Adrenergic Blockers Flashcards
This type of glaucoma is chronic…
open angle
this glaucoma results in a shallow anterior chamber resulting in blocked aq humor flow
closed angle
What is the focus of glaucoma tx?
reduce production of aq humor
increase humor removal
What is class DOC for glaucoma and what is the moa?
Prostaglandin analogues
increases aq humor outflow
This drug class is the second choice for glaucoma. they work by reducing production of aq humor. What class, and what 2 drugs?
Beta Blockers
Timolol, Betaxolol
The third line drugs for glaucoma work by decreasing humor production and increasing removal…
alpha 2 agonists
The last line of drugs used for glaucoma tx due to bad vision side effects… what specific drug?
cholinergic agonists
pilocarpine
this type of alpha blocker has the following characteristics…
Maximum effect maintained
ED50 (required dose) increased resulting in right shift
Reversible Alpha Blockers
This type of alpha blocker has the following characteristics:
ED50 increased, resulting in right shift of curve
Maximum response is diminished
Irreversible Alpha Blockers
___________ Receptor Blockers have the following effects:
Vasodilation
Reflex Tachycardia
Orthostatic Hypotension
Epi reversal
Miosis
Nasal Congestion
Decreased resistance to urine flow
Inhibition of ejaculation
Alpha receptor blockers
What drug class has the following effect:
decreased peripheral vascular resistance, especially when standing
Alpha Blockers
What drug class has the following effect:
Reflex tachycardia due to decreased BP and baroreflex induced receptor stimulation and NE release
Alpha blockers
What drug class has the following effect:
blocked receptor results in blocking of compensatory vasoconstriction
alpha blockers
What drug class has the following effect:
dilation of blood vessels in skeletal muscle resulting in decreased BP, increased HR
reverses Fx of epi
alpha blockers
What drug class has the following effect:
relaxes radial muscles of eye
alpha blockers
What drug class has the following effect:
causes vasodilation in nasal mucosa
alpha blockers
A patient presents with sudden onset severe HTN, Tachycardia, Arrhythmia.
What should you be suspicious of?
Pheochromocytoma
How do you dx pheochromocytoma?
measure 24hr urine NE and VMA
What drug class has the following effect:
Decreased HR, Contractility, Conduction, CO, and O2 demand in heart
Decreased BP with chronic use
Beta blockers
What drug class has the following effect:
decreased renin release
beta blockers
What drug class has the following effect:
bronchoconstriction
beta blockers
What drug class has the following effect:
decreased IOP
beta blockers
What drug class has the following effect:
inhibits glycogenolysis making hypoglycemia difficult to dx and recover from
beta blockers
What drug class has the following characteristic:
cannot be used in the eye as a local anesthetic
beta blockers
What drug class has the following effect:
decreases mortality after an MI
beta blockers
Phentolamine and Phenoxybenzamine are both what class?
non-specific alpha blockers
Which of the non-specific alpha blockers is irreversible, Phentolamine or Phenoxybenzamine?
Phenoxybenzamine
What type of bond does Phenoxybenzamine form with alpha receptors?
covalent
This non-specific alpha blocker has the following indications…
Tx of HTN and rarely in HTN crisis
Prevention of necrosis w/ accidental vasoconstrictor administration
Phentolamine
Patients with what condition should be prescribed phentolamine with caution?
CAD
This non-specific alpha blocker is DOC for:
pre-op patients with severe HTN from Pheo
Phenoxybenzamine
This non-specific alpha blocker has the following SFx:
orthostatic Hypotension
Tachycardia
Inhib. of ejaculation
phenoxybenzamine
This non-specific alpha blocker has the following SFx:
Hypotension
Tachycardia
Arrythmia
Myocardial ischemia
Phentolamine
Which alpha blocker is alpha-1 selective?
prazosin
This alpha blocker has the following indications:
Tx of HTN and BPH
Decrease LDL, TGs
Increase HDL
Prazosin
Use of this drug with viagra and nitrates can cause hypotension, so must be prescribed with caution…
prazosin
This alpha blocker has a bad 1st dose effect of orthostatic hypotension, so sould be administered at bedtime.
prazosin
What is the mechanism by which prazosin causes hypotension?
blocks alpha-1
decreases peripheral vascular resistance
This alpha blocker is selective for the Alpha-1A receptor…
tamulosin
Is tamulosin useful in treating HTN?
no
This alpha blocker has the following therapeutic effects:
Tx of BPH
Decrease LDL, TGs
Increase HDL
Tamulosin
This alpha blocker has the following adverse effects:
Ejaculation dysfunction
HA
Dizziness
Tamulosin
Which beta blockers are non-specific?
Propranolol
Timolol
Which drugs are combined alpha and beta blockers?
Carvedilol
Labetalol
Beta-1 Receptor blockers include:
Betaxolol
Esmolol
Metoprolol
Nebivolol
Which non-specific beta blocker is metabolized by CYP450 enzymes?
Propranolol
Which drugs are P450 inhibitors?
cimetidine
Which drugs are P450 inducers?
barbiturates
phenytoin
rifampin
This non-specific beta blocker should not be stopped abruptly…
propranolol
Which beta blocker has been shown to decrease mortality post-MI?
propranolol
This drug has the following contraindications:
Acute HF Asthma AV Block Bradycardia Cardiogenic Shock Pheo
propranolol
This drug has the following indications:
Tx of Arrythmia, Early HF, Angina, HTN
Tx of Hyperthyroidism
Migraine prevention
propranolol
Why should propranolol be prescribed with caution in patients with DM?
revival of hypoglycemia made difficult
This drug has the following adverse effects:
worsens COPD
Bronchoconstriction
Exacerbates late-stage HFrEF and bradycardia
Propranolol
This non-specific beta blocker is similar to propranolol, but is used in treatment of glaucoma…
timolol
Who should be prescribed timolol with caution?
asthma
Describe the routes of admin for timolol and the absorption…
PO and topical
some systemic absorption
This beta-1 receptor blocker is primarily effective on the heart tissue by reducing HR and contractility…
metoprolol
Because it is a beta-1 receptor blocker, metroprolol has what advantage over propranolol?
fewer SFx.
Better exercise tolerance, safer in DM and asthma
This beta 1 receptor blocker has the following indications…
HTN, Angina, HF, Post-MI
Migraine Prophylaxis
Metoprolol
This selective beta-1 receptor blocker is similar to metoprolol, but is used to treat glaucoma…
betaxolol
Patients with what condition should be prescribed betaxolol with caution?
asthma
This Beta 1/cardio receptor blocker has rapid action, a fast half-life and is administered IV…
Esmolol
This beta-1/cardio blocker is indicated for:
emergent treatment of arrhythmia
Critically ill patients who need to avoid long-lasting beta blocker SFx
esmolol
This beta 1 receptor blocker is the most selective for beta 1 and causes endothelial NO release
Nebivolol
Carvedilol is contraindicated in patients with what condition?
asthma
This combined alpha and beta receptor blocker has the following adverse effects:
orthostatic hypotension
bronchoconstriction
carvedilol
This alpha-beta receptor blocker has the following indications:
Tx of HTN and HF after MI
carvedilol
this alpha-beta receptor blocker is lipid neutral…
carvedilol
Carvedilol and labetalol both cause vasodilation without what adverse effect?
reflex tachycardia
This combined alpha and beta blocker has the following indications:
HTN during pregnancy
Tx of HTN emergency
Labetalol
This combined alpha and beta receptor blocker has the following contraindications…
orthostatic hypotension
bronchoconstriction
hepatotoxicity
labetalol