N324 MedSurg II Quiz

Class: Beta adrenergic agonist

Action & uses: Acts on beta1-ceptors in the heart to increase inotropic activity (increase contractility) & increase conduction through AV node (increase HR).

AE: Angina, increased myocardial workload, tachycardia

Nursing Implications:
-Monitor ECG & BP closely while pt receives this drug.
-Admin via infusion pump.
-Marked HTN & tachycardia, & appearance of dysrhythmias are usually reversed by promptly decreasing the dose.

Class: Phosphodiesterase inhibitor

Action & Uses: Inhibits cyclic AMP phosphodiesterase in cardiac & smooth muscle, thereby increasing myocardial contractility (increased CO) & causing vasodilation (decreased PAWP, decreased SVR). Little chronotropic activity, therefore does not significantly increase myocardial oxygen demand or increase HR.

AE: Ventricular dysrhythmias, hypotension

NI:
-Monitor ECG & BP closely while pt receives this drug.
-Admin via infusion pump.
-In presence of significant hypotension, stop infusion, notify HCP.

Class: Selective alpha adrenergic agents

Action & Uses: Sympathomimetic agent that acts directly on alpha adrenergic receptor to cause peripheral vasoconstriction (increase BP). Has some beta1 activity @ high doses

AE: Ventricular dysrhythmias

NI:
-Monitor BP closely while pt receives this drug
-Titrate dose to target BP as ordered by HCP. Give @ lowest dose possible to maintain BP.
-Admin via infusion pump.
-If admininstering drug via periphaerl IV site, monitor site closely for infiltration. If infiltration dose occur, stop infusion & call HCP immediately (infltration can cause ischemia & necrosis of tissue).
-Avoid abrupt w/d: when drug is d/c'ed infusion rate is slowed gradually.

Class: Non-selective alpha adrenergic agents

Action & uses: sympathomimetic agent that acts directly on alpha adrenergic receptors to cause peripheral vasoconstriction (increase BP). Has moderate beta1 inotropic activity (increase contractility).

AE: Ventricular dysrhythmias, increased myocardial workload, hepatic or renal necrosis

NI:
-Monitor BP closely while pt receives this drug.
--Titrate dose to target BP as ordered by HCP. Give @ lowest dose possible to maintain BP.
-Admin via infusion pump
-If admininstering drug via periphaerl IV site, monitor site closely for infiltration. If infiltration dose occur, stop infusion & call HCP immediately (infltration can cause ischemia & necrosis of tissue).
-Avoid abrupt w/d: when drug is d/c'ed infusion rate is slowed gradually.

Class: Non-selective alpha adrenergic agents

Action & uses: Has dose-dependent pharmacologic effects. At doses < 5 mcg/kg/min, dopaminergic receptors are activated leading to vasodilation in renal & mesenteric vascular beds. At doses of 5-10 mcg/kg/min., the beta1 adrenergic effects predominate resulting in increased myocardial contractility & increased HR. At doses > 10 mcg/kg/min, alpha-adrenergic effects predominate leading to arterial vascoconstriction (increased BP).

AE: Tachycardia (particular at higher doses), dysrhythmias, hypotension

NI:
-Notify HCP of decrased urine output in absence of hypotension, increasing tachycardia, dysrhythmias, or signs of peripheral ischemia (pallor, cyanosis, mottling, coldness).
-Monitor lung sounds in pts. w/ pulmonary congestion or edema b/c of its vasoconstrictive properties, it can increase venous return to rt. side of the heart & can worsen pulmonary edema
-Admin via infusion pump
-If admininstering drug via periphaerl IV site, monitor site closely for infiltration. If infiltration dose occur, stop infusion & call HCP immediately (infltration can cause ischemia & necrosis of tissue).
-Avoid abrupt w/d: when drug is d/c'ed infusion rate is slowed gradually.