Explain the differences in how phenylephrine is used to treat glaucoma and shock

Discussion Topics, Chapter 30, Adrenergic Agonists

Discussion Topics

Learning Objective(s)

1. Ms. Jones is an 80-year-old in the critical care unit receiving treatment for shock. She is currently receiving Dopamine at 10 mcg/kg/min and Dobutamine at 10 mcg/kg/min with a stable blood pressure and heart rate. Currently, she is not able to interact with family or the health care team. Her medical history includes mild heart failure and mild hypertension, which are treated with oral medications. She has many family members with her, including a son who is using the Internet to gather information on her medications.

a. The son asks why his mother is on dopamine and dobutamine “when they are the same medication.” How do you answer his question?

b. If the dopamine and dobutamine reach the maximum therapeutic range, what medication would you anticipate adding to help maintain blood pressure, heart rate, and tissue perfusion?

2. Mr. Jones has been prescribed phenylephrine drops for his glaucoma. He calls the clinic very upset that the drops burn his eyes. After careful questioning, Mr. Jones admits that he was not willing to pay for prescription eye drops and decided to use the over-the-counter nasal drops because “they are the same drug.”

a. What patient teaching is essential in the situation?

b. Explain the differences in how phenylephrine is used to treat glaucoma and shock.

3. A child has been prescribed the adrenergic agonist Albuterol to be taken at home.

a. What teaching is essential to provide to the parents who may seek over-the-counter allergy and cold preparations for their child?