lOMoARcPSD|11700591
Pharm Exam 2 notes
Adrenergic Agonists
o Adrenergic- sympathetic nervous system
o Increase HR, increase oxygen (bronchodilation), Increase blood flow, Resp rate increase, pupils dilate,
blood glucose increase
o Patient going to be very alert and awake
o Mimic norepinephrine and Epinephrine
o It can affect the heart, bronchi (lungs), GI tract
Urinary bladder, eyes
Alpha 1
o Increases cardiac contractility, vasoconstriction
o Dilates pupils
o Increases bladder & prostate contraction
Beta 1
o Increases cardiac contractility, heart rate
o Increases renin secretion, blood pressure
Beta 2
o Decreases GI tone and motility
o Bronchodilation
o Increases blood flow in skeletal muscles
o Relaxes smooth muscles of uterus
o Activates liver glycogenolysis – increases blood sugar
Remember beta 1 – 1 heart so it mainly affects the heart
Beta 2 – 2 lungs so it mainly affects the lungs
Alpha 1 increases the blood pressure (A- Arteries)
Epinephrine
Nonselective – stimulates alpha 1, beta 1, and beta 2
Alpha 1 increases the blood pressure
Beta 1 increases the heart rate
Beta 2 promotes bronchodilation
Increase HR, increase oxygen (bronchodilation), Increase blood flow, Resp rate increase, pupils dilate, blood
glucose increase
Emergency Drug
Uses
o Anaphylaxis, anaphylactic shock
o Bronchospasms, status asthmaticus
o Cardiogenic shock, cardiac arrest
Therapeutic response when Heart rate between 60-100
Side effects/Adverse reactions
o GI disturbances
o Sweating, headache, insomnia, dizziness, agitation, anxious
o Hyperglycemia
o Palpitations, cardiac dysrhythmia
o Tachycardia (heart rate over 100 adverse reaction)
o Hypertension (above 140/90 adverse reaction)
Contraindications
o Tachycardia
, lOMoARcPSD|11700591
o Glaucoma (due to dilation of the pupils is going to increase pressure in the eye)
o Labor (vasoconstricting of the vessels occur and will stop blood flow to the baby)
Caution
o Hypertension
o Prostatic hypertrophy
o Diabetes mellitus
Interactions
o MAOI’s tricyclic antidepressants – intensify and prolong effect
o Beta blockers – block effect
o Digoxin – can increase risk of dysrhythmia
o Lab – increases blood sugar
Assessment
o Vital signs (pt will be placed on a monitor)
o Medication/medical history (what if they were on morphine and overdose on it then we can just give
naloxone and we can use epinephrine)
o Current symptoms
o Baseline glucose level
Nursing interventions
o Monitor blood pressure, heart rate and urine output
o Monitor IV site for infiltration. Give IV push slowly (1 mg/minute) unless in cardiac arrest we will give it
faster
o Patient on cardiac monitor when giving IV
o Monitor for side effects/adverse reactions – report hypertension, irregular heart rate, tachycardia
o Monitor blood glucose in diabetic patients with long term use (albuterol)
Teaching
o The side effects/adverse reactions to report (palpitations)
o Avoid drugs that increase the blood pressure such as cold medication and diet pills
o Avoid adrenergic when breastfeeding
o Nasal sprays should only be used 3-5 days
o Take medication as prescribed
o How to use inhaled drugs or drops – return demonstration
Epi-Pen Teaching
o If pt uses it they need to call 911
o Inform provider if EpiPen is used more than twice a week
o Have EpiPen with you at all times
o Do not refrigerate EpiPen but store in cool, dark place
o Use EpiPen at first sign of reaction
o Inspect the contents for particles and do not use if particles are pink or brown
o Inject subcutaneously in the outer thigh and hold in place for 5-10 seconds
o After administration massage the injection site
o Report side effects/adverse reactions
, lOMoARcPSD|11700591
Adrenergic blockers
Action
o Block the alpha1 receptor sites (A- Arteries)
o Results in vasodilation, decreased blood pressure, pupil constriction, reduces contraction of the smooth
muscle in the bladder neck and prostate
o THEY DO NOTHING TO THE HEART RATE
Use
o Antihypertensive
o Benign prostatic hypertrophy (BPH)
o Reynaud’s disease
All drugs in this class end in ‘sin’- these drugs work mainly on the vessels
Beta Blockers -LOL
Action
Beta 1 Blocker
o Blocks beta adrenergic receptor sites
o Decreases movement of epinephrine
o Suppresses renin-angiotensin-aldosterone system
Beta2
o Bronchoconstriction
o Contracts uterus
o inhibits glycogenolysis
o Leads to hypoglycemia
Uses
o Antihypertensive
o Angina
o Heart failure
o Dysrhythmias
Drugs in this class end in ‘olol’ – these drugs work on the heart and vessels
Selective versus non-selective
Drug starts with A-M more selective to beta 1 have less of a chance of causing bronchoconstriction
Drug starts with N-Z non-selective and blocks beta 1 and beta 2
Side effects/Adverse reactions: Opposite of adrenergic drugs
o Drowsy, dizzy, headaches
o Depression, decreased libido
o Orthostatic hypotension
o Bradycardia, hypotension
o Masking of hypoglycemia
Contraindications
o Heart block, bradycardia
o Asthma (unless selective beta 1 – these begin with letters A-M as a rule – atenolol. These are safer than
non-selective)
o Pregnancy
Caution
o Renal dysfunction
Pharm Exam 2 notes
Adrenergic Agonists
o Adrenergic- sympathetic nervous system
o Increase HR, increase oxygen (bronchodilation), Increase blood flow, Resp rate increase, pupils dilate,
blood glucose increase
o Patient going to be very alert and awake
o Mimic norepinephrine and Epinephrine
o It can affect the heart, bronchi (lungs), GI tract
Urinary bladder, eyes
Alpha 1
o Increases cardiac contractility, vasoconstriction
o Dilates pupils
o Increases bladder & prostate contraction
Beta 1
o Increases cardiac contractility, heart rate
o Increases renin secretion, blood pressure
Beta 2
o Decreases GI tone and motility
o Bronchodilation
o Increases blood flow in skeletal muscles
o Relaxes smooth muscles of uterus
o Activates liver glycogenolysis – increases blood sugar
Remember beta 1 – 1 heart so it mainly affects the heart
Beta 2 – 2 lungs so it mainly affects the lungs
Alpha 1 increases the blood pressure (A- Arteries)
Epinephrine
Nonselective – stimulates alpha 1, beta 1, and beta 2
Alpha 1 increases the blood pressure
Beta 1 increases the heart rate
Beta 2 promotes bronchodilation
Increase HR, increase oxygen (bronchodilation), Increase blood flow, Resp rate increase, pupils dilate, blood
glucose increase
Emergency Drug
Uses
o Anaphylaxis, anaphylactic shock
o Bronchospasms, status asthmaticus
o Cardiogenic shock, cardiac arrest
Therapeutic response when Heart rate between 60-100
Side effects/Adverse reactions
o GI disturbances
o Sweating, headache, insomnia, dizziness, agitation, anxious
o Hyperglycemia
o Palpitations, cardiac dysrhythmia
o Tachycardia (heart rate over 100 adverse reaction)
o Hypertension (above 140/90 adverse reaction)
Contraindications
o Tachycardia
, lOMoARcPSD|11700591
o Glaucoma (due to dilation of the pupils is going to increase pressure in the eye)
o Labor (vasoconstricting of the vessels occur and will stop blood flow to the baby)
Caution
o Hypertension
o Prostatic hypertrophy
o Diabetes mellitus
Interactions
o MAOI’s tricyclic antidepressants – intensify and prolong effect
o Beta blockers – block effect
o Digoxin – can increase risk of dysrhythmia
o Lab – increases blood sugar
Assessment
o Vital signs (pt will be placed on a monitor)
o Medication/medical history (what if they were on morphine and overdose on it then we can just give
naloxone and we can use epinephrine)
o Current symptoms
o Baseline glucose level
Nursing interventions
o Monitor blood pressure, heart rate and urine output
o Monitor IV site for infiltration. Give IV push slowly (1 mg/minute) unless in cardiac arrest we will give it
faster
o Patient on cardiac monitor when giving IV
o Monitor for side effects/adverse reactions – report hypertension, irregular heart rate, tachycardia
o Monitor blood glucose in diabetic patients with long term use (albuterol)
Teaching
o The side effects/adverse reactions to report (palpitations)
o Avoid drugs that increase the blood pressure such as cold medication and diet pills
o Avoid adrenergic when breastfeeding
o Nasal sprays should only be used 3-5 days
o Take medication as prescribed
o How to use inhaled drugs or drops – return demonstration
Epi-Pen Teaching
o If pt uses it they need to call 911
o Inform provider if EpiPen is used more than twice a week
o Have EpiPen with you at all times
o Do not refrigerate EpiPen but store in cool, dark place
o Use EpiPen at first sign of reaction
o Inspect the contents for particles and do not use if particles are pink or brown
o Inject subcutaneously in the outer thigh and hold in place for 5-10 seconds
o After administration massage the injection site
o Report side effects/adverse reactions
, lOMoARcPSD|11700591
Adrenergic blockers
Action
o Block the alpha1 receptor sites (A- Arteries)
o Results in vasodilation, decreased blood pressure, pupil constriction, reduces contraction of the smooth
muscle in the bladder neck and prostate
o THEY DO NOTHING TO THE HEART RATE
Use
o Antihypertensive
o Benign prostatic hypertrophy (BPH)
o Reynaud’s disease
All drugs in this class end in ‘sin’- these drugs work mainly on the vessels
Beta Blockers -LOL
Action
Beta 1 Blocker
o Blocks beta adrenergic receptor sites
o Decreases movement of epinephrine
o Suppresses renin-angiotensin-aldosterone system
Beta2
o Bronchoconstriction
o Contracts uterus
o inhibits glycogenolysis
o Leads to hypoglycemia
Uses
o Antihypertensive
o Angina
o Heart failure
o Dysrhythmias
Drugs in this class end in ‘olol’ – these drugs work on the heart and vessels
Selective versus non-selective
Drug starts with A-M more selective to beta 1 have less of a chance of causing bronchoconstriction
Drug starts with N-Z non-selective and blocks beta 1 and beta 2
Side effects/Adverse reactions: Opposite of adrenergic drugs
o Drowsy, dizzy, headaches
o Depression, decreased libido
o Orthostatic hypotension
o Bradycardia, hypotension
o Masking of hypoglycemia
Contraindications
o Heart block, bradycardia
o Asthma (unless selective beta 1 – these begin with letters A-M as a rule – atenolol. These are safer than
non-selective)
o Pregnancy
Caution
o Renal dysfunction
