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Anesthesia Pharm II > Alpha and Beta Antagonists > Flashcards

Alpha and Beta Antagonists Flashcards

1
Q

Alpha Adrenergic Antagonists are?

A

Phentolamine
Prazosin
Yohimbine
Phenoxybenzamine

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2
Q

Phenoxybenzamine binds how?

A

Covalently to the alpha receptor causing an irreversible blockade

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3
Q

Phentolamine, Prazosin,Yohimbine binds how?

A

Reversibly and is a competitive antagonist

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4
Q

Phenoxybenzamine and Phentolamine, work on which sites

A

Presynaptic Alpha 2 and Post synaptic Alpha 1

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5
Q

Prazosin works on which sites

A

Alpha 1

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6
Q

Yohimbine works on which sites

A

Alpha 2

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7
Q

Phentolamine effects Alpha 1 and 2 effects

A

A1 ->Peripheral vasodilation and decrease BP

A2->Increase in HR (Baroreceptor response) and CO

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8
Q

Phentolamine onset and duration

A

Onset 2 min

Duration 10-15 minutes

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9
Q

Phentolamine Alpha 1 and 2 effects

A

Alpha 1 -

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10
Q

Phentolamine use

A

Acute HTN emergencies with intra-op manipulation of Phenochromocytoma

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11
Q

Phentolamine Dose

A

30-70 mcg/kg continuous infusion

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12
Q

Phenoxybenzamine is a ?

A

Haloalkylamine derivative

Nonselective Alpha Blocker

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13
Q

Phenoxybenzamine onset

A

Slow 60 minute to peak effect

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14
Q

Phenoxybenzamine side effects

A

Orthostatic Hypotension

Impaired vasoconstriction with Large BP drop with blood loss or vasodilating drugs (Volitiles)

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15
Q

Phenoxybenzamine Clinical uses

A

BP control in Phenochromocytoma Pts

Excessive vasoconstriction in hemorrhagic shock

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16
Q

Yohimbine is a

A

Alpha 2 antagonist causing increased Norepi release

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17
Q

Yohimbine used to treat ?

A

Idiopathic Hypotension

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18
Q

Prazosin is a?

A

Alpha 1 antagonist

19
Q

Prazosin dilates veins, arterioles or both

20
Q

The Gold standard of Beta blockers is ?

A

Propranolol

21
Q

Chronic administration of Beta blockersis associated with ?

A

Up regulation of Beta receptors

22
Q

Which Beta Blockers are Selective Beta 1 antagonists in normal doses?

A

Metoprolol, Atenolol, Esmolol

23
Q

Bradycardia and myocardia depression are produce by Beta Blockers due to?

A

Blocking of the SNS to the heart

24
Q

Beta 1 blockade causes?

A

Decrease HR and CO

25
Q

Beta 2 blockade causes?

A

Increase Perif resistance including coronary resistance

26
Q

Chronic Propranolol use can cause what with fentanyl?

A

Decrease pulmonary first pass uptake

27
Q

Metoprolol A Beta 1 antagonist prevents

A

Increase in Inotropy and Chronotropy to Beta stimulation

28
Q

Esmolol

A

Beta 1 selective

Given IV only

29
Q

Esmolol Onset and Duration

A

Onset 5 min

Duration 10-30

30
Q

Esmolol elimination

A

Plasma esterases

31
Q

Esmolol Dose

A

0.2-0.5 mg/kg IV

32
Q

Beta Blocker can

A

Cross the BBB and Placenta

Alters airway resistance

33
Q

Beta Blocker contraindication

A

Existing AV block or Heart Failure.
Not Recommended for COPD Pts
May mask Hypoglycemia

34
Q

Cardiovascular effects of Beta Blockers reflect SNS innervation removal to the heart. AKA

A

Beta 1 Blockade

35
Q

NON selective Beta Blockers result in Beta 2 Blockade causing unopposed ?

A

Alpha 1receptor peripheral vasoconstriction

36
Q

Beta Blocker OD treatement

A

Atropine 7 mcg/kg
Dobutamine if a pure BB Present
Glucogon 1-10 mg IV (DRUG OF CHOICE)

37
Q

Beta 2 Blockers increase airway resistance T/F?

38
Q

Clinical Uses Of Beta Blockers?

A 
Treatment of HTN
Angina
Post MI
Pre-op prep for Hyperthyroid
Prevention of excessive SNS activity
Suppression of cardiac dysrhythmias
39
Q

Labetalol is a ?

A

Alpha1 and Beta 1,2 Antagonist ( Blocker)

40
Q

Labetalol Dose

A

0.25 mg/kg

41
Q

Labetolol lowers BP by decreasing SVR Alpha 1 Blockade and prevents reflex tachycardia by ________?

A

Beta 1 blockade

42
Q

Labetalol does not change?

43
Q

Labetalol side effects

A

Orthostatic Hypotension
Bronchospasms
CHF, Bradycardia, heart block

Anesthesia Pharm II (19 decks)

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