Antiadrenergic Drugs Flashcards
effect of alpha antagonists on genitourinary system
- relaxation of smooth muscle in prostate
- decreased resistance to flow of urine
what cardiac arrhythmias can be treated with beta blockers
- a flutter and a fib
- ventricular ectopic beats
effects of beta blockers on eye
reduce production of aqueous humor –> reduces intraocular pressure
adverse effects of alpha antagonists
- postural hypotension
- tachycardia
- retention of fluid and salt
- impaired ejaculation
- nasal stuffiness
if pt is having hypoglycemic episodes, instead of a beta blocker what should you switch to
beta1-selective
effect of alpha antagonists on cardiovascular system
- decreased peripheral vascular resistance
- decreased BP
- postural hypotension
- reflex tachycardia
adverse effects of beta blockers on the CNS system
- what drug should you switch to?
- sedation
- sleep disturbances
- depression
–> switch to more hydrophilic drug
effect of alpha antagonists on eye
- relaxation of pupillary dilator muscle - miosis (constricted pupils)
are beta blockers indicated in acute congestive heart failure
no
effects of beta blockers on respiratory system
increase airway resistance
what beta blockers are used to treat chronic heart failure
- metoprolol
- carvedilol
effects of beta blockers on blood vessels
- initial rise in PVR
- chronic use –> decrease in PVR (lowers BP in hypertensive pts)
what alpha antagonist would you use to treat BPH
tamsulosin
(greater selectivity for alpha1A than alpha1B)
- alpha1A is the most important alpha receptor subtype mediating prostate smooth muscle contraction
what alpha antagonists would you use to treat chronic (essential) hypertension
prazosin doxazosin (both alpha1 selective)
effects of beta blockers on cardiovascular system
- negative inotropic effect
- negative chronotropic effect
- slow AV node conduction
benefits of using beta blockers with ISA
- less risk for bradycardia
- increase in VLDL/HDL
describe beta blockers with intrinsic sympathomimetic activity (ISA)
partial agonists at beta adrenergic receptors that block sympathetic effects BUT have submaximal effects of their own = a bunted sympathetic response
effects of beta blockers on metabolism
- inhibit lipolysis
- increase VLDL and decrease HDL, reducing the HDL cholesterol/LDL cholesterol ratio
- inhibits glycogenolysis and gluconeogensis in liver
what beta blockers are used in long term use post MI
- propranolol
- metoprolol
adverse effects of beta blockers on the CV system
- depression of HR, cardiac contractility, and excitability
- exacerbation of peripheral vascular dz
what alpha antagonists would you use to treat erectile dysfunction
combination of phentolamine and a nonspecific vasodilator papaverine (injected into penis)
what beta blockers is used to treat hyperthyroidism
propranolol
adverse effects of beta blockers on the respiratory system
- what drug should you switch to?
- increase airway resistance
- trigger bronchospasm and asthma attack
–> switch to beta-1 selective
what type of inhibitor is metyrosine
a synthesis inhibitor (inhibits synthesis of tyrosine hydroxylase)
- indirect
what beta blocker is used to treat glaucoma
betaxolol
are beta blockers safer for type I or type II DM patients
type 2, since they do not usually have hypoglycemic episodes
adverse effects of abrupt discontinuation of beta blockers
- enhanced cardiac stimulation and arrhythmias
- increased risk in pts with ischemic heart dz
compare phentolamine and phenoxybenzamine in terms of binding to receptor and its effects
phentolamine: covalent, short acting
phenoxybenzamine: non-covalent, long acting
adverse effects of beta blockers on lipid profile
- what drug should you switch to?
- chronic use increases VLDL and decreases HLD
–> switch to partial agonist drug
what is the adverse effect of using prazosin and doxazosin to treat BPH
drop in BP
which alpha receptor is the most important subtype mediating prostate smooth muscle contraction
alpha1A
what type of antagonist is phenoxybenzamine
non-competitive irreversible alpha antagonist
effects of beta blockers on renin-angiotensin system
inhibits renin release
what alpha antagonists would you use to treat pheochromocytoma
phentolamine
phenoxybenzamine
what part of the synapse does guanethidine work at
pre-synaptic neuron
what type of antagonist is phentolamine
reversible competitive alpha antagonist
how do beta blockers help treat angina pectoris
- decrease cardiac work and reduce O2 consumption
- reduce frequency of anginal episodes and improve exercise tolerance
