adrenergic-blocking agents

Question 1

adrenergic blockers

Answer 1

bind to adrenergic receptors, but inhibit or block stimulation of the sympathetic nervous system (SNS)
alpha blockers- beta blockers
- have opposite effect of adrenergic agents

Question 2

adrenergic blockers are also known as:

Answer 2

adrenergic antagonists and sympatholytics

Question 3

sympatholetics inhibit (or lyse)

Answer 3

sympathetic neurotransmitters, such as norepinephrine and epinephrine

Question 4

how are adrenergic blockers classified?

Answer 4

by what type of adrenergic receptor they block

Question 5

drug effects and indications of alpha blockers

Answer 5

cause both arterial and venous dilation, reducing peripheral vascular resistance and BP
used to treat hypertension
effect on receptors on prostate gland and bladder decreased resistance to urinary outflow, thus reducing urinary obstruction and relieving the effects of BPH (enlarged prostate gland)

Question 6

what are three agents used for the treatment of hypertension and BPH?

Answer 6

Prazosin (minipress) 1mg-20mg po oer day in 2-4 divided doses (HTN ONLY)

Doxazosin (cardura) 1-16mg po per day (HTN &BPH)

Terazosin (hytrin) 1-20mg po per day (HTN & BPH)

Question 7

what are three agents used for the treatment of BPH?

Answer 7

tamsulosin (Flomax) 0.4-0.8 mg po daily

alfuzosin (Uroxatral) 10mg/day

silodosin (rapaflo) 8 mg po day (4mg po daily for renal dysfunction

Question 8

what agent is used for pheochromocytoma?

Answer 8

phentolamine

used to control and prevent hypertension in patients with pheochromocytoma

Question 9

what is pheochromocytoma?

Answer 9

a tumor on the adrenal gland, causes increased outflow of catecholamines

Question 10

what is the dose for phentolamine?

Answer 10

5mg IV given 1-2 hours before surgery; repeat 5mh doses as needed every 2-4 hours.

Question 11

extravasation of vasopressors: phentolamine

Answer 11

quickly reverses the potent vasoconstrictive effects of the estravasated vasopressors such as norepinephrine and epinephrine, it restores blood flow and prevents tissue necrosis.

Question 12

dose of extravasation of vasopressors: phentolamine:

Answer 12

infiltrate the area with a small amount of solution made by diluting 5-10mg in 10mL 0.9% sodium chloride within 12 hours of extravasation
do not exceed 0.1-0.2mg/kg

Question 13

alpha blockers side effects on the cardiovascular system

Answer 13

palpitations
orthostatic hypotension
tachycardia
edema
dysrhymias
chest pain

Question 14

alpha blockers side effects on the CNS

Answer 14

dizziness
headache
drowsiness
anxiety
depression
vertigo
weakness
numbness
fatigue

Question 15

alpha blockers side effects on the Gastrointestinal system

Answer 15

nausea
vomiting
diarrhea
constipation
abdominal pain

Question 16

alpha blocker side effects pertaining to other parts of the body

Answer 16

incontinence
nosebleed
tinnitus
dry mouth
pharyngitis
rhinitis
impotence

Question 17

beta blockers

Answer 17

block stimulation of beta receptors in the SNS
compete with norepinephrine and epinephrine
selective and nonselective OR nonspecific or cardioselective respectively

Question 18

beta 1 receptors

Answer 18

located primarily on the heart

beta blockers selective for these receptors are called cardioselective beta blockers

Question 19

beta 2 receptors

Answer 19

located primarily on smooth muscles of bronchioles and blood vessels

Question 20

non specific beta blockers

Answer 20

beta blockers that block both beta 1 and beta 2 receptors

Question 21

cardioselective (beta 1) MOA

Answer 21

reduces SNS stimulation of the heart (HTN,MI, HF)
decreases heart rate
prolongs SA node recovery
slows conduction rate through the AV node (atrial fibrillation, fast heart rate)
decreases myocardial contractility, thus decreasing myocardial oxygen demand (chest pain, HF, MI)

Question 22

nonspecific (beta 1 and beta 2) effects on the heart MOA

Answer 22

reduces SNS stimulation of the heart (HTN,MI, HF)
decreases heart rate
prolongs SA node recovery
slows conduction rate through the AV node (atrial fibrillation, fast heart rate)
decreases myocardial contractility, thus decreasing myocardial oxygen demand (chest pain, HF, MI)

Question 23

nonspecific (beta 1 and beta 2) MOA bronchioles

Answer 23

constriction, resulting in narrowing of airways and shortness of breath

Question 24

nonspecific (beta 1 and beta 2) MOA blood vessels

Answer 24

vasoconstriction