Tapering over 2 3 days to prevent rebound HTN No missing doses Adrenergic

Tapering over 2 3 days to prevent rebound htn no

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Tapering over 2-3 days to prevent rebound HTN No missing doses Adrenergic Antagonists Alpha blocker Beta blocker Vasodilation Antagonize or block the effects of Catecholamine “selective” or “nonselective” “selective” or “nonselective” beta1 receptors Tx for HTN, BPH, Raynaud’s disease, Migraine HA HTN, Post MI Nonselective Alpha Antagonists : Phentolamine (Regitine) & Phenoxybenzamine (Dibenzyline)- Tx for pheochromocytoma (prevention from HTN crisis) Selective Alpha 1 Antagonists : Reversibly block the effects of catecholamines (vascular , bladder neck, prostate smooth muscles ) & Doxazosin Praz osin (Minipress) Tamsul osin (Flomax) ADRs Risk for significant 1 st does orthostatic hypotension -Syncope occurs within 30-90 minutes Peripheral edema due to fluid retention nasal congestion, blurred vision, drowsiness-subsided after 7-10 days of continues therapy, dry mouth, constipation, impotence, and urinary frequency Hypotensive Sx: dizziness, HA, fatigue, Tachycardia, Nausea Clinical HTN BPH
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use Monitoring Fluid retention, Baseline WBC/LFT prior to therapy Digital rectal exam, prostate-specific antigen (PSA) prior Education First dose at bedtime (hypotension or syncope) Without food intake No NSAIDs Dry mouth- oral hygiene notify providers before taking OTCs for cough, cold, allergy remedies Take 30 minutes after food intake Improvement of Sx will take 4-6 weeks (Urinary frequency, incomplete bladder emptying, interruption…) Beta Blockers: : Cardiovascular Effect—Negative inotropism, chronotropism, & dromotropism Renal effect: reduction in less ATII medicated vasoconstriction & aldosterone-mediated volume expansion Respiratory Effect: (Beta 2) Interfere with endogenous adrenergic bronchodilator activity bronchial constriction Ocular Effect: Decrease intraocular pressure decrease aqueous humor manufactore or outflow Metabolic and Endocrine effect: (Beta2) effects on liver to inhibit lipolysis increased triglycerides, cholesterol, but decrease HDL; effects on liver to inhibit gluconeogenesis d/t epinephrine impacts glucose metabolism and delivery of gluconeogenic substrates from peripheral stores restricts glucose uptake and inhibit insulin secretion Other effects: fatigue, depression, sexual dysfunction Metoprolol (selective) Propranolol (non-selective) Atenolol (Beta1 selective drug) ADRs Most common—Hypotension, bradycardia (assess BP biweekly; below 50bpm report required) Bronchospasm -report SOB/ Difficulty in breathing Dizziness & drowsiness Insomnia can be prevented with not taking the last dose of the day late Depression & confusion Contraindication for 1 st
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  • Spring '14
  • Henrikson,J
  • Bradycardia

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