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The autonomic nervous system (ANS) works to keep the body’s homeostasis against internal and external changes in the environment which alter the body’s internal functions (e.g., blood pressure regulation, urinary excretion, water balance, and digestive functions). Adrenergic agonists are autonomic nervous system drugs that stimulate the adrenergic receptors of the sympathetic nervous system (SNS), either directly (by reacting with receptor sites) or indirectly (by increasing norepinephrine levels). An adrenergic agonist is also called a sympathomimetic because it stimulates the effects of SNS. Adrenergic agonists are further classified into three: alpha- and beta-adrenergic agonists, alpha-specific adrenergic agonists, and beta-specific adrenergic agonists. Adrenergic Agonists: Generic and Brand NamesHere is a table of commonly encountered adrenergic agonists, their generic names, and brand names:
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Alpha- and Beta-Adrenergic Agonists
Therapeutic ActionThe desired and beneficial actions of alpha- and beta-agonists are as follows:
IndicationsAlpha- and beta-agonists are indicated for the following medical conditions:
Here are some important aspects to remember for indication of adrenergic agonists in different age groups: Children
Adults
Older adults
PharmacokineticsHere are the characteristic interactions of alpha- and beta-adrenergic agonists and the body in terms of absorption, distribution, metabolism, and excretion:
Contraindications and CautionsThe following are contraindications and cautions for the use of alpha- and beta-agonists:
Adverse EffectsUse of alpha- and beta-agonists may result to these adverse effects:
InteractionsThe following are drug-drug interactions involved in the use of alpha- and beta-agonists:
Here are important nursing considerations when administering alpha- and beta-agonists: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing Diagnosis and Care PlanningHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy: Implementation with RationaleThese are vital nursing interventions done in patients who are taking alpha- and beta-agonists:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Alpha-Specific Adrenergic Agonists
Therapeutic ActionThe desired and beneficial action of alpha-agonists is:
IndicationsAlpha-agonists are indicated for the following medical conditions:
PharmacokineticsHere are the characteristic interactions of alpha-agonists and the body in terms of absorption, distribution, metabolism, and excretion:
Contraindications and CautionsThe following are contraindications and cautions for the use of alpha-agonists:
Adverse EffectsUse of alpha-agonists may result to these adverse effects:
InteractionsThe following are drug-drug interactions involved in the use of alpha-agonists:
Here are important nursing considerations when administering alpha-agonists: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing Diagnosis and Care PlanningHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:
Implementation with RationaleThese are vital nursing interventions done in patients who are taking alpha-agonists:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Beta-Specific Adrenergic Agonists
Therapeutic ActionThe desired and beneficial action of beta-agonists is:
IndicationsBeta-agonists are indicated for the following medical conditions:
PharmacokineticsHere are the characteristic interactions of beta-agonists and the body in terms of absorption, distribution, metabolism, and excretion:
Contraindications and CautionsThe following are contraindications and cautions for the use of beta-agonists:
Adverse EffectsUse of beta-agonists may result to these adverse effects:
InteractionsThe following are drug-drug interactions involved in the use of beta-agonists:
Here are important nursing considerations when administering beta-agonists: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing Diagnosis and Care PlanningHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy: Implementation with RationaleThese are vital nursing interventions done in patients who are taking beta-agonists:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Practice Quiz: Adrenergic AgonistsHere are some practice questions for this study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. All of the following are true about dopamine and dobutamine, except: A. They bind to both alpha- and beta-receptorsB. They can increase heart rate and cause bronchoconstrictionC. Dopamine is the sympathomimetic of choice for shock D. Administration of these drugs can put patients with peripheral cardiovascular disease into exacerbation 1. Answer: B. They can increase heart rate and cause bronchoconstriction Dopamine and dobutamine are alpha- and beta-receptors. They can increase the heart rate and cause bronchodilation as well as increasing the rate and depth of respirations. They can put patients with peripheral CV disease into exacerbation because of their vasoconstrictive effects. Lastly, dopamine is the sympathomimetic of choice for shock. 2. The sympathomimetic found in many OTC cold products. A. salmeterolB. albuterolC. phenylephrine D. terbutaline 2. Answer: C. phenylephrine Phenylephrine is often found in OTC allergy and cold preparations so primary caregivers should be instructed to check labels for ingredients and not combine drugs with similar ingredients. 3. Nurse Jake was doing his usual morning routine care for his patient receiving parenteral isoproterenol when he noticed a developing extravasation in the site. Which is the best nursing action for this situation? A. Provide skin care and warm compress because it will subside in 1-2 hours.B. Explain to the client that it is an expected side effect of the drug.C. Document and endorse to next nurse on duty because extravasation need long hours of observation before an appropriate course of nursing actions can be determined. D. Inject 10 mL of saline with 5 mg of phentolamine to save the area from necrosis. 3. Answer: D. Inject 10 mL of saline with 5 mg of phentolamine to save the area from necrosis. The vasoconstrictive effects of isoproterenol can cause necrosis. Management for this is infiltrating the site with 10 mL saline containing 5-10 mg of phentolamine within 12 hours to save the area from necrosis. 4. This drug is used to control hypertension and is used as an epidural infusion for patients suffering from cancer pain. A. midodrineB. clonidineC. albuterol D. isoproterenol 4. Answer: B. clonidine Clonidine specifically stimulates alpha2-receptors of the CNS leading to decreased CNS outflow of norepinephrine. Orally and transdermally, it is used to control hypertension and as an injection, it is for epidural infusion for controlling cancer pain. 5. A pregnant patient on 32 weeks age of gestation came rushing to the emergency complex because of increased watery discharge and frequent uterine contractions. Upon physical examination, patient was confirmed to have ruptured of membranes and is in preterm labor. Which of the additional PE findings will render beta-agonists contraindicated as part of her management for uterine relaxation? A. HbA1c of 6 D. few to many pus cells in urinalysis 5. Answer: B. blood pressure of 150/70 mmHg and +3 proteinuria This could signify a possibility of eclampsia and this can be complicated by drug effects of beta-agonists (e.g. uterine relaxation and increased blood pressure). Recommended ResourcesRecommended resources and reference books. Disclosure: Includes Amazon affiliate links. See AlsoHere are other nursing pharmacology study guides:
Gastrointestinal System Drugs
Respiratory System Drugs Endocrine System Drugs Autonomic Nervous System Drugs Immune System Drugs Chemotherapeutic Agents Reproductive System Drugs
Nervous System Drugs Cardiovascular System Drugs References and SourcesReferences and sources for this pharmacology guide for Adrenergic agonists:
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