1What are the two major groups of adrenergic antagonists?
alpha-adrenergic blocking agents
beta-adrenergic blocking agents
2What is the therapeutic use of alpha blockade?
hypertension -> lowers BP by causing vasodilation
benign prostatic hyperplasia (BPH) -> frequent urination
pheochromocytoma -> catecholmine-secreting tumor on the adrenal medulla
Reynaud's disease -> peripheral vascular disorder
3What are adverse effects of alpha 1 blockade?
orthostatic hypotension -> blockade of receptors on veins, decrease muscle tone in venous wall
reflex tachycardia -> reflex to increase heart rate via the autonomic nervous system (ANS) -> get immediate response and heart rate increases
males -> impotence
4What is the most significant adverse effect of alpha 2 blockade?
reflex tachycardia
5Prazosin (Minipress)
Class: selective alpha 1- adrenergic antagonist
Use: HTN, men with BPH
Adverse: orthostatic hypotension, relfex tachycardia, nasal congestion
Nursing Implication:
6Phentolamine
prevention of tissue necrosis after the extravasation of drugs that produce alpha1-mediated vasoconstriction (such as norepinephrine)
adverse: reflex tachycardia
IV, IM
7What are the therapeutic applications of beta blockade?
angina pectoris -> decreased cardiac workload and reduce oxygen demand, prevent ischemia and pain
hypertension
cardiac dysrhythmias, myocardial infarction
8Nonselective beta-adrenergic blocking agents ???
produce broader spectrum of adverse effects than do the "cardioselective"
9What are the adverse effects of beta 1 blockade?
bradycardia- excessive slow heart rate -> 42 bpm can cause pt to fall when you get up
10What are the adverse effects of beta 2 blockade?
bronchoconstriction -> lungs can cause constriction of the bronchi (DONT GIVE TO ASTHMATIC)
drugs that block beta 2 receptors are contraindicated for people with asthma
pt with need for beta drug give beta 1 selective
11Propranolol (Inderal)
nonselective -> will do Beta 1 and Beta 2
Use: HTN, MI, Angina
Adverse: bronchoconstriction
Drug interactions: Insulin
12Metroprolol (Lopressor)
selective blockade of beta 1
Use: HTN, Angina, MI
Adverse: bradycardia, decreased CO, AV block