Adrenergic Antagonists Lecture PDF

Question 1

Pheochromocytoma

Answer 1

Catecholamine secreting tumor derived from cells of SANS, tumors usually in the adrenal medulla, can produce hypertension and a high heart rate from its secretions,often treated by removal of tumor but require use of a adrenergic antagonists to prevent hypertension chronically or pre-op

Question 2

a1 adrenergic antagonists therapeutic uses (5)

Answer 2

• essential hypertension
• pheochromocytoma
• raynauds
• bph
• reversal of toxicity brought on by a1 agonists

Question 3

a1 adrenergic antagonists ADR’s (5)

Answer 3

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• inhibition of ejaculation or impotence
• Na+ retention and increased blood volume (increase renin)

Question 4

2 groups of a adrenergic antagonists

Answer 4

• nonselective (block a1 and a2)

- selective a1 blockade

Question 5

Prazosin (minipress) drug class and therapeutic uses (2)

Answer 5

• selective a1 blockade adrenergic antagonist

- produces vasodilation treating hypertension and BPH

Question 6

Prazosin (minipress) ADR 1st dose effect

Answer 6

Refers to tendency for about 1% of patients to lose consciousness 30-60 min after receiving first dosage, to minimize effect initial dose must be small then gradually increased, or for administration of initial dose at bedtime

Question 7

Tamsulosin (flomax)

Answer 7

selectively blocks a1 blockers on smooth muscle of bladder neck and prostatic capsule, only indicated for BPH and NOT effective at treating Htn

Question 8

phentolamine (regitine) blocks ___ and ___ receptors and is often used in the IV treatment of ______

Answer 8

a1 and a2, pheochromocytoma

Question 9

B adrenergic antagonists therapeutic uses (4)

Answer 9

(result primarily from blockading B1 receptors in heart)

• hypertension
• angina pectoris
• cardiac arrhythmias
• heart failure (cardioprotective by improving cardiac contractility)

Question 10

B1 blockade ADRs (4)

Answer 10

• bradycardia
• reduced cardiac output
• AV heart block
• rebound cardiac excitation

Question 11

Rebound cardiac excitation

Answer 11

Refers to how long term use of B1 blockades can sensitize the heart to catecholamines, and abrupt cessation of it can result in anginal pain and ventricular arrhythmias (medication must be tapered off)

Question 12

B2 blockade ADRs (3)

Answer 12

• bronchoconstriction
• inhibit glycogenolysis (hypoglycemia)
• CNS effects

Question 13

3rd generation B adrenergic antagonist agents and 2 examples

Answer 13

• Agents that block a adrenergic receptors in addition to B receptors
• carvedilol, labetolol

Question 14

High lipid solubility allows for…

Answer 14

…penetration of BBB easily

Question 15

Propranol (inderal LA) drug class and therapuetic uses (4) and administration

Answer 15

-nonselective B adrenergic antagonist (B1 and B2)

• HTN
• Angina pectoris
• Cardiac arrhythmias
• stage fright

Available PO or IV

Question 16

Propranol (Inderal LA) ADR’s (4)

Answer 16

• Bradycardia
• Bronchoconstriction
• those with severe allergies (bronchospasm) might need epi
• suppression of glycogenolysis, not an issue in healthy patients but diabetics who are alerted to hypoglycemia by tachycardia will not be made aware

Question 17

To avoid Na+ retention and increased blood volume when a patient is on an a adrenergic antagonist, they are often also treeated with…

Answer 17

…a diuretic

Question 18

Propranolol (inderal) usage for stage fright

Answer 18

Because drug is lipid soluble it readily crosses the BBB and thus a single dose is used to help relax patient