Adrenergic Antagonists

Question 1

What are the types of adrenergic antagonists?

Answer 1

• Non-Selective (β1 and β2)
• Cardioselective (β1)
• Partial Agonist (β1 and β2)

Question 2

What are the non-selective β blockers?

Answer 2

Propranolol, nadolol, timolol

Question 3

What are the effects of propranolol, nadolol and timolol?

Answer 3

Decreased HR
Decreased contractility
Decreased renin release
Reduced sympathetic activation Inhibition of aqueous humor production

Question 4

Propranolol, nadolol, timolol indication

Answer 4

Hypertension
Angina
Glaucoma
Heart failure
Arrhythmia

Question 5

Propranolol, nadolol, timolol Toxicity

Answer 5

Bronchospasm
Mask symptoms of hypoglycemia
Bradycardia

Question 6

Propranolol, nadolol, timolol Contraindications

Answer 6

Bronchospasm during asthma
Sinus bradycardia
2nd and 3rd degree heart block
Cardiogenic Shock

Question 7

What are cardioselective β1-blockers?

Answer 7

Metoprolol, atenolol, esmolol

Question 8

What are the effects of metoprolol, atenolol, esmolol?

Answer 8

Decrease HR
Decrease contractility
Decrease renin release
Decreased sympathetic activation

LIMITED effect on respiratory system

Question 9

Metoprolol, atenolol, esmolol indication

Answer 9

Hypertension (metoprolol, atenolol),
Angina (metoprolol, atenolol)
Arrhythmia

Question 10

Metoprolol, atenolol, esmolol Toxicity

Answer 10

Depression
Insomnia
Hypotension
Bradycardia

Question 11

Metoprolol, atenolol, esmolol Contraindication

Answer 11

Sinus bradycardia
2nd and 3rd degree heart block
Cardiogenic Shock

Question 12

What is the half life of esmolol like?

Answer 12

Esmolol has very short half-life ~9 mins

Question 13

What is a partial agonist of β1 and β2?

Answer 13

Pindolol

Question 14

What is the effect of pindolol?

Answer 14

Decrease BP
Decrease contractility
Decrease renin release
Decreased sympathetic activation

Question 15

Pindolol indication

Answer 15

Hypertension in those who are less tolerant of bradycardia and reduced exercise capacity caused by other beta blockers without partial agonist activity

Question 16

Pindolol Toxicity

Answer 16

Same as for non-selected beta blockers

Bronchospasm
Mask symptoms of hypoglycemia
Bradycardia

Question 17

Pindolol Contraindications

Answer 17

Bronchospasm during asthma
Sinus bradycardia
2nd and 3rd degree heart block
Cardiogenic Shock

Question 18

What non-selective α-receptor antagonists?

Answer 18

Phenoxybenazmine (irreversible)

Phentolamine (reversible)

Question 19

What are the effects of phenoxybenzamine an phentolamine?

Answer 19

Decreased BP by inhibiting vasoconstriction

Increased chronotropy and inotropy due to blockade of pre-synaptic α2-receptor

Question 20

Phenoxybenzamine indication

Answer 20

Hypertension associated with perioperative treatment of pheochromocytoma, test for pheochromocytoma

Question 21

Phentolamine indication

Answer 21

Dermal necrosis and sloughing with vasoconstrictor extravasation

Question 22

Phenoxybenzamine an phentolamine Toxicity

Answer 22

Prolonged hypotension
Reflex tachycardia
Nasal Congestion

Question 23

Phenoxybenzamine an phentolamine Contraindications

Answer 23

Coronary Artery Disease

Question 24

What are the selective α1-receptor blockers?

Answer 24

Prazosin, doxazosin, and terazosin

Question 25

What are the effects of prazosin, doxazosin, and terazosin?

Answer 25

Inhibit vasoconstriction, resulting in vasodilation and decreased BP
Prostate muscle relaxation

Question 26

What is unique about the effect of prazosin, doxasin and terazosin on the heart?

Answer 26

They give less cardiac stimulation than non-selective α-blockers due to preservation of α2- adrenergic function

Question 27

Prazosin, doxazosin, and terazosin indication

Answer 27

Hypertension

Benign prostatic hyperplasia (BPH)

Question 28

Prazosin, doxazosin, and terazosin Toxicity

Answer 28

Syncopy

Orthostatic hypotension