acrocyanosis
decreased amount of oxygen delivered to the extremities, causing the feet or hands to turn blue
adrenergic receptors
specific receptor sites located throughout the body for the endogenous sympathetic neurotransmitters norepinephrine and epinephrine
agonists
drugs with a specific receptor affinity that mimic the body's natural chemicals (hormones, neurotransmitters)
Angina
paroxysmal (sudden) chest pain caused by myocardial ischemia
antagonists
drugs that bind to specific receptors and inhibit or block the response of the receptors
dysrhythmias
irregular heart rhythms; almost always called arrhythmias in clinical practice
extravasation
the leaking of fluid from a blood vessel into the surrounding tissues, as in the case of an infiltrated intravenous infusion
first-dose phenomenon
severe and sudden drop in blood pressure after the administration of the first dose of an alpha-adrenergic blocker
intrinsic sympathomimetic activity
the paradoxical action of some beta-blocking drugs (acebutolol) that mimics the action of the sympathetic nervous system
lipophilicity
the chemical attraction of a substance (drug molecule) to lipid or fat molecules
orthostatic hypotension
a sudden drop in blood pressure when a person stands up. also referred to postural hypotension or orthostasis
pheochromocytoma
a vascular adrenal gland tumor that is usually benign but secretes epinephrine and norepinephrine and thus often causes central nervous system stimulation and substantial blood pressure elevation
Raynauds Disease
a narrowing of small arteries that limits the amount of blood circulation to the extremities, causing numbness of the nose, fingers, toes and ears in response to cold temperature or stress
sympatholytics
drugs that inhibit the postganglionic functioning of the sympathetic nervous system
adrenergic blockers
bind to adrenergic receptors but have the opposite effect, therefore they inhibit or block stimulation by the SNS. also referred to as sympatholytics or antagonists
alpha1 receptors
located on tissue, muscle, or organ that the nerve stimulates
alpha2 receptors
located on the actual nerves that stimulate the presynaptic effector cells
beta1 receptors
located primarily on the heart
beta2 receptors
located on the smooth muscles of the bronchioles, arterioles, and blood vessels
alpha blockers, beta blockers, alpha/beta blockers
types of adrenergic-blocking drugs
alpha adrenergic blocking drugs
interrupt stimulation of the SNS at the alpha1 adrenergic receptors. They work by direct competition of norepinephrine or by a noncompetitive process
alpha1 blockers effects
vasodilation, reduced smooth muscle tone in organs such as the bladder and prostate
prazosin (minipress)
alpha blocker that causes both arterial and venous dilation, which reduces peripheral vascular resistance and blood pressure. Used to treat hypertension.
tamsulosin
alpha blocker that reduces smooth muscle contraction of the bladder neck and prostatic portion of the urethra reducing urinary obstruction and relieves some of the effects of BPH.
contradictions for alpha-blockers
known drug allergies, peripheral vascular disease which may include hepatic and renal disease, coronary artery disease, peptic ulcer and sepsis
alpha blockers adverse effects
palpitations, orthostatic hypotension, tachycardia, edema, chest pain, dizziness, HA, anxiety, depression, weakness, numbness, fatigue, N&V, diarrhea, constipation, abdominal pain, incontinence, dry mouth and pharygitis
profound hypotension
phentolamine can interact with beta blockers, alcohol and erectile dysfunction drugs by an additive effect that causes?
reduction of phentolamine effects
epinephrine can interact with phentolamine as an antagonist and cause?
risk of bleeding
tamsulosin interacts with warfarin by competing for plasma protein binding sites and causes?
risk of hypotension
tamsulosin interacts with antihypertensives, alcohol and erectile dyfunction drugs by an additive effect that causes?
phentolamine (Regitine)
alpha blocker that reduces peripheral vascular resistance and is also used to treat hypertension. Use for hypertension caused by pheochromocytoma, it also treats infiltration of vasoconstricting drugs such as norepinephrine, epinephrine and dopamine.
cardioselective beta1 blockers
block the beta1 receptors on the heart reducing myocardial stimulation which in turn reduces heart rate, slows conduction of the AV node, prolongs the SA node recovery and decreases the force of contractility.
indications for beta blockers
angina, MI, cardiac dysrhythmias, hypertension, and heart failure, treat migraines, glaucoma
contraindications for beta blockers
known drug allergies, uncompensated heart failure, cardiogenic shock, heart block or bradycardia, pregnancy, severe pulmonary disease, Raynaud's disease
adverse effects of beta blockers
atrioventricular block, bradycardia, heart failure, dizziness, fatigue, depression, drowsiness, unusual dreams, N&V, constipation, diarrhea, agranulocytosis, thrombocytopenia, hyperglycemia, hypoglycemia, hyperlipidemia, impotence, alopecia, broncospasm,
decreased beta blocker activity
antacids cause decreased absorption of beta blockers causing
reduced beta blocker effects
antimuscarinics and anticholinergics are antagonist of beta blockers and cause
enchanced bradycardic effects of digoxin
digoxin causes and additive effect with beta blocker and create
additive hypotensive effects
diuretics, cardiovascular drugs, and alcohol have an additive effect with beta blockers and cause
prolonged neuromuscular blockade
neuromuscular blocking drugs have an additive effect with beta blockers and cause
delayed recovery from hypoglycemia
oral hypoglycemic drugs, insulin masks signs of hypoglycemia and cause
Atenolol (Tenormin)
a cardioselective beta blocker that is commonly used to prevent future heart attacks in patients who have had one. Also used to treat hypertension, angina, thyrotoxicosis to help block excessive thyroid activity.
Carvedilol (Coreg)
acts as a nonselective beta blocker, alpha1 blocker, a calcium channel blocker and an antioxidant. It is used primarily for the treatment of heart failure but also beneficial for hypertension and angina.
metoprolol (Lopressor)
a beta1 blocker often used after MI.
propranolol (Inderal)
a prototypical nonselective beta1 and beta2 blocking drug used after MI, treatment of tachydyrhythimia associated with cardiac glycoside intoxication, tx of hypertrophic subaortic stenosis, migraine headache, essential tremor (Contraindicated in bronchial
those who should not take beta2 blockers
history of asthma, emphysema, bronchitis, bronchospasms because of the negative effect on the underlying condition
vasodilation
predominant response of alpha blockers, by blocking the effect of vasoconstriction
result of vasodilation
causes a drop in blood pressure and a reduction in urinary obstruction
blocking of beta1 blockers
causes a decrease in heart rate, conduction and contractility
blocking of beta2 blockers
causes a decrease in bronchial smooth muscle relaxation or bronchoconstriction
vasodilation expected
what effect is expected when phentalamin (regitine) is injected into and infiltrated IV of dopamine?
tapering off medication to prevent rebound hypertension
guidelines for administration and monitoring of beta blockers
bradycardia
beta1 blocker my result in which affect of the heart?
protect the heart from circulating catecholamines
what is the main purpose of a beta blocker used in a recent MI patient?
asthma, respiratory condition
history of what condition should be assessed when starting a non selective beta blocker
Orthostatic hypotension, increased urine flow, headaches
what potential effects should be monitored when starting an alpha blocker for BPH
D. supraventricular dysrhythmias.
Nonselective beta blockers may be used to treat hypertension and
A. chronic obstructive pulmonary disease (COPD).
B. heart failure.
C. heart block.
D. supraventricular dysrhythmias.
C. atenolol (Tenormin).
An example of a cardioselective beta blocker includes
A. propranolol (Inderal).
B. labetalol (Normodyne).
C. atenolol (Tenormin).
D. sotalol (Betapace).
D. abrupt medication withdrawal may lead to a rebound hypertensive crisis
When teaching a patient about beta blockers such as atenolol (Tenormin) and metoprolol (Lopressor), it is important to inform the patient that
A. these medications may be taken with antacids to minimize gastrointestinal distress.
B. hot baths and showers
B. nonselective beta-adrenergic antagonist.
Propranolol (Inderal) is an effective
A. selective alpha-adrenergic antagonist.
B. nonselective beta-adrenergic antagonist.
C. beta1-adrenergic antagonist.
D. beta2-adrenergic antagonist.
B. phentolamine (Regitine)
During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. The nurse would expect to administer which medication?
A. nadolol (Corgard)
B. phentolamine (Regitine)
C. dobutamine (Dobutrex)
D. ver
A. Risk for decreased cardiac tissue perfusion related to effects of medication.
The priority nursing diagnosis for a patient taking metoprolol (Lopressor) would be
A. Risk for decreased cardiac tissue perfusion related to effects of medication.
B. Acute confusion related to adverse central nervous system effects of the drug.
C. Defic
A. "If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions.
Patient teaching for a patient being discharged on a beta blocker includes which statement?
A. "If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions."
B. "If you become dizzy, do not take yo
A. carvedilol (Coreg)
The nurse is admitting a patient with a history of angina and hypertension who is currently experiencing moderate heart failure. The patient's current medication regimen includes digoxin (Lanoxin), furosemide (Lasix), and quinapril (Accupril). Which medic
A. Hypertension
C. Angina pectoris
D. Cardiac dysrhythmias
Beta blockers are used to treat which disorders? (Select all that apply.)
A. Hypertension
B. COPD
C. Angina pectoris
D. Cardiac dysrhythmias
E. Raynaud's disease
alpha blocker
Raynaud's disease is treated with what?