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Pharmacology > Adrenergic Blockers > Flashcards

Adrenergic Blockers Flashcards

1
Q

When are beta blockers used?

A 
Angina
Hypertension
Cardaic arrhythmias
Pheochromocytoma
Prevent migraine
Prevent heart attacks
Glaucoma
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2
Q

When are alpha blockers used?

A

Hypertension

Prostatic hypertrophy

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3
Q

Propranolol

A

Mainly blocks B1 in heart
Also blocks renin release
–JG cells have B1
Large individual variation in effect

Non-selective, also blocks B2

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4
Q

Timolol

A

Non-selective (blocks B1 and B2)

DOES NOT BLOCK Na channels (like propranolol does) -

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5
Q

Pindolol

A

Partial agonist
Less decrease in HR and BP

Useful in angina and HTN

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6
Q

Atenolol, metoprolol

–generally, use

A

Selective for B1

Less effect on lungs (can be used better in people with lung problems)

Metoprolol
–especially good asthma and in preventing CV problems e.g. in HTN

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7
Q

Atenolol vs Metoprolol - excretion/metabolism

A

Metroprolol is excreted via the urine
–good option for those with liver problems

Atenolol is metabolized by the liver (2C9)
–good option for those with kidney problems

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8
Q

Which are the most popular of all cardiovascular drugs?

A

Beta blockers

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9
Q

Why are beta blockers useful for angina?

A

They decrease HR and force, thus decreasing work

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10
Q

Why are beta blockers useful for HTN?

A

They initially decrease BP due to decrease in CO

No postural hypotension

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11
Q

Why are beta blockers useful for migraines?

A

Useful for prophylaxis

B-blockers decrease pulse pressure (which will decrease CO) – this seems to relieve some of the throbbing pain

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12
Q

Why are beta blockers useful for “hyper dynamic circulatory state”?

A

In emotional situations, there is excessive increase in HR

Can use prior to dental procedures, performances, etc. to prevent this excessive increase in HR

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13
Q

Why are beta blockers useful for glaucoma?

A

Inhibit formation of aqueous humor

can use either B1 or B2 blockers for the eye, but mostly B2 in eye

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14
Q

What are the drugs of choice for glaucoma?

A

Prostaglandin analogs

They increase the outflow through accessory uveoscleral pathway

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15
Q

What are disease states in which you should take precautions for using Beta blockers?

A 
Asthma
CNS "depression"
Poor circulation
Diabetes
Rebound tachycardia
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16
Q

Beta blockers and CNS depression

A

Beta blockers may cause CNS depression, especially in those with high lipid solubility (e.g. pindolol and propranolol)

Don’t use in patients with a history of depression

17
Q

Beta blockers ad circulation

A

Decreased CO leads to tiredness, numbness, tingling, muscle ache

Don’t use in pregnancy

Decreased exercise tolerance

18
Q

Beta blockers and diabetes

A

Block B2 to inhibit mobilization of liver glycogen

Increases the effect of insulin

19
Q

Beta blockers and Rebound tachycardia

A

On cessation of beta blocker therapy, rebound tachycardia can occur
–to avoid this, taper over a period of weeks

20
Q

Alpha blockers MOA

A

competitive alpha-1 block

some also block alpha 2

21
Q

How are alpha blockers useful in prostatic hypertrophy?

Example of drug used?

A

Used to improve urine flow

Tamulosin (flomax)

  • specific for alpha 1A receptors
  • less effect on blood vessels (1B)
22
Q

How are alpha blockers useful in hypertension?

Examples

A

Dilate arteries and veins

Prasosin - t1/2 = 3 hrs
Terazosin - t1/2 = 12 hrs

23
Q

Phentolamine

A
  • -can cause tachycardia

- -used to block necrosis by injected sympathomimetics

24
Q

Precautions and side effects of alpha 1 blockers

A

Postural hypotension
Nasal stuffiness
Impaired sex function - failure of ejaculation
Urinary incontinence

25
Q

What were the first known adrenergic blockers?

A

Ergot alkaloids

Found on rye and other grains

  • -cause gangrene dur to toxic effect on blood vessels – this would happen when ate bread, etc. that was contaminated
  • -also cause angina, hallucinations, abortions
26
Q

Ergot alkaloids

A

alpha block is not part of clinical action, not even side effects

Have partion agonist activty on apha1 and 5HT1D receptors

Main effect = prolonged contraction of smooth muscle

  • –act mostly on capacitance blood vessels
  • –uterine smooth muscle also contracted
27
Q

When is ergot used?

A

In migraines - to relieve painful throbbing

In post partum bleeding

28
Q

Tx of migraines
-ergot - when? how?

What else can be used? with what types of migraines?

A

Ergot should be taken at start of headache
–even more effective when taken with caffeine

Mild migraine - aspirin
Moderate migraine - ergot
Severe migraine - beta blocker

29
Q

Explain with ergot alkaloids are useful with post partum bleeding

A

Must bleeding occurs after the placenta tears away from the uterine wall

Ergot alkaloids contract uterus and stop bleeding

Pharmacology (45 decks)

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