Summary Nur 210 Exam 2 study Guide

Pharmacology – Exam 2 Study Notes and Practice questions


Effects of Adrenergic Agonists at Receptors
 Alpha-1
o Increases Cardiac contractility, vasoconstriction
o Dilates pupils
o Increases bladder & prostate contraction
 Beta-1 – affects the heart
o Increases cardiac contractility, heart rate
o Increases renin recreation, blood pressure
 Beta-2 – affects the lungs
o Decreases GI tone & motility
o Bronchodilation
o Increases blood flow in skeletal muscles
o Relaxes smooth muscles of uterus
o Activates liver glycogenolysis – increases blood sugar
Adrenergic Agonist – Alpha & Beta
 Epinephrine
o Non-selective
o Action: Activates the sympathetic nervous system
 Alpha-1 – increases BP
 Beta-1 – increases HR
 Beta-2 – promotes bronchodilation
o Uses: nasal congestion, asthma, bronchospasm, allergic reaction, anaphylaxis, severe
hypotension, and cardia arrest
o Side Effects: GI disturbances, sweating, headache, insomnia, dizziness, agitation,
anxious, hyperglycemia. Adverse Effects: - palpitations, tachycardia, HTN, necrosis IV site
out of vein (infiltration)
o Contraindications: Tachycardia, Glaucoma, Labor
o Caution: HTN, BPH, DM, Hyperthyroidism
o Interactions: MAOI’s, TCA (tricyclic antidepressants), Beta blockers, Digoxin. Labs:
increased blood sugar
Beta-2 Adrenergic Agonist
 Albuterol
o Action: Selective to beta-2 adrenergic receptors in the lungs. Relaxes smooth muscle
which promotes bronchodilation
o Uses: bronchospasm, asthma, bronchitis, COPD
o Side Effects: Tremors, nervousness, restlessness, insomnia, GI upset, sweating
o Adverse Effects: HTN, tachycardia, palpitations, hyperglycemia
o Contraindications: Hypersensitivity, Allergy
o Caution: cardiac problems, HTN, hyperthyroidism, Diabetes, renal dysfunction
o Interactions: other drugs that increase BP & HR, antagonist effect with other drugs that
lower BP & HR. Labs: may increase glucose level
Adrenergic Agonist Drugs
 Assessment:

, Pharmacology – Exam 2 Study Notes and Practice questions


o Baseline vital signs, medication/medical history, current symptoms, baseline glucose
level
 Nursing Interventions:
o Monitor BP, HR & urine output
o Monitor IV site for infiltration. Give IV push slowly (1mg/min) unless in cardiac arrest
o Patient on cardiac monitor when giving IV
o Monitor for SE/AE – report HTN, irregular HR, tachycardia
o Ok to give with food
o Monitor blood glucose in diabetic patients
 Patient Teaching:
o Teach SE/AE and to report reactions
o Avoid drugs that increase BP, such as cold medicines & diet pills
o Avoid adrenergics when breastfeeding
o Nasal sprays should only be used 3-5 days continuously; more causes rebound nasal
congestion
o Take medication as prescribed
o Teach how to use inhaled drugs or drops – return demonstration
o EpiPen Teaching:
 Inform provider if EpiPen is used more than 2x/wk
 Have EpiPen with you at all times
 Do not refrigerate EpiPen but store in cool, dark place
 Use EpiPen at first sign of reaction
 Inspect contents for particles & don’t use if they are pink or brown
 Inject SQ in the outer thigh, hold in place for 5-10 seconds
 After administration, massage the injection site for 10 seconds
 Report SE/AE reactions
o Evaluation: patient’s response to medication
 Improvement of symptoms?
 Any side effects/adverse reactions?
 Patient understands medication and use? Presence

, Pharmacology – Exam 2 Study Notes and Practice questions


Adrenergic Blockers (Antagonist) - Alpha and Beta blockers
 Action: Blocks the alpha-1 receptor sites. Results in vasodilation, decreased BP, pupil
constriction, reduces smooth muscle contraction in bladder and prostate
 Use: Anti-hypertensive, BPH, Reynaud’s disease
o All drugs in this class end in “sin” – these drugs work mainly on the vessels

Adrenergic Blockers (Antagonist) - Beta blockers
 Action: Beta-1 Blocker
o Blocks beta adrenergic receptor sites, decreases movement of epinephrine, and
suppresses renin-angiotensin-aldosterone system.
 Uses: Anti-hypertensive, Angina, Heart failure, Dysrhythmias
o Drugs in this class end in “olol” - these drugs work mainly on the heart & vessels
 Side effects/Adverse reactions: Opposite of adrenergic drugs
o Drowsy, dizzy, HA, depression, decreased libido, orthostatic hypotension, bradycardia,
hypotension, and masking of hypoglycemia
 Contraindications: Heart block, bradycardia, asthma, pregnancy
 Caution: Renal dysfunction, Diabetes
 Interactions: decreased effect with NSAIDs, increased effect with other anti-hypertensives &
anti-dysrhythmics, Increased risk of hypoglycemia w/ insulin and sulfonylureas & masks the
symptoms
 Assessment: Baseline vitals, EKG, current medications/medical history
 Interventions:
o Monitor vitals – report marked changes in BP or HR below 60bpm
o Report bothersome side effects that don’t improve, such as dizziness, lightheadedness,
stuffy nose, or depression
o Provide for safety
 Patient Teaching:
o Take medication at the same time every day
o Therapeutic effect can take several weeks
o Patient to monitor their BP & HR and record (in log or notebook)
o Get up slowly to help prevent orthostatic hypotension
o To side effects/adverse reactions to report
o Do not drive until response to drug is known
 Evaluation:
o Blood pressure decreases, HR decreases, and side effects are managed