Chapter 20 Pharm

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1
What are adrenergic agonists?
produce their effects by activating adrenergic receptors
aka sympathomimetic
2
What is the chemical classification of adrenergic agonists?
catecholamines and noncatecholamines
3
What are catecholamines?
neurotransmitters that can be found in the body naturally
cannot be use orally
brief duration of action
cannot cross the BBB
4
What are noncatecholamines?
albuterol, ephedrine
can be given orally
metabolized slowly by MOA--longer half life
more able to cross the blood brain barrier
5
What are the two responses from alpha 1 receptors?
1. Vasoconstriction ( most common)
- blood vessels
- skin
- viscera
- mucous membranes
2. Mydriasis - dilation of the rafdial muscle of the iris
6
What are the theraputic applications of alpha 1 activation?
homeostasis -- can stop bleeding via vasoconstriction
nasal decongestion -- mucosal vasoconstriction
elevation of BP -- vasoconstriction
7
Adverse of alpha 1 activation
hypertension from widespread vasoconstriction
8
Alpha 2
reduction of sympathetic outflow to heart and blood vessels
relief of severe pain
9
Uses of beta 1 activation
profound hypotension
maintain blood flow to vital organs
10
Adverse effects of beta 1 activation
dysrhythmias
angina
11
What are the therapeutic applications of beta 2 activation?
asthma promotes bronchodilation
12
Adverse of beta 2 activation
hyperglycemia
13
What does activation of peripheral dopamine receptors cause?
dilation of the vasculature of the kidneys
14
What is the treatment for anaphylaxis?
epinephrine, injected IM, is the treatment of choice for anaphylactic shock
15
Epinephrine
Class: catecolamine or adrenergic agonist
Use: controls superficial bleeding, elevates blood pressure, restores cardiac function in arrest, bronchial dilation in asthma, treatment of choice for anaphylactic shock
Adverse: hypertensive crisis, dysrhythmias, angina pectoris
Nursing Implication: short half life
16
Routes for epinephrine?
EpiPen
IV (monitor closely)
IM
SubQ
NO PO -> SYNTHETIC CATECOLAMINE
17
Norepinephrine (Levophed)
Class: catecholamine, adrenergic agonist
Use: hypotensive states, cardiac arrest
Adverse: necrosis with extravasation (IV not in vein well and gets into tissue)
Nursing Implication: check IV regularly
18
Isoproterenol (Isuprel)
beta 1 and beta 2
catacholamine
cardiovascular
19
Dopamine
Use: increase cardiac output, increase renal perfusion
Adverse: necrosis with extravasation
Nursing Implication: check IV regularly
20
Albuterol
Class: noncatecholamine
Use: ashtma (selective for beta 2)
Adverse: tremor, tachycardia
Nursing implications:
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