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CRITICAL THINKING CASE STUDY dalt patient has asthma. An adrenergic agonist is A

ID: 138831 • Letter: C

Question

CRITICAL THINKING CASE STUDY dalt patient has asthma. An adrenergic agonist is An older adult patient has hypertension and asthma. Asn ected for treatment. adrenergic blocker is selected for treatment. la ir he dru adantages and disadvantages associ- 1. What are the drug advantages and disadvantages associated with the use of doxazosin, prazosin, propranolol, meto- prolol, and atenolol for this patient? Explain your answer 2. What needs to be included when teaching this patient atnd with the use of an adrenergic agonist, such as ephed- in. metaproterenol,or albuterol, for this patient? Explain sage afactor in drug selection? Explain your answer. about the use of an adrenergic blocker?

Explanation / Answer

*) 1. Advantages and Disadvantages of adrenergic agonists.(epihendrin,metaproterenol or albuterol).

              * Advantages

                         #Epihendrin

                          * Epihendrin act as bronchodilators by stimulating beta 2 receptors so useful in

                                  treatment of asthma of this patient.

                      #Albuterol

                                * Albuterol is a sympathomimetic and selective beta 2 agonist and it can stimulate

                                  beta receptor which result in bronchodilation so useful in asthmatic patient.

                * Disadvantages

                             # Epihendrin

                                        * Continuous administration of this drug in between short intervals result in

                                           Tachyphylaxis.

                                        * Hypertension because of pheripheral vasoconstriction when using repeatedly

                                        * Epihendrin is a CNS stimulant so it can produce anxiety,insomnia,tremors

                                           and changes in mental status.

                             # Albuterol

                                           * HIgh doses of this drug result in hypokalemia.

                                           * Muscle cramps,tremors,palpitations are common side effects because of

                                             it's action in smooth muscles.

                                           * Albuterol can produce paradoxical reactions(opposite effect) which result

                                             in bronchospasm.

2. Importance of age in drug selection

                        *Changes in doses are needed for children,infants and adults because of their difference

                           body surface area,weight,Liver maturation,GI absorption and immunity.

                        * Some category of drugs like anesthetics produce over reaction in children compared

                          to adult so age is important when using anesthetics.

                        *Old age people have weakness in immune status so when prescribing drugs for oldage

                          changes needed in dosage.

*) 1. Advantages and disadvantages of (Doxazosin,prazosin,propanolol,metapropanolol and atenolol)

                  *Advantages

                            # Doxazosin and prazosin

                                          * Prazosin is a alpha 1 antagonist so it act as a vasodilator and used in

                                            acute heart failure.

                                          * Doxazosin also a alpha 1 antagonist used to treat hypertension and benign

                                             prostatic hyperplasia associated urinary retention.

                            # Proponolol,metaproponolol and atenolol

                                         *This drugs are included in category of beta blockers and used in treatment of

                                          hypertension,angina pectoris and cardiac arrythmias.

                * Disadvantages

                                     # Prazosin and Doxazosin

                                                    * Doxazosin cause orthostatic hypotension,dizziness,fatigue and

                                                      vertigo because of vasodilation properties.

                                                    * Prazosin also cause dizziness,fatigue,nausea and palpitations.

                                      # Proponolol,metaproponolol and atenolol

                                                     * This category of beta blockers disadvantages are depressing myo

cardial contractibility impulse conduction velocity,bronchoconstriction

automaticity of heart due to block the beta receptors.

Teaching patient about use of adrenergic blockers

   * Teaching should include common side effects which are discussed above

                                            and said them to take action if side effects occur.

                                       *   Explain the patient that when taking beta blockers your heart rate will be

                                            slow.

                                        * Take beta blockers(eg:proponolol) along with food.

                                        * Do not stop use of this drugs without the opinion of doctor.

                                        * Adrenergic blockers are stopped gradually by one or two weeks

                                          of time so strictly follow physicians guidelines.

                                                  

                  

                                  

                         

                 

   

                     

                      

                            

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