Antiadrenergic drugs Flashcards
What are the non-selective alpha receptor antagonists
phentolamine
phenoxybenzamine
What are the a1 receptor selective antagonists
all end in suffix -osin
prazosin
tamsulosin
doxazosin
cardiovascular effects of alpha antagonists
Decreased peripheral vascular resistance and blood pressure
postural hypotension
reflex tachycardia
Genitourinary system effects of alpha antagonists
relaxation of smooth muscle in prostate
decreased resistance to the flow of urine
Eye effects of alpha antagonists
relaxation of pupillary dilator muscle - miosis
What alpha antagonist is used to treat pheochromocytoma (catecholamine-producing adrenal medulla tumor
Phentolamine
phenoxybenzamine
metyrosine
What alpha antagonist is used to treat chronic (essential) hypertension
prazosin
doxazosin
nonselective alpha blockers are NOT used
What alpha antagonist is used to treat erectile dysfunction
Combo of phentolamine and a non specific vasodilator papverine (injected into peen)
What alpha antagonist is used in patients with benign prostate hyperplasia to treat chronic urinary obstruction
Tamsulosin
Adverse effects of alpha antagonists
seen less with a1 selctive antagonists postural hypotension nasal stuffiness tachycardia retention of fluid and salt impaired ejaculation
B1 and B2 (nonselesctive blockers
propranolol
pindolol
nadolol
B1 selective blockers
metoprolol
betaxolol
acebutolol
atenolol
Clinical use of beta blockers in hypertension
Antihypertensive effect is delayed
Both beta blockers and mixed a and B blockers are used
Clinical use of beta blockers in angina pectoris
blocking cardiac
clinical use of beta blockers in heart failure
metoprolol, carvedilol
Clinical use of beta blockers in glaucoma
Betaxolol - a blocker w/o local anesthetic activity
The mechanism involves the reduction in the production of aqueous humor by the ciliary body
Clinical use of beta blockers in hyperthyroidism
propranolol
CNS adverse effects of beta blockers
sedation
sleep disturbances
depression
switch to a more hydrophilic drug
Respiratory adverse effects of beta blockers
increase airway resistance
trigger bronchospasm and asthma attack in susceptible individuals
switch to a beta 1 selective
cardiovascular adverse effects off beta blockers
depression of heart rate, cardiac contractility and excitability
switch to a partial agonist
Adverse effects on the lipid profile
Chronic use - increase VLDL and decrease HDL
Seen with both selective and non-selection B blockers
switch to a partial agonist drug
Abrupt discontinuation of beta-blocker therapy
Abrupt discontinuation leads to enhanced cardiac stimulation and arrhythmias
Increased risk in pts with ischemic heart disease
Gradually taper beta blocker dosing to prevent sympathetic hyperresponsiveness and potential toxicity
