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Author: Admin | 2025-04-28
Patients who smoke or have allergic or seasonal rhinitis, asthma, or COPD.Common drug examples include propranolol, nebivolol, and timolol.Therapeutic ActionThe desired and beneficial actions of nonselective beta-adrenergic blocking agents are as follows:Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatusReduction of vascular tone in the CNSIndicationsNonselective beta-adrenergic blocking agents are indicated for the following medical conditions:These drugs are used for a wide range of conditions, including hypertension, stage fright (situational anxiety), migraines, angina, and essential tremors.Timolol and carteolol in ophthalmic form are used for reduction of intraocular pressure in patients with open-angle glaucoma.PharmacokineticsHere are the characteristic interactions of nonselective beta-adrenergic blocking agents and the body in terms of absorption, distribution, metabolism, and excretion:RouteOnsetPeakDurationOral20-30 min60-90 min6-12 hIVImmediate1 min4-6 hT1/2: 3-5 hoursMetabolism: liverExcretion: urineContraindications and CautionsThe following are contraindications and cautions for the use of nonselective beta-adrenergic blocking agents:Allergy to any component of the drug. To prevent hypersensitivity reactionBradycardia, heart blocks, shock, HF. Can be exacerbated by the cardiac-suppressing effects of these drugsBronchospasm, COPD, acute asthma. Can be worsen due to blocking of the sympathetic bronchodilationPregnancy. Teratogenic effects have occurred in animal studies with all these drugs except sotalol; neonatal apnea, bradycardia, and hypoglycemia can occurLactation. Potential effects to the neonate include slowed heart rate, hypotension, and hypoglycemiaDiabetes, hypoglycemia. Drugs can block the normal signs and symptoms of hypo- and hyperglycemiaThyrotoxicosis. Adrenergic blocking effects on the thyroid glandRenal or hepatic dysfunction. Can interfere with drug metabolism and excretion.Adverse EffectsUse of nonselective beta-adrenergic blocking agents may result to these adverse effects:CNS: headache, fatigue, dizziness, depression, paresthesia, sleep disturbances, memory loss, disorientationCV: bradycardia, heart block, HF, hypotension, peripheral vascular insufficiencyRespiratory: difficulty of breathing, coughing, bronchospasm, severe pulmonary edema, severe bronchial obstructionGI: GI upset, nausea, vomiting, diarrhea, gastric pain, colitisGU: decreased libido, impotence, dysuria, Peyronie diseaseOther: decreased exercise tolerance, hypo- or hyperglycemia, liver changesAbrupt withdrawal: angina, MI, hypertension, strokeInteractionsThe following are drug-drug interactions involved in the use of nonselective beta-adrenergic blocking agents:Clonidine. Paradoxical hypertension can occur; increased rebound hypertension with clonidine withdrawal.NSAIDs. Decreased antihypertensive effectEpinephrine. Initial hypertensive episode followed by bradycardiaErgot alkaloids. Peripheral ischemia may occurInsulin and other antidiabetic agents. Potential change in blood glucose levelsNursing ConsiderationsHere are important nursing considerations when administering nonselective beta-adrenergic blocking agents:Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:Assess for contraindications or cautions (e.g. history of allergy to drug, heart failure, pregnancy or lactation status, etc.) to avoid adverse effects.Establish
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