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Pharm > Adrenoceptor Antagonist > Flashcards

Adrenoceptor Antagonist Flashcards

Exam 4

1
Q

Adrenoceptor antagonist overview

A
  • reduce sympathetic stimulation
  • used to manage glaucoma, migraines, cardiovascular disease, and urinary obstruction
  • block alpha and beta receptors
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2
Q

Alpha adrenoceptor antagonist

A
  • alpha blocker

- selective and nonselective

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3
Q

Phenoxybenzamine

A
  • nonselective alpha blocker
  • only noncompetitive/irreversible alpha blocker
  • DOA is 3-4 days
  • noncompetitive for NE and epi
  • causes vasodilation and decreases BP
  • clinical use: HTN in pheochromocytoma (adrenal medulla tumor)
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4
Q

Phentolamine

A
  • nonselective alpha blocker
  • competitive/reversible alpha blocker
  • causes vasodilation, decreased BP
  • clinical use: HTN in pheochromocytoma and to treat necrosis and ischemia after injection of alpha agonist
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5
Q

Selective alpha 1 blockers drugs

A
  • Doxazosin (Cardura)
  • Prazosin (minipress)
  • Terazosin( Hytrin)
  • Alfuzosin (uroselective alpha 1 blocker - uroxatral)
  • Tamsulosin (uroselective alpha 1 blocker - flomax)
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6
Q

Selective alpha 1 blockers

A
  • relax vascular and other smooth muscles (urinary bladder, urethra, and prostate)
  • also cause vasodilation and decrease BP
  • don’t cause as much reflex tachycardia compared to nonselective blockers
  • ARD: hypotension (orthostatic), dizziness, sedation
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7
Q

Alpha antagonist effects on CVS

A
  • prevent arteries from constricting by blocking alpha 1 and 2
  • lower BP
  • clinical use: HTN
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8
Q

Alpha antagonist effects on GU

A
  • blockade of alpha 1: block smooth muscle contraction at base of bladder and prostate
  • increase urine flow
  • clinical use: BPH
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9
Q

Adverse reactions of alpha antagonist

A
  • postural hypotension: lightheadedness and syncope
  • reflex tachycardia
  • miosis (pupil constriction)
  • nasal stuffiness
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10
Q

Beta adrenoceptor antagonist

A
  • beta blocker
  • MOA: bind to receptor and block effect of endogenous catecholamine such as NE and epi
  • high doses lose their selectivity and they will start to hit other receptors
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11
Q

Nonselective beta blockers

A
  • Nadolol (Corgard)
  • Pindolol (Visken)
  • Propranolol (Inderal)
  • Timolol (Timoptic)
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12
Q

Selective beta 1 blockers

A
  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Esmolol (Breviblock)
  • Metoprolol (Lopressor, Toprol XL)
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13
Q

Alpha and beta blockers

A
  • Carvedilol (Coreg)

- Labetalol (Trandate)

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14
Q

Beta blocker effects on CVS

A
  • decrease BP (decrease cardiac output and renin secretion)
  • decrease HR
  • decrease contractility
  • decrease AV conduction
  • clinical use: angina, MI, SVT, HTN, HF
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15
Q

Beta Blocker effects on respiratory

A
  • beta 2 blockade increase airway resistance
  • no clinical use
  • avoid non-selective beta blockers in asthma
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16
Q

Beta blocker effects on eye

A
  • beta blockade decreases aqueous humor production and IOP

- Clinical use: glaucoma

17
Q

Beta blocker effects on hepatic

A

-decrease hepatic venous pressure gradient and portal hypertension

18
Q

Beta blocker effects on metabolic effects

A
  • beta blockade inhibits recovery from hypoglycemia (your sns kicks in when hypoglycemic)
  • No clinical use, but care on meds that cause hypoglycemia (diabetics)
19
Q

Local anesthetic effects of beta blockers

A
  • no related to receptor blockade
  • not an effect when taken orally, just topically
  • effect you want to avoid when using the beta blocker topically in eye for glaucoma
  • Timolol has no anesthetic effect - used in glaucoma
20
Q

Other clinical uses of beta blockers

A
  • prevention of migraine
  • muscles tremors
  • EtOH withdrawal
  • anxiety: especially performance associated (gets rid of symptoms of anxiety but not the anxiety itself)
21
Q

Beta blocker effects on CNS

A
  • depression
  • sedation
  • sleep disturbances
  • rarely psychotic reactions
22
Q

Beta blocker effects on peripheral vascular disease

A
  • beta 2 stimulation vasodilates blood vessels in leg

- blockers can block this and make peripheral vascular disease worse

23
Q

Beta blocker effects on heart failure

A
  • need beta 1 stimulation of hear to make pump harder
  • blockers can treat heart failure, but also can make it worse
  • keep pt off of blocker during acute phase, but can use during chronic therapy
  • improve % of blood pumped from left ventricle with each heartbeat
  • slow progression of heart failure
  • decrease risk of death caused by MI and failure

Pharm (7 decks)

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