Alpha and Beta Blockers

Question 1

2 non-selective alpha blockers

Answer 1

1. phenoxybenzamine

2. phentolamine

Question 2

phenoxybenzamine use

Answer 2

pheochromocytoma–> irreversible blocks, so even the high levels of catecholamines cannot overcome the blockade

Question 3

phentolamine use

Answer 3

is reversible; given to pts on MAO inhibitors who eat tyramine containing foods

Question 4

4 A1 selective drugs

Answer 4

1. Prazosin
2. Terazosin
3. Doxazosin
4. Tamsulosin

• all have -osin suffix!!

Question 5

AE of A1 blockers (5)

Answer 5

1. 1st dose orthostatic hypotnesion
2. dizziness
3. HA
4. reflex tachcardia
5. Rebound HTN on withdrawal

Question 6

A2 selective antagonist

Answer 6

Mirtazepine –> used for depression

*AE: sedation, increased serum cholesterol, increased appetite

Question 7

5 B1 selective antagonists (“A BEAM”)

Answer 7

1. Acebutolol (partial B agonist)
2. Betaxolol
3. Esmolol (short acting)
4. Atenolol
5. Metoprolol

Question 8

4 nonselective B antagonists (b1 = b2) (“Please Try Not Being Picky”)

Answer 8

1. Propanolol
2. Timolol
3. Nadolol
4. Pindolol

Question 9

nonselective A (vasodilatory) and B antagonists

Answer 9

1. carvedilol

2. labetolol

Question 10

2 partial B agonsists

Answer 10

1. Acebutolol (B1 selective)
2. Pindolol (B1 = B2)

*due to weak agonism, act as antagonists, b/c they block the more potent effects of NE and Epi on receptors

Question 11

6 indications for beta blocker use

Answer 11

1. Angina pectoris ( decrease HR and contractility, leading to reduced 02 demand)
2. MI (decrease mortality)
3. Supraventricular tachcardia ( decrease AV node cond.; class II anti-arrhythmic)
4. HTN (decrease C.O. and renin release)
5. CHF (slows progression of chronic failure)
6. Glaucoma ( decreased secretion of aqueous humor)
7. Hyperthyroidism

Question 12

what vessel issue are beta blockers the DOC for?

Answer 12

aortic dissection

Question 13

2 drugs used for supraventricular tachycardia

Answer 13

1. metoprolol

2. esmolol

Question 14

2 drugs used for glaucoma

Answer 14

1. timolol

2. nadolol

Question 15

what 3 CV adverse effects can beta blockers cause

Answer 15

1. bradycardia
2. AV block
3. CHF

Question 16

what 3 CNS AEs can beta blockers cause

Answer 16

1. sedation
2. seizures
3. sleep alterations

Question 17

What two pt populations should beta blockers be used with extreme caution in

Answer 17

1. COPD/ asthmatics

2. diabetics

Question 18

why are beta blockers potentially dangerous for diabetics (2)

Answer 18

1. can cause hypoglycemia (decrease glycogenolysis and glugacon release)
   2, prevent sympathetic symptoms that warn of hypoglycemia

Question 19

why should beta blockers never be given if cocaine intoxication is suspected, even if they would decrease HR?

Answer 19

beta blockade would leave A1 free to be stimulated unopposed by B2–> extreme elevation in BP to dangerous levels