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SGU Pharm deck -term4 > Adrenergic agonist and antagonist 2 > Flashcards

Adrenergic agonist and antagonist 2 Flashcards

1
Q

non selective a-ADRENERGIC BLOCKERS

A

Phenoxybenzamine

Phentolamine

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2
Q

PHENOXYBENZAMINE

A

Phenoxybenzamine is a haloalkylamine which alkylates and thus irreversibly blocks a1 adrenergic receptors. Closely related chemically to the nitrogen mustards. Slightly selective for a1 receptors. Also blocks H1, muscarinic and serotonin receptors and inhibits reuptake of norepinephrine by presynaptic adrenergic nerve terminals.

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3
Q

Phenoxybenzamine uses

A

Pheochromocytoma (normal or inoperable forms )

given preoperatively to help control hypertension and sweating

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4
Q

phenoxybenzamine cardiovascular effects

A

By blocking a receptors, phenoxybenzamine prevents vasoconstriction of peripheral blood vessels by endogenous catecholamines. Decreased peripheral resistance provokes reflex tachycardia. The ability to block presynaptic a2 receptors in the heart can contribute to increased cardiac output. The drug has been unsuccessful in maintaining low blood pressure in hypertension and is no longer used for this purpose

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5
Q

phenoxybenzamine administration protocol

A

Phenoxybenzamine can also be useful in the chronic treatment of inoperable or metastatic pheochromocytoma. A -blocker may be required after -receptor blockade has been instituted in order to control tachycardia. -blockers should not be given before establishing effective  blockade, since unopposed  blockade could cause blood pressure elevation due to increased vasoconstriction

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6
Q

Phenoxybenzamine AE

A

ADVERSE EFFECTS
• Postural hypotension, nasal stuffiness, nausea and vomiting. • It can inhibit ejaculation. • May induce tachycardia, mediated by the baroreceptor reflex, and is contraindicated in patients with decreased coronary perfusion.

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7
Q

phentolamine

A

Phentolamine blocks serotonin receptors, and is an agonist at muscarinic, H1 and H2 receptors.
Reversibly blocks a1 and a2 receptors

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8
Q

epinephrine reversal

A

All a-adrenergic blockers reverse the a-agonist effects of epinephrine

For example, the vasoconstrictive action of epinephrine is blocked, but vasodilation of other vascular beds caused by stimulation of b-receptors is not blocked. Therefore, the systemic blood pressure decreases in response to epinephrine given in the presence of phenoxybenzamine.

> he actions of norepinephrine are not reversed but diminished,

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9
Q

prazosin

A

A1 selective blocker
> decreases peripheral resistance
>suppresses CNS sympathetic outflow
> has small favorable effects on plasma lipids (Lowers LDL/TG and increases HDL)
> approved drug for hypertension (but not the DOC)

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10
Q

TERAZOSIN & DOXAZOSIN

A

Structural analogs of prazosin. These agents have a longer half-life than prazosin, allowing less frequent dosing. Approved for hypertension and BPH

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11
Q

Tamsulosin

A

α1A-receptor predominates in genitourinary smooth muscle. Tamsulosin is a selective antagonist at α1A-receptors. The selectivity of tamsulosin for α1A-receptors may decrease the incidence of orthostatic hypotension relative to that associated with prazosin and other nonsubtype selective α1-adrenoceptor antagonists. Approved for BPH. Little effect on blood pressure

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12
Q

propranolol

A

Prototype nonselective -blocker. Blocks 1 and 2.

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13
Q

propranolol uses

A

hypertension/glaucoma/migraine/hyperthyroidism/angina pectoris/atrial fibrillation /myocardial infarction/ performance anxienty / essential tremor /

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14
Q

Prophylaxis for migraine

A

B adrenergic blocker propranolon

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15
Q

decreases intraocular pressure -b antagnoist

A

timolol

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16
Q

nadolol

A

Long duration of action. • Indicated for the long-term management of patients with angina pectoris. • Indicated for the management of hypertension
(b antagnost non selective )

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17
Q

timolol

A

• Treatment of hypertension. • Prophylaxis of migraine headache. • Treatment of open-angle glaucoma.
(b non selective blocker )

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18
Q

do b blockers induce postural hypotension

A

no they dont (A blockers do)

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19
Q

long term management of angina pectoris

A

nadolol and atenolol /metoprolol

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20
Q

B1 blockers -selective

A

atenolol
metorpolol
esmolol

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21
Q

Atenolol

A

Useful in hypertensive patients with impaired pulmonary function. • Useful in diabetic hypertensive patients who are receiving insulin or oral hypoglycemic agents.
b1 blocker

22
Q

metoprolol

A

Useful in hypertensive patients with impaired pulmonary function. • Useful in diabetic hypertensive patients who are receiving insulin or oral hypoglycemic agents.

23
Q

atenolol and metorpolol uses

A

Management of hypertension. • Long-term management of patients with angina pectoris. • Management of patients with acute myocardial infarction to reduce cardiovascular mortality.

24
Q

esmolol

A

Ultra-short acting 1-selective adrenergic antagonist. Esmolol contains an ester bond; esterases in red blood cells rapidly metabolize esmolol to a metabolite with low affinity for  receptors. Consequently, esmolol has a half life of about 10 minutes. Therefore, during continuous infusions of esmolol, steady state concentrations are achieved quickly, and the therapeutic effects are terminated rapidly upon discontinuation of the infusion. Esmolol is given IV.

25
Q

b blocker drug for patients on insulin

A

atenolol and metoprolol

26
Q

can cause hepatic injury

27
Q

labetolol

A

A1/B1 blocker

28
Q

carvedilol

A

A1/b1 blocker

29
Q

pindolol

A

PArtial agonist

30
Q

Methyrosine

A

a-methyltyrosine (ihbitis tyrosine hydroxylase

31
Q

reserpine

A

NE storage inhibitor –irreversibly binds to VMAT

32
Q

Tetrabenzine

A

inhibitors of NE storage –reversibly binds to VMAT

33
Q

cromolyn

A

histamine antagonist

34
Q

nedocromil

A

histamine antagonist

35
Q

chloropheniramine

A

H1 RECEPTOR ANTAGONISTS 1st generation

36
Q

cyclizine

A

H1 RECEPTOR ANTAGONISTS 1st generation

37
Q

dimenhydrinate

A

H1 RECEPTOR ANTAGONISTS 1st generation

38
Q

diphenhydramine

A

H1 RECEPTOR ANTAGONISTS 1st generation

39
Q

hydroxyzine

A

H1 RECEPTOR ANTAGONISTS 1st generation

40
Q

meclizine

A

H1 RECEPTOR ANTAGONISTS 1st generation

41
Q

promethazine

A

H1 RECEPTOR ANTAGONISTS 1st generation

42
Q

fexofenadine

A

H1 RECEPTOR ANTAGONISTS 2nd generation

43
Q

loratadine

A

H1 RECEPTOR ANTAGONISTS 2ndt generation

44
Q

ceterizine

A

H1 RECEPTOR ANTAGONISTS 2ndt generation

45
Q

B drug that can be given to asthmatic or COPD patients

A

selective b1 recepotr blocker-atenolol/metoprolol

46
Q

b drug for atrial fibrillation

A

b antagnosit - esmolol - super fast acting

47
Q

Carvidilol

A

a/B antagnosit - for CHF and hypertension management

48
Q

Labetolol

A

a1/b1 receptor blocker for hypertention

49
Q

pindolol

A

patrial agonist b blocker / contains sympathomemetic activity / fro patients with diminshed cardiac reserves and propensity to bradycardia

50
Q

difference between prazosin and b blocker

A

prozin (a blocker ) decreases ldl and increases hdl

b blocker increase ldl and decrease hdl s

SGU Pharm deck -term4 (10 decks)

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