Adrenergic Blockers Flashcards
Adrenergic β- Blockers have what result on ⍺ responses?
⍺ processes become dominant
reverse true for ⍺-Blockers?
Normal result of ⍺1 stim?
Excitatory: mydriasis (C radial mm) C bv to skeletal mm, skin C hold urine ejaculation
Normal result of ⍺2 stim?
Inhibitory:
↓ NE release
↓ insulin secretion
R GI
⍺1-Blockade causes?
(Decreased vasoconstriction) ↓ peripheral resistance -> ↓ BP ↓ venous return (ortho/standing hypoTN) Miosis Nasal congestion ↑ urine flow (tx BPH) ↓ ejaculation
⍺2-Blockade causes?
↑ NE release
↑ insulin release
Normal results of β1 stim?
Inhibitory:
↑ renin
↑ HR, cond, contr
Normal results of β2 stim?
Inhibitory: R bronchioles R bv in skeletal mm R coronary/cerebral arteries (↑ HR, cond, contr) R GI/U ↑ glycogenolysis/genesis
Normal results of β3 stim?
Inhibitory:
↑ lipolysis
β1-Blockade causes?
↓ renin
β2-Blockade causes?
Bronchoconstriction
↓ rate/force contraction = ↓ CO, ↓ O2 demand
↓ IO pressure
↓ glycogenolysis
β3-Blockade causes?
↓ lipolysis
Competitive ⍺ agonsists shift dose-response curve?
Right (need more NE to cause effect)
Max effect is same
Competitive ⍺ agonsists duration dependent on? (2)
dissociation from receptor
1/2 life
Irreversible ⍺ agonsists shift does-response curve?
Right
Max response diminished
Irreversible ⍺ agonsists duration dependent on?
exceed 1/2 life (stays bound)
Reflex tachycardia results from ⍺-Blockade why? (2)
1) ↓ BP -> stim baro -> stim sypathetics (↓ vagal input)
2) ⍺2 block -> ↑ NE release -> ↑ β heart stim
Ortho HTN results from ⍺-Blockade why?
⍺1 block = ↓ vasoconstriction of veins
↓ contraction -> ↓ filling pressure -> ↓ BP
EpiNE reversal of ⍺-Blockade?
blocked ⍺ exposes β:
Epi dilates bv to skeletal mm ->
↓ BP -> reflex ↑ HR
Phentolamine (Regitine) affects what receptors?
⍺1 and ⍺2
Phentolamine effects on ⍺1?
(⍺-block)
↓ peripheral resistance -> ↓ BP
Phentolamine effects on ⍺2?
(⍺-block)
↑ NE = ↑ baro -> cardiac stim (β)
Phentolamine side-effects?
HypoTN
Tachycardia
Arryth
myocard ischemia
Phentolamine used to tx?
HTN from pheonchromocytoma or MAO inhibitors
necrosis post ⍺-agonist infusion
Phentolamine contraindicated for?
CAD peptic ulcers (stims histamine = acid prdxn)
Phenoxybenzamine affects what receptors?
IRREVERSIBLE ⍺-block
Phenoxybenzamine effects on ⍺ receptors?
(lasts several days)
↓ BP -> reflex tachycardia
⍺1 block = ↓ vasoconstriction -> ortho hypoTN
⍺2 block = inhibit NE reuptake
Phenoxybenzamine side-effects?
tachycardia
ortho hypoTN
nasal congestion
↓ ejaculation
Phenoxybenzamine used to tx?
pheochromocytoma (high symp tone),
irreversible binding prevents HTN
Phenoxybenzamine contraindicated?
hypovolemic,
alcohol use,
vasodilators
= severe hyopTN
Pheochromocytoma is?
adrenal neoplasm:
releases NE/Epi
Pheochromocytoma signs/sxs?
tx?
sudden-onset severe HTN, tachycardia, arrhy
Phenoxybenzamine
surgery
Prazosin affects what receptors?
⍺1 antagonist
Prazosin effects on ⍺1?
relax artery/vein smooth mm ->
↓ peripherial resistance,
↓ venous return/preload
no effect on ⍺2 means:
No ↑ CO
No tachycardia reflex
No NE increase