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Pharm Test 3 > Anti-Adrenergics > Flashcards

Anti-Adrenergics Flashcards

1
Q

A1 B2 vascular distribution

A

A1 everywhere

B2 only coronary arteries + skeletal muscle

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2
Q

Selective a1 blocker

A

Prazosin

REVERSIBLE

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3
Q

Block A1 selectively?

A

Decrease BP

Reflex tach

NE only can act on the heart

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4
Q

Phenoxybenzamine

A

A1 selective somewhat, but also a2

IRREVERSIBLE = must synthesize new receptors to revers

Duration = 24 hr

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5
Q

Phentolamine

A

Block A1 + A2 (non-selective)

Block A1 = decrease BP

Block a2 = prevent feedback inhibtion by releasing NE, more NE released on B1, more tach

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6
Q

How do selective a blocker increase tach?

A

Turn off A1, BP down, Baroreceptor turns on NE release to B1 on heart to for tach

Presynapse a2 = mediates NE release on vessel AND heart (mediate tach)

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7
Q

A2 role on presynaptic membrane?

A

Sense NE in terminal, turn off NE release

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8
Q

How do non-selective give WORSE tach?

A

A2 pre-synaptic mediation turned off, too much vasodilation, too much tach

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9
Q

HTN?

A

Prazosin (selective A1)

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10
Q

Pheochormocytoma tumor?

A
  • Phenoxybenzamine (a1)
  • Phentolamine (a2 - some on vessels)
  • Propanolol (betas)

Tumor secretes catecholamine (NE/Epi) need to mitigate all this release by stablilizing all receptors

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11
Q

Benign Prostatic hypertrophy?

A

RELAX BLADDER SMOOTH MUSCLE

  • Phenoxybenzamine
  • Prazosin (/terazosin)
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12
Q

alpha block S.E.?

A
  • Postural HypoTN
  • Reflex tach (both, worse w/ non-selective)
  • nasal stuffiness (a receptors in nose)
  • inhibition of ejaculation
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13
Q

Epi reversal

A

NORMAL

  • 1st Betas = drop BP
  • 2nd Alphas = raise BP

W/ ALPHA BLOCKER FIRST
*BP stays low

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14
Q

Block b2 receptors?

A

Never!!! (Lungs)

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15
Q

Selectivity of beta blockers

A

Best can do is B1 block 100 over b2

Block 100% of B1, blocked 50% of b2

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16
Q

B2 block side effect

A

Bronchospasm

17
Q

Intrinsic sympathomimetic activity - partial b blocker

A

PARTIAL beta blocker - dampening intrinisic tone

  • Pindolol
  • Acebutolol
18
Q

Propanolol

A

Non-selective B1+b2

Oldest

19
Q

Non-selective B blocker S.E.

A
  • Cardiac - B1 block, lower HR, CO,Exercise difficult, DOWN BP
  • DOWN renin release (b1)
  • Decrease in sympathetic tone via CNS
  • UP VLDL/ DOWN HDL
  • hypoglycemia (less with b1 selective)
  • bronchospasm
20
Q

Glaucoma

A

Timolol

B1 make aqueous humor (blocking lowers pressure)

21
Q

Selective B1 blockers

A
  • Atenolol

* Esmolol (t1/2 8 mins) = for ER BP reduction

22
Q

Selective B1 S.E.

A
  • cardiac
  • less broncho
  • High doses= none are selective
23
Q

Labetalol

A

=alol = Mixed alpha beta blocker

  • B:a1 (4:1) = acute management of HTN crisis
  • chronic HTN
24
Q

Carvedilol

A

Mixed B:a1 (10:1)

  • CHF
  • Anti-htn
  • anti-oxidant
25
Q

B blocker uses

A
  • HTN
  • Cardiac arrythmias
  • angina
  • migraine prophylaxis
  • early MI , prophylactic after
  • Pheochormocytoma
  • HF (carvediol)
  • performance anxiety

*possible cancer progression reduction

26
Q

b blocker S.E.

A

(b1) = down CO, Heart block, bradycardia

(B2) bronchoconstriction

CNS lethargy

27
Q

Guanethidine

A

COMES IN BY NET transporter, Decrease NE release overall by trapping it presynaptically (MAO breaks down)

*anti-HTN (historically)

SE = Postural HypoTN

28
Q

Reserpine

A

Enters lipid solube, blocks VMAT (no NE recycle) = empty presynaptic

*Historically anti-HTN

29
Q

A2 in brain/ A2 ags as anti-adrenergics

A

Pre/post synaptic a2 BLOCK sympathetic outflow in brain

A2 everywhere presynaptic in perpiphery

30
Q

A2 ags for anti-adrenergic

A
  • Clonidine = works directly at a2

* a-methyl-dopa = must be metabolized to a-methyl-NE

31
Q

A-methyl-dopa uses

A

ALPHA 2 ANTI-ADRENERGIC

  • essential hypertension
  • Safe in pregnancy

S.E. = high autoimmune response, (+) Coomb’s, (autoantibodies against Rh antigen on erythrocytes)

32
Q

Clonidine

Use

A

ALPHA 2 AG ANTI-ADRENERGIC

  • essential HTN
  • Reduction of withdrawal in opioid (a2 involved)
  • Open-angle glaucoma (apraclonididne)
  • ADHD

S.E. = HTN crisis with withdrawal
Dry mouth, sedation

33
Q

A2 AG ANTi-adrenergic

S.E.

A
  • Dry mouth
  • HTN crisis on clonidine withdrawal
  • A-methyl-dopa = up immune => (+) Coomb’s. (Autoantibodies against Rh antigen on erythrocytes)
34
Q

Dexmedetomide

A

A2 AG ANTI-ADRENERGIC

  • sedation critically ill/injured patients in intensive care, now non-intubated as well
  • a2s = locus coeruleus (probably)

Pharm Test 3 (11 decks)

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