Alpha and Beta Blockers Flashcards
2 non-selective alpha blockers
- phenoxybenzamine
2. phentolamine
phenoxybenzamine use
pheochromocytoma–> irreversible blocks, so even the high levels of catecholamines cannot overcome the blockade
phentolamine use
is reversible; given to pts on MAO inhibitors who eat tyramine containing foods
4 A1 selective drugs
- Prazosin
- Terazosin
- Doxazosin
- Tamsulosin
- all have -osin suffix!!
AE of A1 blockers (5)
- 1st dose orthostatic hypotnesion
- dizziness
- HA
- reflex tachcardia
- Rebound HTN on withdrawal
A2 selective antagonist
Mirtazepine –> used for depression
*AE: sedation, increased serum cholesterol, increased appetite
5 B1 selective antagonists (“A BEAM”)
- Acebutolol (partial B agonist)
- Betaxolol
- Esmolol (short acting)
- Atenolol
- Metoprolol
4 nonselective B antagonists (b1 = b2) (“Please Try Not Being Picky”)
- Propanolol
- Timolol
- Nadolol
- Pindolol
nonselective A (vasodilatory) and B antagonists
- carvedilol
2. labetolol
2 partial B agonsists
- Acebutolol (B1 selective)
- Pindolol (B1 = B2)
*due to weak agonism, act as antagonists, b/c they block the more potent effects of NE and Epi on receptors
6 indications for beta blocker use
- Angina pectoris ( decrease HR and contractility, leading to reduced 02 demand)
- MI (decrease mortality)
- Supraventricular tachcardia ( decrease AV node cond.; class II anti-arrhythmic)
- HTN (decrease C.O. and renin release)
- CHF (slows progression of chronic failure)
- Glaucoma ( decreased secretion of aqueous humor)
- Hyperthyroidism
what vessel issue are beta blockers the DOC for?
aortic dissection
2 drugs used for supraventricular tachycardia
- metoprolol
2. esmolol
2 drugs used for glaucoma
- timolol
2. nadolol
what 3 CV adverse effects can beta blockers cause
- bradycardia
- AV block
- CHF
what 3 CNS AEs can beta blockers cause
- sedation
- seizures
- sleep alterations
What two pt populations should beta blockers be used with extreme caution in
- COPD/ asthmatics
2. diabetics
why are beta blockers potentially dangerous for diabetics (2)
- can cause hypoglycemia (decrease glycogenolysis and glugacon release)
2, prevent sympathetic symptoms that warn of hypoglycemia
why should beta blockers never be given if cocaine intoxication is suspected, even if they would decrease HR?
beta blockade would leave A1 free to be stimulated unopposed by B2–> extreme elevation in BP to dangerous levels
