_____ _____ can occur w/any dose of an alpha blocker and pts must be warned to get up slowly from a supine position.
Orthostatic hypotension
_____ _____ cause both arterial and venous dilation, reducing peripheral vascular resistance and blood pressure (BP)
Alpha Blockers
_____ _____ are used to treat hypertension
Alpha Blockers
_____ _____ have effect on receptors on prostate gland and bladder decreases resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of benign prostatic hyperplasia (BPH).
Alpha Blockers
When phentolamine is used to diagnose the presence of pheochromocytoma, the nurse will assess for what indicative finding?
A.
To help establish a diagnosis of pheochromocytoma, a single intravenous dose of phentolamine is given to the hypertensive patient who is suspected of having the tumor. If the blood pressure declines rapidly, it is highly likely that the patient has a pheochromocytoma.
When administering an alpha blocker for the first time, it is most important for the nurse to assess the patient for the development of what adverse effect?
B.
The primary adverse effects of alpha blockers are those related to their effects on the vasculature. First-dose phenomenon, which is a severe and sudden drop in blood pressure after the administration of the first dose of an alpha-adrenergic blocker, can cause patients to fall or pass out. All patients must be warned about this adverse effect before they take their first dose of an alpha blocker. Orthostatic hypotension can occur with any dose of an alpha blocker, and patients must be warned to get up slowly from a supine position.
_____/_____ is used to relieve impaired urinary flow in men w/benign prostatic hyperplasia, but it also can cause orthostatic hypotension when changing positions from sitting or lying positions. Because of these effects the blood pressure may become dramatically lowered, and lightheadedness may occur, increasing the risk of falling
Tamsulosin (Flomax)
Common Alpha Blockers
there are 7
Phenoxybenzamine HCl (Dibenzyline)
Phentolamine (Generic)
Terazosin (Hytrin)
Doxazosin (Cardura)
Alfuzosin (Uroxatral)
Prazosin (Minipress)
Tamsulosin (Flomax)
_______/_______ is an alpha blocker that reduces peripheral vascular resistance when given systemically. A local SubQ injection around the site of extravasated vasoconstricting drugs such as Dobutamine, cause an alpha adrenergic receptor blockade and vasodilation. This allows for _____ blood flow to the ischemic tissue and may prevent permanent tissue damage.
Phentolamine (Regitine)
increased
_____/_____ establish a diagnosis of pheochromocytoma
Phentolamine (Regitine)
_____/_____ are most commonly used to treat the extravasation of vasoconstricting drugs such as norepinephrine, epinephrine, and dopamine
Phentolamine (Regitine)
_____/_____ is contraindicated in known hypersensitivity, myocardial infarction (MI), and coronary artery disease
Alpha blocker
Phentolamine (Regitine)
Drugs that interact with alpha blockers, such as ____/____, include erectile dysfunction drugs in which additive hypotension effects may occur.
Tamsulosin (Flomax)
_____/_____ are alpha blocker used primarily to treat BPH; is exclusively indicated for male patients however, can be used in female patients with kidney stones
Tamsulosin/ Flomax
Tamsulosin/ Flomax Contraindications include:
there are 2
known drug allergy
concurrent use of erectile dysfunction drugs such as sildenafil
Tamsulosin/Flomax adverse effects include:
there are 3
headache
abnormal ejaculation
rhinitis
_______ ____ _____ drugs may precipitate bradychardia, hypotension, heart block, heart failure, bronchoconstriction, and/or increased airway resistance, therefore any pre-existing respiratory condition i.e. asthma might be worsened by the concurrent use of any of these meds.
Non-selective beta blocking
Selective beta blockers are also called ______ ____ blockers and block only the beta-adrenergic receptors in the heart that are located on the postsynaptic effector cells.
cardioselective beta
_____ ____ _____ cause the same effrects on the heart as cardioselective beta blockers but they also: _____ bronchioles, resulting in narrowing of airways and shortness of breath, and produce ______ of blood vessels.
Nonselective beta blockers
constrict
vasoconstriction
____ _____ are frequently given to pts after they have suffered an MI because of their cardioprotective properties.
Beta blockers
Beta blockers are used for _____ to decrease demand for myocardial oxygen.
angina
Beta blockers are used for their cardioprotective properties because they inhibit stimulation from circulating ______.
catecholamines
Beta blockers are used for dysrhythmias because of their ____ __ _____ properties.
class II antidysrhythmic
Beta blockers are used for migraine headaches because ______ allows entry into CNS
Lipophilicity
Even though some beta blockers may be used for the treatment of some types of heart failure. Any pt on beta blockers should be assessed often for the development of ____ _____, which is a potential adverse effect of this drug.
heart failure
_____ & _____ are currently used in the treatment of heart failure.
Propranolol and metoprolol
Beta blockers are used for their ______ effects because they have the ability to reduce SNS stimulation of the heart and force of myocardial contraction
antihypertensive
Beta blockers are used for _____ _____.
heart failure
Beta blockers are used topically for ______.
Glaucoma
A 58-year-old patient is recovering in the intensive care unit after a myocardial infarction (MI). The nurse notes an order for the beta blocker metoprolol (Lopressor). What is the purpose of this drug?
A.
Studies have shown increased survival in patients given metoprolol after experiencing an MI. Metoprolol has a cardioprotective effect by decreasing the heart’s response to circulating catecholamines resulting from the MI.
_____ is a potential adverse effect of beta blockers and may cause pts to stop taking this med.
Impotence
Adverse effects of Beta Blockers Include:
there are 16
Dizziness
depression
unusual dreams
drowsiness
dry mouth
alopecia
Agranulocytosis
thrombocytopenia
AV block
bradycardia
heart failure
wheezing
bronchospasm
Nausea
Vomiting
Diarrhea
Constipation
The nurse knows that the adverse effects of a nonselective beta blocker are likely to be the most immediately life threatening in which patient?
D.
Although beta blockers may mask signs and symptoms of hypoglycemia, nonselective beta blockers may cause bronchoconstriction, which would be detrimental to the patient with asthma.
pts need to be weened off ______ ____ _____ slowly because rebound hypertension and chest pain are possible with abrupt withdrawal, the drug should never be stopped abruptly nor doses skipped.
cardioselective beta blockers
Cardioselective Beta Blockers:
there are 6, w/6 brand names
Betaxolol (Kerlone)
Esmolol (Brevibloc)
Acebutolol (Sectral)
Nebivolol (Bystolic)
Metoprolol (Lopressor, Toprol-XL)
Atenolol (Tenormin)
_____ ______ can occur with beta blockers. Self monitoring at home, pts will be instructed on how to take their apical pulse at home and then instructed to contact their prescriber if their pulse rate decreases to <60BPM.
Cardiac depression
When taking adrenergic-blocking drugs the nurse should teach patients to change positions slowly to prevent or minimize _____ _____.
postural hypotension
When taking adrenergic-blocking drugs the nurse should instruct pts to avoid _____ and ______ ingestion. Also avoid hazardous activities until blood levels become stable.
caffeine
alcohol
When taking ____ _____ drugs (in general) the nurse should instruct pts to notify their MDs if palpitations, dyspnea, nausea, or vomiting occurs.
adrenergic-blocking
A patient with type 2 diabetes is taking a beta blocker as part of treatment for hypertension. Which complication is most likely to develop?
B.
Beta blockers may mask the signs and symptoms of hypoglycemia.
When a patient has experienced extravasation of a peripheral infusion of dopamine, the nurse will inject the alpha blocker phentolamine (Regitine) into the area of extravasation and expect which effect?
D.
When administering beta blockers, the nurse will follow which guideline for administration and monitoring?
B.
The nurse providing teaching for a patient who has a new prescription for beta1
blockers will keep in mind that these
drugs may result in which effect? (Select all that apply.)
a. Tachycardia
b. Impotence
c. Bradycardia
d. Bradypnea
e. Fatigue
b, c, e
A patient who has recently had a myocardial infarction has started therapy with a beta blocker. The nurse explains that the main purpose of the beta blocker for this patient is to
D.
Before initiating therapy with a nonselective beta blocker, the nurse will assess the patient for a history of which condition?
A.
A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effects? (Select all that apply.)
a. Orthostatic hypotension
b. Increased blood pressure
c. Increased urine flow
d. Headaches
e. Bradycardia
a, c, d
The nurse is reviewing the mechanism of action of alpha adrenergic drugs. Adrenergic blockade at the alpha receptors leads to which effects? (Select all that apply.)
a. Miosis
b. Vasodilation
c. Vasoconstriction
d. Bradycardia
e. Reduced blood pressure
