Adrenergic Antagonists

Question 0

T or F

A2 receptor blockade leads to tachycardia

Answer 0

True. It eliminates negative feedback which leads to more NE release.

Question 1

Name 2 non selective Alpha receptor antagonists.

Answer 1

Phentolamine and Phenoxybenzamine

Question 3

___ and ____ are almost exclusively for the mgmt of pheochromocytomas

Answer 3

Phentolamine and Phenoxybenzamine

Question 4

____ reversibly binds to alpha receptors, causes vasodilation, is a treatment for NE extravasation and is a reversal of LA injection

Answer 4

Phentolamine

Question 5

___ irreversibly binds to alpha receptors and an overdose of this drug is treated with NE

Answer 5

Phenoxybenzamine

Question 5

Non specific B antagonist.
Main indication = thyroid storm (thyrotoxicosis) and Pheos.
No longer commonly used
Side effects = bronchospasm, CHF and AV heart block.
Withdrawal syndrome = rebound HTN, tachycardia and angina

Answer 5

Propranolol (Inderal)

Question 7

___ is a non selective beta antagonist that has been associated with rebound HTN, tachycardia and angina when patients stop taking it due to the up-regulation of beta receptors

Answer 7

Propranolol (Inderal)

Question 7

What type of beta blocker should be used in pts w/ reactive airway disease?

Answer 7

B1 selective antagonist

Question 9

____ is an ultra short acting B1 selective antagonist.

Answer 9

Esmolol (BreviBloc)

Question 9

Mixed antagonist (A1 B1 and B2).
Decr PVR and renin, some decr in HR.
Common drug of choice for intraop HTN

Answer 9

Labetalol

Question 10

____ is the common drug of choice for intraop HTN because decreases PVR and renin, and causes some decrease in HR.

Answer 10

Labetalol

Question 11

The main indication for use of _____ is treatment of a thyroid storm (thyrotoxicosis) or pheochromocytomas.

Answer 11

Propranolol (Inderal)

Question 12

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Atenolol

Answer 12

B1 selective antagonist

Question 13

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Labetalol

Answer 13

Mixed antagonist (A1 B1 and B2)

Question 14

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Carvedilol.

Answer 14

B1 selective antagonist

Question 15

This non-selective beta blocker is no longer commonly used because of its following side effects: bronchospasm, CHF, bradycardia and AV heart block.

Answer 15

Propranolol (Inderal)

Question 16

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Metoprolol

Answer 16

B1 selective antagonist

Question 17

This adrenergic antagonist’s short duration of action is due to its rapid redistribution (2 min) and ester hydrolysis (9 min).

Answer 17

Esmolol (BreviBloc)

Question 18

T or F. Labetalol causes reflex tachycardia.

Answer 18

False. It is a mixed antagonist with alpha and beta receptor antagonism.

Question 19

___ is a good choice for preventing tachycardia and hypertension during intubation and emergence.

Answer 19

Esmolol

Question 20

What are 3 side effects associated with alpha-1 receptor blockade?

Answer 20

Side effects: hypotension, orthostatic hypotension, tachycardia

Question 21

Phenylephrine will have what effect on a patient who has taken Phenoxybenzamine?

Answer 21

No effect. Phenylephrine response is completely blocked

Question 22

NE will have what effect on a patient who has taken Phenoxybenzamine?

Answer 22

Norepinephrine response: tachycardia due to B1 activation

Question 23

NE will have what effect on a patient who has taken Phenoxybenzamine?

Answer 23

Epinephrine response: tachycardia and severe hypotension due to B2-mediated vasodilation

Question 24

How does an alpha-2 receptor blockade work and what does it cause?

Answer 24

A2-receptor blockade -> eliminates negative feedback -> more NE release -> tachycardia

Question 25

When treating a pheochromocytoma, which should you do first and which should you do second…alpha block vs beta block.

Answer 25

A-blockade before B-blockade