JIANNE DENISE P.

CALO BSN- 2Q

SYMPATHOLIC DRUGS MECHANISM OF SIDE EFFECTS ADVERSE EFFECTS NURSING

ACTION CONSIDERATION /
MANAGEMENT
ALPHA ADREGENERIC Alpha-blockers exert Postural hypotension (a Hypotension, weakness, To avoid adverse effects,
BLOCKERS their form of low blood tachycardia, and check for contraindications
pharmacological pressure that happens trembling are all or cautions (e.g., history of
effects by affecting when you stand up from symptoms. The drug allergy, CV diseases,
the sympathetic sitting or lying down) inhibition of alpha-1 pregnancy or lactation
nervous system. receptors causes status, etc.).
Alpha-adrenergic Dizziness and faintness vascular smooth muscle
receptors are relaxation and Establish a baseline
classified into two Headache vasodilation, resulting in physical examination to
types: alpha-1 and hypotension. The monitor for any potential
alpha-2. The majority Tachycardia (a heart remaining negative negative effects.
of alpha-1 rate over 100 beats per effects result from
adrenergic receptors minute) increased Examine orientation, affect,
are found on norepinephrine release and reflexes to look for
vascular smooth Nasal stuffiness when alpha-2 receptors CNS changes caused by
muscle. Both are simultaneously drug therapy.
systemic arterial Peripheral edema antagonized. This
blood pressure and release causes beta To determine changes in
peripheral resistance Decreased ejaculation receptor stimulation due function, monitor CV status
rise as a result of to norepinephrine (blood pressure, pulse rate,
vasoconstriction. spillover, resulting in peripheral perfusion).
Norepinephrine tremulousness and
binds to this receptor tachycardia. Monitor urine output, which
more strongly than reflects kidney perfusion,
epinephrine. as another indicator of
cardiac function.

These medications should

never be stopped abruptly.
BETA ADREGENERIC Blocks stimulation of Feeling tired, dizzy or Peripheral Take apical pulse for 1 full
BLOCKERS beta1-adrenergic lightheaded (these can vasoconstriction minute. Withhold dose and
(myocardial) and be signs of a slow heart Orthostatic hypotension notify prescriber if patient
beta2-adrenergic rate) Bradycardia has bradycardia or
(pulmonary, Cold fingers or toes Arrythmias tachycardia.
vascular, and (beta blockers may Heart Failure Use cautiously with renal
uterine) receptor affect the blood supply Myocardial infarction or hepatic impairment,
sites. to your hands and feet) and sudden death with a sinus node dysfunction,
brupt withdrawal in pulmonary disease,
Difficulties sleeping or angina therapy diabetes mellitus,
nightmares hyperthyroidism,
Raynaud’s syndrome,
Feeling sick hypertensive emergencies,
myasthenia gravis.

Advise patient to take with

meals at same time every
day to minimize GI upset

Caution patient not to stop

taking drugs suddenly. Tell
him dosage must be
tapered

Inform patient that drug

may cause muscle aches
or bone pain. Advise him to
discuss activity
recommendations and pain
management with
prescriber.

These medications should

never be stopped abruptly.
CENTRALLY ACTING Presynaptic 2- Nausea, vomiting, Arrythmias Assess
ALPHA2 AGONIST adrenergic receptor constipation, dry mouth Hypertension Vital signs, especially
stimulation in the Bradycardia Heart Failure blood pressure and heart
CNS dilates Clonidine: rebound rate
peripheral blood hypertension when Laboratory test results;
vessels lowers stopped abruptly, CNS renal function
peripheral resistance depression
lowers blood Guanfacine, Monitor
pressure methyldopa: orthostatic Side effects
hypotension, sedation Evaluate therapeutic
Methyldopa: response: blood pressure
granulocytopenia, within a normal range
thrombocytopenia,
hemolytic anemia, Client Education:
hepatotoxicity, hepatic • Purpose of
necrosis medication: blood
pressure control
• Transdermal patch
• Apply every seven
days at a consistent
time each week
• Apply to a clean,
dry, intact and
hairless skin
➢ Chest or upper arm
preferred
➢ Rotate the
application site
➢ Proper disposal of a
used patch
• Do not discontinue
abruptly
• Notify healthcare
provider for
symptoms of
hypertension:
sweating, flushing,
nervousness,
 severe headache,
blurred vision
• Dry mouth, suggest
- Use sugar-free hard
candy or gum;
frequent sips of
water
• Drowsiness
- Avoid alcohol or
other CNS
depressants
- Avoid activities that
require alertness
• Dizziness,
bradycardia and
hypotension
- Make position
changes slowly; use
caution when going
up and down stairs
• Lifestyle
modifications for
blood pressure
management
- Weight loss,
smoking cessation,
increased physical
activity as tolerated,
low sodium diet
- Blood pressure self-
monitoring
- Abnormal readings
that warrant medical
attention
ADREGENERIC RESPERPINE Gastrointestinal upset CNS: Encourage patients to take
NEURON BLOCKERS It blocks the Mg/ Depression (suicidal medications as prescribed.
ATP dependent Mild diarrhea that may tendency)
vesicular mano last for days Nightmares Report constipation or the
amine transporter Extra Pyramidal development of any urinary
Sweating over the back (Parkinson) effects hesitancy or bladder
GUANATHEDINE/ and hind legs. distention.
BRETYLIUM Cardiovascular system:
It inhibits nerve Depression, droopy Mild postural These medications should
impulse coupled N. eyes and dropped penis hypotension never be stopped abruptly.
A release from
vesicles (bretylium) GIT:
Displaces N.A from Diarrhea
storage vesicles Acidity
Engages and blocks
the N.A reuptake at Nasal Region:
axonal membrane Nasal Congestion

Reproductive System:
Delayed ejaculation
ALPHA 1 Blocking peripheral Dizziness, headache, Postural Hypotension Assessment:
ADREGENERIC 1-adrenergic and drowsiness
BLOCKERS receptors dilates Anxiety, CNS Nasal Stuffiness Weight, vital signs,
peripheral blood depression orthostatic blood pressure
vessels, reduces Palpitations, orthostatic
peripheral hypotension, reflex Monitoring:
resistance, and tachycardia, and edema
lowers blood Blurred vision Side effects
pressure. Dry mouth Evaluate for the
Nausea, diarrhea, and therapeutic response:
constipation blood pressure control
Urinary frequency,
incontinence,
impotence, and priapism Client Education:
Doxazosin: arrhythmias • Purpose of
and hepatitis medication: blood
pressure control
• Take with or without
food
• Take consistently;
do not abruptly stop
medication to avoid
rebound
hypertension
• Take first dose at
bedtime to avoid
severe orthostatic
hypotension and
syncope
• Continue to make
position changes
slowly, sit down if
dizziness occur
• Contact healthcare
provider if
hypotension and
dizziness persist
• Avoid alcohol
• Check with
healthcare provider
before taking over-
the-counter
medications
• Blood pressure self-
monitoring
technique
- Desired blood
pressure; readings
that require medical
attention
• Lifestyle
modifications:
maintaining a
healthy weight,
smoking cessation,
 reducing their intake
of sodium,
increasing physical
activity as tolerated

These medications should

never be stopped abruptly.
BETA 1 ADREGENERIC Adenylate cyclase is Blood: Bradycardia / Arrythmias Avoid OTC medications
BLOCKERS activated, and Agranulocytosis, because of possible
intracellular cAMP thrombocytopenia Cardiac failure interactions.
increases.
Cardiovascular: Hypotension Possible drug interactions
AV block, bradycardia, may occur with:
congestive heart failure, Brochospasm / - Antacids (aluminum
peripheral vascular Bronchoconstriction hydroxide type)
insufficiency - Antimuscarinics /
Heptatoxicity anticholinergics
CNS: - Diuretics and
Dizziness, mental Sexual Impairment cardiovascular
depression, lethargy, drugs
hallucinations Withdrawal of - Neuromuscular
propranolol after chronic blocking agents
use should be gradual, - Oral hypoglycemic
otherwise rebound agents
hypertension, worsening Avoid caffeine (excessive
of angina and even irritability)
sudden death can occur Teach patients to change
positions slowly to prevent
or minimize postural
hypotension

These medications should

never be stopped abruptly.
REFERENCES

Crawford, L. & Hunt, L. (March 6, 2016). Cardiac Medication Review. Retrieved on September 20, 2022 from
https://slideplayer.com/amp/10162571/

Tabangcora, I. (May 3, 2022). Adrenergic Antagonists (Sympatholytics). Retrieved on September 20, 2022 from
https://nurseslabs.com/adrenergic-antagonists-sympatholytics/

Klabunde. R. (2005-2022). Cardiovascular Pharmacology Concepts. Retrieved on September 20, 2022 from
https://cvpharmacology.com/vasodilator/Central-acting

WHAT ARE CENTRAL ALPHA-2 AGONISTS AND HOW DO THEY WORK?. Retrieved on September 20, 2022 from
https://www.rxlist.com/what_are_central_alpha-2_agonists_and_how_do_they/drug-class.htm

Podrid, P. (2022). Major side effects of beta blockers. Retrieved on September 20, 2022 from uptodate.com/contents/major-side-
effects-of-beta-blockers

Alpha 1 Adrenergic Receptor Antagonists. Retrieved on September 20,2022 from

ncbi.nlm.nih.gov/books/NBK548719/#:~:text=(Brief%20overview%20of%20currently%20available,priapism%2C%20thrombocytopenia
%20and%20atrial%20fibrillation%3B

Alpha-blockers. Retrieved on September 20, 2022 from https://my.clevelandclinic.org/health/treatments/22321-alpha-blockers