Nursing Implications of Adrenergic Blocking Antagonists

Assess for allergies and history of COPD, hypotension, cardiac dysrhythmias, bradycardia,
heart failure, or other cardiovascular problems
Any preexisting condition that might be exacerbated by the use of these drugs might be a
contraindication to their use
Avoid over-the-counter medications because of possible interactions
Assess blood pressure and pulse prior to administration
Hold for SBP <100 or ordered parameters
Hold for pulse < 60 or ordered parameters
Encourage patients to take medications
as prescribed
Instruct patients that these medications should never be stopped abruptly
Inform patients to report constipation or the development of urinary hesitancy or bladder
distention
Teach patients to change positions slowly to prevent or minimize postural hypotension
Instruct patients to avoid caffeine (excessive irritability)
Instruct patients to avoid alcohol ingestion and hazardous activities until blood levels
become stable
Instruct patients to notify their physician if palpitations, dyspnea, nausea, or vomiting
occurs
Monitor for adverse effects
Monitor for therapeutic effects
Decreased chest pain in patients with angina
Return
to normal BP
and HR
Rebound
hypertension
or chest
pain may occur if this medication is discontinued abruptly
Other
specific
effects,
depending
on if
the
usebecome ill and unable to take medication
Instruct patients to notify their physician
they
Inform patients that they may notice a decrease in tolerance for exercise (dizziness and
fainting may occur with increased activity), and have patients notify the physician if these
problems occur
Inform patients to report the following to their physician:
Weight gain of more than 2 pounds in 1 day or 5 pounds in 1 week
Edema of the feet or ankles
Shortness of breath
Excessive fatigue or weakness
Syncope or dizziness

Prototype Alpha- and Beta-Adrenergic Blocking Agents

Prototype Alpha-Adrenergic Blocking Agent

Prototype Alpha1-Selective Adrenergic Blocking Agents

Prototype Beta-Adrenergic
Blocking Agents

Prototype Beta1Selective Adrenergic Blocking

Agents

Rationale
A patient with essential hypertension is prescribed the beta blocker
metoprolol. Which assessment data should make the nurse question
administering this medication?
The patients blood pressure is 112/90 (the nurse would only question
this if the blood pressure were below normal levels as Beta blockers
will further lower blood pressure)
The patients apical pulse is 56 (The nurse would question
administering a beta blocker if the apical pulse was less than 60
because this medication further will decrease pulse
The patient has an occipital headache (An occipital headache could be
a sign of high blood pressure; therefore, the nurse would administer
the medication
The patient is complaining of a yellow haze (A yellow haze is a
common symptom of digoxin toxicity and would have no bearing on
whether to administer a beta blocker

Beta Adrenergic Blockers

Block stimulation of beta receptors

in
the SNS
Compete with norepinephrine and
epinephrine
**Nonselective beta blockers block both beta 1 and beta2
Can be selective or nonselective
receptors
Beta1 receptors
Located primarily on the heart
Beta blockers selective for these receptors
are called cardioselective beta blockers
Beta2 receptors
Located primarily on smooth muscle of bronchioles and
blood vessels
OtherAdverse Reactions
Nonselective beta blockers may interfere with normal
responses to hypoglycemia (tremor, tachycardia,
nervousness)
May mask signs and symptoms of
hypoglycemia
Use with caution in patients with diabetes
mellitus
Bronchospasm/Wheezing
Impotence
Alopecia
Precautions:
Dry mouth
Heart Failure
Asthma
Emphysema
Hypotension
Diabetes
Thyrotoxicosis
Peptic ulcer

Adrenergic Blocking Medications

Also referred to as sympatholytic
Include four groups
Alpha adrenergic blocking- control the vascular
system (ex: Regitine)
Beta adrenergic blocking- act on receptors of the
heart- olol drugs (ex: atenolol, metoprolol)
Alpha/beta adrenergic blocking- act on alpha
and beta receptors (ex: coreg)
Antiadrenergic- blocks the release of
norepinephrine (ex: clonidine, minipress, and
hytrin)

Alpha/ Beta Blocking:

Block both alpha and beta receptors
Used in the treatment of CHF and HTN
Adverse Reactions
Bradycardia
Hypotension
Weakness, fatigue, and dizziness
Precautions
Bradycardia
Bronchial Asthma/Chronic
bronchitis
Heart failure
Hepatic failure