Antihypertensives: Adrenergic blocking drugs

/ Alpha & Beta Central and Peripherally Acting

How it works? “Action” Nursing management

Peripherally acting: Inhibits norepinephrine in the
PNS ( treats BPH, HTN)
Centrally acting: Decreases CNS activity (HTN)
Why do we give it? ‘’Reason’’
• Certain cardiac arrhythmias
• BAH
• HTN
• Monitor intake and output ratios and daily weight
• Assess for edema daily, especially at beginning of
therapy.
• Monitor BP and pulse prior to starting, frequently
during initial dose adjustment and dose increases
and periodically throughout therapy.
• Titrate slowly in patients with cardiac conditions or
those taking other sympatholytic drugs.
Report significant changes.
• Transdermal: Instruct patient on proper application
of transdermal system. Do not cut or trim unit.
Transdermal system can remain in place during
bathing or swimming.

Adverse effects Interactions:

EENT: dry eyes. • Adrenergic: risk of HTN
CV: AV block, bradycardia, hypotension (with • Levodopa: hypotension, decrease levodopa
epidural), palpitations. • Anesthetic agents: increase anesthetic
GI: dry mouth, constipation, nausea, vomiting. • Beta blockers: hypertension
GU: erectile dysfunction. • Lithium: lithium toxicity
Derm: rash, sweating. • Haloperidol: psychotic behavior
F&E: sodium retention, hyperkalemia
Metab: weight gain.
Neuro: paresthesia.
Misc: withdrawal phenomenon
Contraindications

• Central: Hepatic disease ( active ) , MAOI

antidepressant therapy
• Peripheral: ulcerative colitis , peptic ulcer

Generic Trade Central / peripheral Safe dose Route

100 mcg (0.1 mg)
Clonidine Catapres Central PO, TD
BID

250– 500 mg 2– 3
Methyldopa N/A Central PO
times daily

Cardura, Cardura
Doxazosin Periphera 1 mg once daily PO
XL

1 mg 2– 3 times
Prazosin Minipress Periphera PO
daily