Beta and Alpha blockers

Question 1

Are alpha 1 agonists inhibitory or excitatory?

Answer 1

Excitatory

Question 2

What neurotransmitter do alpha 1 agonists release?

Answer 2

NE; leading to vasoconstriction

Question 3

Are alpha 2 agonists inhibitory or excitatory?

Answer 3

Inhibitory

Question 4

What do alpha 2 agonists inhibit?

Answer 4

NE; leading to vasodilation

Question 5

What does an alpha 1 antagonist do?

Answer 5

Inhibits NE from binding to receptor leading to vasodilation

Question 6

What neurotransmitter do alpha 2 antagonist release?

Answer 6

NE leading to vasoconstriction

Question 7

What does a beta 1 agonist do?

Hint: odd # is excitatory; even # is inhibitory

Answer 7

causes cardiac stimulation

Question 8

What does a beta 2 agonist do?

Answer 8

smooth msl relaxation (airways)

Question 9

What does a beta 1 antagonist do?

Hint: odd is excitatory and even is inhibitory

Answer 9

inhibits cardiac stimulation

Question 10

What does a beta 2 antagonist do?

Answer 10

inhibits smooth msl relaxation (bronchoconstriction)

Question 11

What are some uses for alpha blockers?

Answer 11

antihypertensive, BPH agent, erectile dysfunction, ureteric stone, etc.

Question 12

MOA of alpha blockers to tx BPH?

Answer 12

Decreases urethral resistance

Question 13

Adverse effects of alpha blockers?

Answer 13

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• inhibition of ejaculation
• sodium retention and increased blood volume d/t reduction in BP that leads to release of renin

Question 14

Is Doxazosin (Cardura) a beta or alpha blocker?

Answer 14

Alpha adrenergic antagonist (alpha blocker)

Question 15

When should Doxazosin be taken to minimize orthostatic hypotension?

Answer 15

At night initially

Question 16

MOA of beta 1 in the kidneys?

Answer 16

Release renin

Question 17

MOA of beta 2 in the liver?

Answer 17

promotes glycogenolysis

Question 18

MOA of beta 2 in the msl?

Answer 18

promotes glycogenolysis and enhances contraction

Question 19

MOA of beta 2 in the uterus?

Answer 19

Relaxation of the uterine smooth msl

Question 20

Adverse effects of beta 1 blockers?

Answer 20

bradycardia, reduced cardiac output, precipitation of HF, AV heart block, and rebound cardiac excitation

Question 21

Adverse effects of beta 2 blockers?

Answer 21

bronchoconstriction and hypoglycemia from inhibition of glycogenolysis

Question 22

What do beta blockers end in?

Answer 22

-lol

Question 23

What do we always check before giving a beta blocker?

Answer 23

HR, BP

Question 24

What is the negative chronotropic, inotropic, and dromotropic effect of beta blockers?

Answer 24

decrease in resistance (HR), workload (force of contraction), and cardiac output (conduction speed).

Question 25

What are 1st generation (non selective) beta blockers?

Example: Propanolol

Answer 25

They block all receptors causing low HR but also bronchoconstriction

Question 26

When should we hold off or question the use of beta blockers?

Answer 26

• HR < 60 and SBP < 100
• breathing problems
• severe heart failure sx
• BS < 70
• AV heart blocks
• severe allergic rxns (non selective)

Question 27

What is a 2nd generation (cardio selective) beta blocker? Example: Metoprolol

Answer 27

only blocks beta 1 receptors

Question 28

What is a third generation (vasodilating) beta blocker?

Example: Carvedilol

Answer 28

vasodilates but may block non selective or cardio selective receptors

Question 29

What can happen if pt abruptly stops taking beta blockers?

Answer 29

Rebound HTN

Question 30

What should we be monitoring with administration of a beta blocker?

Answer 30

BP, HR, and EKG

Question 31

Which drugs are selective beta blockers?

Answer 31

Metoprolol, atenolol, and esmolol