Adrenergic drugs mimic the effects of the _____ nervous system, stimulation of this nervous system cause ______, _____ heart rate, pupil _____, & _____ .
sympathetic
bronchodilation
increased
dilation
glycogenolysis
Adrenergic Receptor responses to stimulation cause increased _____ of the cardiac muscle.
contractility
Adrenergic Receptor responses to stimulation cause the kidney to have increased ____secretion
renin
Adrenergic Receptor responses to stimulation cause the genitourinary system to have _____ of the Bladder sphincter, _____ of the penis, and both contraction/relaxation of the _____.
constriction
ejaculation
uterus
Drugs that stimulate the sympathetic nervous system (SNS) are also known as=
there are 3
adrenergic drugs
adrenergic agonists
Sympathomimetics
Stimulation of -adrenergic receptor results in ______.
bronchodilation
Beta-adrenergic receptors are all located on ______ effector cells.
postsynaptic
-adrenergic receptors—located primarily in the ____.
heart
-adrenergic receptors—located in smooth muscle of the _____, _____, and _____ ____.
bronchioles
arterioles
visceral organs
For a PT in shock a primary benefit of giving an adrenergic agonist drug is to _____ cardiac output.
increase
Beta-Adrenergic Agonist Responses
there are 5
Bronchial, gastrointestinal (GI), and uterine smooth muscle relaxation
Glycogenolysis (glycogen in liver breaks down to glucose)
Cardiac stimulation
An increase force of contraction is known as a _____ _____ _____.
positive inotropic effect
When adrenergic receptors are stimulated by an adrenergic drug, three things result:
(1) an increase in the force of contraction (positive inotropic effect)
(2) an increase in heart rate (positive chronotropic effect)
(3) an increase in the conduction of cardiac electrical nerve impulses through the atrioventricular node (positive dromotropic effect)
Stimulation of -adrenergic receptors on the _____, ______ ______, and _____ _____ results in cardiac stimulation.
myocardium
atrioventricular (AV) node
sinoatrial (SA) node
When a PT is taking an adrenergic agonist drug you may observe an _____ heart rate as one of the effects of adrenergic drugs. Sympathetic nervous system stimulation also results in _____, _____ _____, & _____ gastrointestinal motility depending on which receptors are stimulated.
increased
broncholdilation
dilated pupils
decreased
Stimulation of -adrenergic receptors result in?
there are 5
Bronchodilation
Uterine relaxation
Glycogenolysis in the liver
Increased renin secretion in the kidneys
Relaxation of GI smooth muscles (decreased motility)
A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first?
A.
Taking the bronchodilator first will result in a more open airway and thus allow for better penetration by the inhaled corticosteroid.
_____ is indicated for the prevention of bronchospasm, NOT treatment for acute symptoms, the dosage is usually _____, twice daily 12 hours apart for maintenance effects in PT older than __ years old.
Salmeterol
2 puffs
12
drugs that stimulate -adrenergic receptors of bronchial smooth muscles, causing relaxation, resulting in bronchodilation
Bronchodilators
Examples of Bronchodilators AKA Beta2 Adrenergic Receptors:
there are 8
formoterol
levalbuterol
albuterol
pirbuterol
salmeterol
metaproterenol
ephedrine
epinephrine
A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time?
A.
Albuterol is a beta2 agonist that is used for acute bronchospasms. Salmeterol is appropriate for prevention of bronchospasms. Fluticasone is a corticosteroid that is not effective for acute bronchospasms. Advair Diskus is used for daily maintenance, not acute exacerbations.
______ is available ONLY as an IV injectable drug and is given by continuous infusion using an infusion pump.
Because ______ is a Beta1-selective vasoactive adreneric, it works by _____ the cardiac output in heart failure PTs by ______ myocardial contractility & stroke volume. However, adrenergic drugs may worsen a pre-existing cardiac disorder i.e. causing a myocardial infarction in a PT w/_____ ____ ____.
Dobutamine
increasing
increasing
coronary artery disease
The vasoactive adrenergic ______ is a -selective vasoactive adrenergic drug that is structurally similar to the naturally occurring catecholamine ______.
dobutamine
dopamine
The vasoactive adrenergic drug, _______, stimulates beta1 receptors on heart muscle (myocardium); increases cardiac output by increasing contractility (positive inotropy), which increases the stroke volume, especially in patients with heart failure
dobutamine
The Beta1-selective vasoactive Adrenergic, ______, is an intravenous drug; given by continuous infusion
dobutamine
Treatment of _____ _____ is an indication for the use of epinephrine. It is also the drug of choice for the treatment of ______.
cardiac arrest
anaphylaxis
______ is an endogenous vasoactive catecholamine.
Epinephrine
________, acts directly on both the alpha- and beta-adrenergic receptors of tissues innervated by the SNS
Epinephrine
A Prototypical nonselective adrenergic agonist?
Epinephrine
_______ is administered in emergency situations, and is one of the primary vasoactive drugs used in many advanced cardiac life support protocols.
Epinephrine
A patient on a dobutamine drip starts to complain that her intravenous line “hurts.” The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first?
A.
Infiltration of an intravenous solution containing an adrenergic drug may lead to tissue necrosis from excessive vasoconstriction around the intravenous site. Phentolamine is often used for the treatment of infiltration, but the first thing the nurse must do is to stop the infusion of the adrenergic drug. Slowing the medication will not stop further tissue damage. The physician should be notified, but the infusion should be stopped first
A patient on a dobutamine drip starts to complain that he feels a “tightness” in his chest that he had not felt before. What will the nurse do first?
D.
Before anything else is done, the patient’s vital signs should be checked for alterations. The dopamine rate should not be increased. Extravasation rarely causes chest tightness. Although an electrocardiogram would be prudent, it's not the priority until after the vital signs demonstrate that the patient is stable.
A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. What is the nurse’s immediate assessment priority?
D.
During administration of albuterol, a fast-acting beta2 agonist, the nurse should monitor the patient’s respiratory status, including Spo2 (with a pulse oximeter), respiratory rate, and breath sounds, to ensure that the medication is having a therapeutic effect. The other items can be handled after her respiratory status is stable.
1. The nurse caring for a patient who is receiving beta1 agonist drug therapy needs to be aware that these drugs cause which effect? (Select all that apply.)
a. Increased cardiac contractility
b. Mydriasis= pupil dilation
c. Decreased heart rate
d. Bronchoconstriction
e. Increased GI tract motility
A, B
During a teaching session for a patient who is receiving inhaled salmeterol, the nurse emphasizes that the drug is indicated for which condition?
B.
For a patient receiving a vasoactive drug such as intravenous dopamine, which action by the nurse is most appropriate?
A.
A patient is receiving dobutamine for shock and is complaining of feeling more “skipping beats” than yesterday. What will the nurse do next?
A.
When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect which effect?
D.
The nurse is monitoring a patient who is receiving an infusion of a beta-adrenergic agonist. Which adverse effects may occur with this infusion? (Select all that apply.)
a. Mild tremors
b. Bradycardia
c. Tachycardia
d. Palpitations
e. Drowsiness
f. Nervousness
a,c, d, f
The nurse is reviewing the home medications for a newly admitted patient, and notes that the patient takes Mirabegron (Myrbetriq). The nurse will conclude that the patient has which condition?