostomia (dry mouth), rebound HTN

  • Constipation, impotence, gynecomastia, CNS effects

• Cautions: pregnancy (methyldopa safe tho), abuse, older ppl

what classification

centrally acting alpha 2 agonists