Autonomic pharmacology VI

Question 1

what is the affinity for labetalol for adrenergic receptors?

Answer 1

higher affinity for B compared to a1

Question 2

what effect does labetalol have on the heart?

Answer 2

lowers BP with limited HR increase (good for high sympathetic states like pheochromocytoma)

Question 3

what is the clinical use for labetalol?

Answer 3

hypertension, pheochromocytoma

Question 4

what are the first generation, non selective B adrenergic antagonists?

Answer 4

1. propanolol
2. nadolol
3. timolol
4. pindolol

Question 5

what are the second generation, selective B adrenergic antagonists?

Answer 5

1. atenolol
2. metoprolol
3. esmolol
4. betaxolol
5. acebutolol

AMEBA

Question 6

what are the third generation mixed a-B adrenergic antagonists?

Answer 6

1. labetolol

2. carvedilol

Question 7

which B adrenergic antagonists have intrinsic sympathomimetic activity?

Answer 7

1. pindolol

2. acebutolol

Question 8

what is the clinical use for drugs that have intrinsic sympathomimetic activity?

Answer 8

effect to decrease HR is less - helps in cases where you are concerned about potential severe bradycardia

Question 9

what are the cardiovascular effects of beta blockers?

Answer 9

1. negative inotropy
2. negative chronotropy
3. decrease myocardial oxygen consumption
4. decrease renin release

Question 10

what are the respiratory effects of beta blockers?

Answer 10

1. B2 blockade - increase airway resistance (undesirable in asthmatic patients)
2. no beta blocker is 100% free of B2 blocking effect

Question 11

what is the effect of beta blockers in the eye?

Answer 11

decrease aqueous humor production leading to decreased intraocular pressure

Question 12

what are the effects of beta blockers on metabolism?

Answer 12

1. inhibits lipolysis
2. may decrease glucagon release
3. increase VLDL
4. decrease HDL

Question 13

what are the therapeutic uses for beta blockers?

Answer 13

1. hypertension
2. ischemic heart disease
3. cardiac arrythmias
4. heart failure
5. glaucoma
6. hyperthyroidism (symptomatic - to decrease HR)
7. neurologic diseases

Question 14

what are the important considerations when choosing beta blockers?

Answer 14

1. cardioselectivity (AMEBA group good here)
2. intrinsic sympathomimetic activity (if you do not want the HR to drop too much)
3. lipid solubility

Question 15

what are the adverse effects of beta blockers?

Answer 15

1. fatigue 
2 worsening peripheral vascular disease 
3. worsening bronchospasm 
4. decreased sexual function  
5. increased incidence of diabetes 
6. mask hypoglycemia