Book cover for Pharmacology and the Nursing Process

Pharmacology and the Nursing Process

Linda Lane Lilley, Shelly Rainforth Collins, Julie S. Snyder

ISBN #9780323087896

7th Edition

394 Questions

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2,697 Students Helped

Homework Questions

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Summary
Learning Objectives
Key Concepts
Example Problems
Explanations
Common Mistakes

Summary

Chapter 22 on Antihypertensive Drugs provides an in-depth look at various drug classes including alpha blockers, beta blockers, and alkylating agents. It emphasizes the clinical applications of these drugs, such as the use of phentolamine in pheochromocytoma and tamsulosin in BPH. Critical aspects such as drug mechanisms, pharmacokinetics, contraindications, and interactions are highlighted to ensure optimized patient care and minimized adverse effects.

Learning Objectives

1

Understand the profiles, mechanisms, and clinical applications of alpha blockers, beta blockers, and alkylating agents.

2

Explain how drugs like phentolamine and tamsulosin are used in specific conditions such as pheochromocytoma and BPH.

3

Analyze the pharmacokinetics, contraindications, and adverse effects associated with these drug classes.

4

Evaluate the importance of considering drug interactions in optimizing patient care in antihypertensive therapy.

Key Concepts

CONCEPT

DEFINITION

Alpha Blockers

Drugs that inhibit alpha-adrenergic receptors, used in both the diagnosis and treatment of conditions such as pheochromocytoma and improving urinary flow in BPH.

Beta Blockers

Medications that block beta-adrenergic receptors, commonly used to manage cardiovascular conditions and reduce heart rate, with specific pharmacokinetic profiles and contraindications.

Alkylating Agents

A class of drugs that interfere with DNA replication, used primarily as antineoplastic agents but also discussed in the context of their effects and interactions in antihypertensive therapy.

Phentolamine

An alpha blocker used both diagnostically and therapeutically in pheochromocytoma, where it counteracts the effects of excessive catecholamine release.

Tamsulosin

A selective alpha blocker that improves urinary flow in patients with benign prostatic hyperplasia (BPH) by reducing smooth muscle tone in the prostate and bladder neck.

Pharmacokinetics

The study of how drugs are absorbed, distributed, metabolized, and excreted in the body.

Contraindications

Specific situations or conditions in which a drug should not be used because it may be harmful to the patient.

Example Problems

Example 1

The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients? a Dry mouth b Hypotension c Restlessness d Constipation

Example 2

When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs? a Alpha blockers such as doxazosin (Cardura) b Diuretics such as furosemide (Lasix) c ACE inhibitors such as captopril (Capoten) d Vasodilators such as hydralazine (Apresoline)

Example 3

A 56-year-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. Which would be the most appropriate response by the nurse? a "Not to worry. Eventually, tolerance will develop." b "The physician can work with you on changing the dose and/or drugs." c "Sexual dysfunction happens with this therapy, and you will learn to accept it." d "This is an unusual occurrence, but it is important to stay on your medications."

Example 4

When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occurring when this drug is taken to treat hypertension? a Diarrhea b Nausea c Dry, nonproductive cough d Sedation

Example 5

A patient has a new prescription for an ACE inhibitor. During a review of the patient's list of current medications, which would cause concern for a possible interaction with this new prescription? (Select all that apply.) a A benzodiazepine taken as needed for allergies b A potassium supplement taken daily c An oral anticoagulant taken daily d An opioid used for occasional severe pain e An NSAID taken as needed for headaches
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Step-by-Step Explanations

QUESTION

How does phentolamine aid in the diagnosis and treatment of pheochromocytoma?

STEP-BY-STEP ANSWER:

Step 1: Identify pheochromocytoma as a tumor that secretes excessive catecholamines, leading to elevated blood pressure and other symptoms.
Step 2: Recognize that phentolamine is an alpha blocker that prevents catecholamines from binding to alpha-adrenergic receptors.
Step 3: Understand that blocking these receptors reduces the effects of excessive catecholamines, which assists in both controlling symptoms and confirming the diagnosis by observing changes in blood pressure.
Final Answer: Phentolamine helps manage and diagnose pheochromocytoma by mitigating the effects of excess catecholamines through its alpha blocker action.

Phentolamine

QUESTION

How does tamsulosin improve urinary flow in patients with benign prostatic hyperplasia (BPH)?

STEP-BY-STEP ANSWER:

Step 1: Recognize that benign prostatic hyperplasia (BPH) leads to enlargement of the prostate, causing bladder outlet obstruction.
Step 2: Understand that tamsulosin selectively blocks alpha1 receptors located in the prostate and bladder neck.
Step 3: Realize that blocking these receptors reduces smooth muscle tone, thereby alleviating the obstruction and improving urinary flow.
Final Answer: Tamsulosin improves urinary flow by reducing smooth muscle tone in the prostate and bladder neck via selective alpha1 receptor blockade.

Tamsulosin

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Common Mistakes

  • Confusing the mechanisms of alpha blockers with those of beta blockers.
  • Overlooking the significance of pharmacokinetic differences when prescribing different drug classes.
  • Ignoring contraindications and potential drug interactions which can lead to adverse patient outcomes.
  • Misinterpreting the dual diagnostic and therapeutic roles of drugs like phentolamine.