Beta Blockers

Question 1

Action of catecholamines on:
Peripheral excitatory action:
Peripheral inhibitory action:
Cardiac excitatory action:
Metabolic action:
Endocrine action:
On CNS:

Answer 1

1-smooth muscle of vessels suppplying skin mucosa and kidney
2- smooth muscle in wall of gut and bronchial tree and blood vessels supplying skeletal muscle
3-increases heart rate and force of cont
4- increase rate of glycogenolysis in liver and muscle and liberation of fa in adipose
5-modulates the secretion of insulin renin and pituitary hornones
6-stimulates respiration increases wakefulness and psychomotor activity and reduces apetite

Question 2

Beta blockers
Definition:
Classification

Answer 2

Bind to beta adrenoreceptors and block the binding of epinephrine and nor
1st generation: non selective (B1 and B2)
2nd generation: B1 selective (cardio)
3rd generation; block alpha adrenoreceptors

Question 3

T or F
B blockers are incompetetive antagonists

Answer 3

False
Competitive

Question 4

Names of non selective 1-B blockers
2-Cardio selective
3-Antagonist with partial agonist activity or intrinsic sympathimimetru activity
Antagonist of both alpha and beta adrenoreceptors

Answer 4

1- propranolol pindolol
2-atenolol acebutolol
3-pindolol acebutolol
4- nebivolol carvedilol

Question 5

1-Cardiac effects
2- renal
3-bronchial
4-metabolic

Answer 5

1- decrease HR and CO ;decrease systolic and diastolic BP and myocardial contractility and O2 consumption
Slow down AV conduction
Fall of action potential anf increased refractory period
2- inhibition of secretion and acti of renin (B1)
3-bronchoconstriction(B2)
4-block glycogenolysis (B2), reduce HDL and increase LDL and increase trig(B1)
5-

Question 6

T or F
B1 antagonist and nebivolol worsen the lipid profile in dyslipidemic patients

Answer 6

False
Improveee (exception)

Question 7

Therapeutic uses of beta blockers
Cardiovascular:
1-
2-
3-
Others:
1-
2-
3-
4-

Answer 7

1- HTN
2- arrythmias
3- angina and myocardial infaction

Glaucoma
Hyperthyrodism
Migraines
Acute panic syndrome and anxiety

Question 8

Pharmacokinetics of Fat soluble :ADME
Same for water soluble: ADME

Answer 8

Fat soluble : A: digestive absorption 80% D: high protein binding and passage of significant biological membranes M: hepatic E: bile

Water: A: incomplete D: low protein binding and low passage M: low hepatic metabolism E: renal

Question 9

List 4 fat soluble beta blockers and 3 water soluble

Answer 9

Fat soluble: alprenolol labetalol metoprolol propronalol (PALM)
Water: atenolol nadolol sotalol(NAS)

Question 10

Side effects of beta blockers
1-
2-
3-
4-
5-
6-

Answer 10

1-bradycardia hypotension AV block
2-bronchoconstriction
3-asthma and COPD especially with non selective
4-cns: fatigue sleep disturbances and depression
5-mask the symptoms of hypoglycemia in diabetic (tachycardia)
6-shouldnt be withdrawn suddenly because sudden withdrawal may worsen angina and cause heart attack

Question 11

Beta blockers drug interaction:
1-
2-
3-

Answer 11

1- aluminum salts cholestyramine: decrease absorption of B blockers
2- phenytoin rifampin and phenobarbital increase drug metabolism
3- cimetidine decrease drug metabolism of propranolol and metoprolol

Question 12

Drugs with positive ISA:
1-
2-
3-
4-

Answer 12

Pindolol
Acebutolol
Celiprolol
Oxprenolol