Adrenergic-agonist Drugs Overview

Adrenergic-agonist Drugs

• Alpha and Beta Adrenergic Agonists
  • Purpose/Indication: Increase cardiac output, bronchodilation, treat hypotension, shock, or asthma.
  • Signs of Improvement: Increased blood pressure, improved respiratory rate, stronger cardiac output.
  • Possible Side Effects: Hypertension, tachycardia, nervousness, headache.
  • Route: IV (e.g., epinephrine for anaphylaxis or cardiac arrest).
• Epinephrine: Treats anaphylaxis, cardiac arrest.
• Norepinephrine (Levophed): Used for shock and severe hypotension.
• Beta-specific Adrenergic Agonists
  • Purpose: Bronchodilation (e.g., albuterol for asthma or COPD).
  • Common Side Effects: Tremors, tachycardia, nervousness.
• Albuterol: Bronchodilation for asthma/COPD.
• Dobutamine: Increases cardiac output in heart failure.
• IV Therapy
  • Complications: Fluid overload, infection, phlebitis, electrolyte imbalances.
  • Labs to Monitor: Electrolytes (e.g., sodium, potassium), renal function (BUN, creatinine).
  • Assessment: Monitor for signs of fluid overload (edema, crackles in lungs), infusion site for infiltration.
• Lactated Ringer's (LR): Fluid resuscitation.
• Normal Saline (0.9% NaCl): Volume replacement.

Women's Health

• Hormonal Contraceptives
  • Adverse Effects: Blood clots, hypertension, weight gain, mood changes.
  • Teaching: Report signs of DVT (calf pain, redness, swelling), consistent daily intake.
  • Emergency Contraceptives: Best within 72 hours of unprotected intercourse; take as soon as possible.
• Combination Pills (ethinyl estradiol and norethindrone): Pregnancy prevention.
• Emergency Contraceptive (levonorgestrel): Prevents ovulation post-intercourse.
• Adrenergic Blockers
  • Alpha-blockers:
    • Purpose: Treat hypertension, benign prostatic hyperplasia (BPH).
    • Side Effects: Orthostatic hypotension, dizziness.
    • Doxazosin: Treats BPH and hypertension.
  • Beta-blockers:
    • Side Effects: Bradycardia, hypotension, fatigue.
    • Teaching: Avoid abrupt discontinuation; monitor pulse before taking.
    • Assessment: Check apical pulse and BP before administering (e.g., amiodarone).
    • Metoprolol: For hypertension and heart failure.
    • Propranolol: Migraine prevention and hypertension.

Lifespan Considerations

• Elderly: Higher risk due to reduced renal/hepatic function, polypharmacy.
• Neonates: Immature liver enzymes reduce metabolism; careful dosing required.
• Pediatric Communication: Age-appropriate explanations and engagement (play therapy for younger children).
• Elderly/Neonates: Warfarin (bleeding risk), digoxin (toxicity), Avoid aspirin due to Reye's syndrome.

Glucose Control

• Hypoglycemia Symptoms: Shakiness, diaphoresis, confusion, tachycardia.
• Treatment: Fast-acting glucose (juice, glucose tabs); glucagon IM for severe cases.
• Teaching: Rotate injection sites, monitor blood sugar regularly.
• Insulin:
  • Rapid-acting (lispro): Controls postprandial glucose.
  • Long-acting (glargine): Basal control.
• Oral Antidiabetics: Metformin: Reduces hepatic glucose production.

Anti-Parkinson's

• Re-evaluation: Improved motor symptoms (less rigidity, tremors).
• Side Effects:
  • Dopaminergic (e.g., levodopa): Dyskinesia, orthostatic hypotension.
  • Anticholinergic (e.g., Benztropine): Dry mouth, blurred vision, constipation.
• COMT Inhibitors (e.g., entacapone): Prolong action of levodopa; fewer "off" periods.

Blood Products

• Indications: RBCs for anemia, platelets for thrombocytopenia, plasma for clotting disorders.
• Precautions: Type and cross-match; monitor for reactions.
• Monitor: Vitals, signs of transfusion reaction (fever, back pain).

Anemia Medications

• Iron Supplements:
  • Teaching: Take with vitamin C; avoid dairy/calcium.
  • Evaluation: Improved energy, pallor reduction, increased Hgb levels.
  • Ferrous sulfate: Corrects iron deficiency.
• Vitamin B12: Cyanocobalamin: Treats pernicious anemia.
• Folic Acid: Prevents neural tube defects in pregnancy.

Antiepileptics

• Priority Treatment: Maintain airway during seizure, administer rescue meds (e.g., lorazepam).
• Common Side Effects: Drowsiness, ataxia, gingival hyperplasia (phenytoin).
• Warning Signs: Aura, increased seizure frequency.
• Phenytoin (Dilantin): Tonic-clonic seizures.
• Levetiracetam (Keppra): Partial seizures.
• Valproic acid: Bipolar disorder and epilepsy

Cholinergic Agonists

• Indication: Glaucoma, urinary retention, Alzheimer's disease.
• Effectiveness: Increased salivation, improved memory (Alzheimer's).
• Crisis Treatment: Atropine.
• Bethanechol: Treats urinary retention.
• Donepezil: Improves symptoms of Alzheimer's disease.

Anticholinergic Drugs

• Uses: Motion sickness, bradycardia, asthma.
• Side Effects: Dry mouth, urinary retention, tachycardia.
• Teaching: Avoid overheating, stay hydrated.
• Evaluation: Symptom relief (e.g., reduced nausea, improved HR).
• Atropine: Treats bradycardia.
• Scopolamine: Prevents motion sickness.
• Ipratropium: Bronchodilator for COPD

Immunizing Drugs

• Vaccines Indications:
  • Influenza: Annual prevention.
  • HPV: Prevent cervical cancer.
  • Zoster: Shingles prevention.
  • Tdap: Tetanus, diphtheria, pertussis.
• Live Vaccines: Measles, Mumps, Rubella (MMR), Varicella (Chickenpox), Zoster (Shingles - live form), Yellow Fever.
• Inactivated (Killed) Vaccines: Hepatitis A, Inactivated Polio (Salk vaccine), Rabies. -Subunit, Recombinant, Polysaccharide, or Conjugate Vaccines: Human Papillomavirus (HPV), Pneumococcal (PPSV23, PCV13), Meningococcal, Hepatitis B -Toxoid Vaccines: Tetanus, Diphtheria

Passive (antibody administration)

• Natural Passive Immunity: Maternal antibodies passed to a baby via placenta (IgG) or breast milk (IgA).
• Artificial Passive Immunity: Pre-formed antibodies administered via injection.
  • Immune Globulins: Hepatitis B immune globulin (HBIG), Rabies immune globulin (RIG)
  • Antitoxins: Tetanus immune globulin (TIG), Botulism antitoxin, Diphtheria antitoxin

This quiz covers the essential aspects of adrenergic-agonist drugs, including their indications, signs of improvement, and potential side effects. You'll learn about specific medications like epinephrine and albuterol, their uses in various medical conditions, and the complications related to IV therapy. Test your knowledge to understand the clinical application of these drugs!