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Cardiovascular Drugs
Pharmacology for Nursing
8
Medical
Undergraduate 3
11/13/2008

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Term
Adrenergic Effect/receptors
Definition
Sympathetic nervous system ["what's up SA" (sympathetic adrenergic)] stimulation
--Alpha-adrenergic receptors: respond to NE
--Beta-adrenergic receptors: respond to EPI
--Dopaminergic receptors: respond to dopamine
Term
Alpha-adrenergic receptors
Definition
alpha1 and alpha2;
Controls release of neurotransmitters
--Alpha-adrenergic agonist response
1) vasoconstriction
2) CNS stimulation
Term
Beta-Adrenergic Receptors
Definition
Beta1=1 heart
Beta2=2 lungs (and organs)
Result: Relaxation of bronchioles, GI, uterine smooth muscle
glycogenolysis, cardiac stimulation
Term
Dopaminergic Receptors
Definition
Causes dilation of the following blood vessels, resulting in increased blood flow
--Renal
--Mesenteric
--Coronary
--Cerebral
Term
Beta-1 stimulation
Definition
Increased force of contraction (positive inotropic effect)
Increased heart rate (positive chronotropic effect)
Increased conduction through the AV node (positive dromotropic effect)
Term
Positive Inotropic drugs
Definition
incr. force of contraction
Treats CHF
1) Cardiac glycosides
--digoxin
2) Phosphodiesterase inhibitors
Term
Cardiac glycosides
Definition
Digoxin (Lanoxin) & Digitoxin
--For CHF or Supraventricular dysrhythmias (atrial flutter)
Incr contractility, decr. conduction by prolonging refractory period
Promotes diuresis
Improvement of symptoms: exertional and paroxysmal nocturnal dyspnea, cough, and cyanosis
----Very narrow therapeutic window----
Monitor electrolytes (low K)
Colored vision (seeing green, yellow, purple)= Adverse effect
--Before giving any dose, count apical pulse for 1 full minute
If less than 60 or more than 120 hold and call physician
Avoid administration with high fiber foods
IF weight gain more than 2 pounds in a day or 5 in a week report stat
Term
Phosphodiesterase Inhibitors
Definition
Short-term management of CHF (given with pt. who had no response to digoxin, dieuretics, or vasodilators
Results in:
Positive inotropic response
Vasodilation
Two agents ((weekly 6h infusions))
--Amrinone (thrombocytopenia most worrisome) and
--milrinone (dyrhythmias , atrial most worrisome)
Monitor for therapeutic effects:
Increased urinary output
Decreased edema, shortness of breath, dyspnea, rales, fatigue
Resolving of paroxysmal nocturnal dyspnea
Improved peripheral pulses, skin color, temperature
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