Pharmacology and the Nursing Process

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

ISBN #9780323087896

7th Edition

394 Questions

2,697 Students Helped

Homework Questions

Summary

Learning Objectives

Key Concepts

Example Problems

Explanations

Common Mistakes

Summary

This chapter section on Respiratory Drugs focuses on key drug profiles including alpha blockers, beta blockers, and alkylating antineoplastic agents. Alpha blockers like phentolamine and tamsulosin are used for hypertension management, BPH treatment, and pheochromocytoma diagnosis. Beta blockers work by reducing cardiac workload through receptor inhibition, and alkylating agents contribute to cancer treatment by causing DNA damage. A thorough understanding of pharmacokinetics is essential to ensure therapeutic effectiveness while minimizing adverse effects and drug interactions.

Learning Objectives

Explain and differentiate the mechanisms of action of alpha blockers, beta blockers, and alkylating antineoplastic agents.

Identify the clinical uses of alpha blockers in managing hypertension, diagnosing pheochromocytoma, and treating benign prostatic hyperplasia (BPH).

Describe how beta blockers reduce cardiac workload through receptor inhibition.

Understand the role of alkylating agents in causing DNA damage to inhibit cancer cell replication.

Recognize the importance of pharmacokinetics in optimizing therapeutic outcomes and minimizing adverse effects and drug interactions.

Key Concepts

CONCEPT

DEFINITION

Alpha Blockers

A class of drugs (e.g., phentolamine, tamsulosin) used to manage hypertension, diagnose pheochromocytoma, and treat benign prostatic hyperplasia by blocking alpha-adrenergic receptors.

Beta Blockers

Drugs that inhibit beta-adrenergic receptors, thereby reducing heart rate and myocardial contractility to decrease cardiac workload.

Alkylating Antineoplastic Agents

A group of chemotherapy drugs that damage the DNA of cancer cells, inhibiting their replication and proliferation.

Pharmacokinetics

The study of how drugs are absorbed, distributed, metabolized, and excreted by the body, which is crucial for optimizing therapeutic outcomes and minimizing adverse effects.

Example Problems

Example 1

A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? a A beta agonist, such as albuterol b An leukotriene receptor antagonist, such as montelukast c A corticosteroid, such as fluticasone d An anticholinergic, such as ipratropium

Example 2

After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/ min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is an a expected adverse effect of the medication. b allergic reaction to the medication. $c$ indication that he has received an overdose of the medication. d idiosyncratic reaction to the medication.

Example 3

A patient has been receiving an aminophylline (xanthine derivative) infusion for 24 hours. The nurse will assess for which adverse effect when assessing the patient during the infusion? a CNS depression b Sinus tachycardia c Increased appetite d Temporary urinary retention

Example 4

During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singulair), the nurse will tell the patient that the drug has which therapeutic effect? a Improves the respiratory drive b Loosens and removes thickened secretions c Reduces inflammation in the airway d Stimulates immediate bronchodilation

Example 5

After the patient takes a dose of an inhaled corticosteroid, such as fluticasone (Flovent), what is the most important action the patient needs to do next? a Hold the breath for 60 seconds. b Rinse out the mouth with water. c Follow the corticosteroid with a bronchodilator inhaler, if ordered. d Repeat the dose in 15 minutes if the patient feels short of breath.

Step-by-Step Explanations

QUESTION

How do alpha blockers like phentolamine and tamsulosin aid in managing hypertension and treating BPH?

STEP-BY-STEP ANSWER:

Step 1: Identify the target receptors affected by these drugs (alpha-adrenergic receptors).
Step 2: Understand that blocking these receptors leads to vasodilation, reducing blood pressure in hypertensive patients.
Step 3: Recognize that relaxation of smooth muscle in the prostate and bladder neck helps alleviate symptoms of BPH.
Step 4: Acknowledge the diagnostic use in pheochromocytoma by facilitating controlled blood pressure fluctuations.
Final Answer: Alpha blockers manage hypertension by causing vasodilation through alpha receptor inhibition and treat BPH by relaxing smooth muscles in the urinary tract.

Alpha Blockers

QUESTION

How do beta blockers reduce cardiac workload?

STEP-BY-STEP ANSWER:

Step 1: Identify that beta blockers work by binding to beta-adrenergic receptors in the heart.
Step 2: Understand that this binding inhibits the effects of adrenaline and noradrenaline.
Step 3: Recognize that the inhibition results in a decreased heart rate and reduced myocardial contractility.
Step 4: Conclude that these effects lead to lower oxygen demand and reduced cardiac workload, beneficial in conditions such as hypertension and heart disease.
Final Answer: Beta blockers reduce cardiac workload by inhibiting beta-adrenergic receptors, thereby lowering heart rate and myocardial contractility.

Beta Blockers

QUESTION

How do alkylating agents function in the treatment of cancer?

STEP-BY-STEP ANSWER:

Step 1: Identify that alkylating agents work by attaching alkyl groups to DNA strands.
Step 2: Understand that this attachment causes DNA cross-linking or breaks which inhibit DNA replication.
Step 3: Recognize that impaired DNA replication leads to cell death, particularly in rapidly dividing cancer cells.
Step 4: Acknowledge that this mechanism forms the basis of their use in chemotherapy.
Final Answer: Alkylating agents cause DNA damage by adding alkyl groups, leading to cross-linking or strand breaks, which inhibit cancer cell replication and promote cell death.

Alkylating Antineoplastic Agents

Common Mistakes

Confusing the uses of alpha blockers, mistakenly applying them to conditions where beta blockers or other classes may be more appropriate.
Overlooking the impact of pharmacokinetics in dosing, which can lead to adverse effects or subtherapeutic outcomes.
Misinterpreting the mechanism of beta blockers, such as assuming they only lower blood pressure without reducing cardiac workload.
Assuming that alkylating agents selectively damage only cancer cells without impacting healthy cells, leading to underestimating potential side effects.