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Cardiovascular Diseases > Beta Blockers > Flashcards

Beta Blockers Flashcards

1
Q

What beta blockers have intrinsic sympathomimetic activity (ISA)?

A

Acebutolol
Celiprolol

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2
Q

What B-Blockers are without ISA?

A

Atenolol
Metoprolol
Esmolol
Bisoprolol
Betaxolol
Bevantolol
Nebivolol

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3
Q

Acebutolol, atenolol, metoprolol, and esmolol are all ________ beta blockers
-Which selectivity?

A

Cardioselective
-B1

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4
Q

What’re the effects of B1 Beta blockers?

A

Decreases heart rate, contractility, and AVN conduction

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5
Q

Which beta blocker is the only beta blocker that causes NO-mediated vasodilation?

A

Nebivolol

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6
Q

Indications of cardioselective B1 beta blockers?

A

Coronary heart disease, compensated heart failure, and arrhythmias

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7
Q

What’re some nonselective beta blockers with ISA?

A

Pindolol
Penbutolol
Oxprenolol

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8
Q

What’re some nonselective beta blockers without ISA?

A

Propranolol
Nadolol
Sotalol
Timolol
Tertalol

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9
Q

What’re some nonselective beta blockers with additional alpha blocking action?

A

Labetolol
Bucindolol
Carvedilol

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10
Q

What’re the effects of nonselective beta blockers with and without ISA?

A

Blocks B1,2, and 3 receptors

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11
Q

Sotalol (NS B-Blocker) also blocks ____ channels resulting in an _________ effect

A

Potassium
Antiarrhythmic

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12
Q

What’re the side effects of nonselective beta blockers?

A

Bronchoconstriction, vasoconstriction, hypo/hyper glycemia, bradycardia and syncope

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13
Q

Indications of:
-Propranolol
-Sotalol
-Timolol

A

-Prop: Essential tumor, portal HTN, migraine prophylaxis, thyroid storm

-Sot: cardiac arrhythmias

-Timolol: Glaucoma

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14
Q

Nonselective beta blockers are the _______ to cardioselective beta blockers

A

Alternative

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15
Q

What’re the effects of NS B-Blockers with alpha blocking action?

A

They’re potent vasodilators and improve endothelial function and vascular remodeling

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16
Q

Due to alpha-blocking action:
Vasodilation causes —> 1._____ peripheral vascular resistance, 2.______ preload, 3._______ after load, and 4. _______ renal blood flow

A

1-3: Decreased
4. Increased

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17
Q

NA B-Blockers with additional alpha blocking action _______ portal HTN and pressure gradient in hepatic venous

A

Reduce

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18
Q

Indications of NS B-Blockers with Alpha action?

A

Pregnancy induced HTN (labetolol)
Esophageal varisces (prophylactic use)

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19
Q

With the exception of Nebivolol, all cardioselective beta blockers begin with letters ____ to _____, while NS B-Blockers begin with letters ______ to ______

A

A-M
N-Z

20
Q

What types of organs are affected by B1 receptors?

A

Heart and Kidneys

21
Q

What’re the effects of the B-Adrenergic blockade on the heart?

A

Anti-arrhythmic effect
Anti-ischemic effect
Anti remodeling effect

22
Q

What is the anti-ischemic effect of the B1-Blockade? (Physiologically explain what happens to rate, contractility, BP, and result)

A

Decreased HR, contractility, BP, oxygen consumption, resulting in anti ischemic effect

23
Q

Explain the antiarrhythmic effect of the B1 blockade

A

Decreased AVN conduction, increased AVN refractory time, and decrease heart rate

24
Q

Explain the process of the B1 blockade on the kidneys (what cells does it act on and what happens)

A

Acts in the juxtaglomerular cells causing decreased renin, decreased angiotensin 2 conversion, decreased water resorption and decreased BP

25
Q

What organs do B2 receptors affect?

A

Smooth muscle, ciliary body of the eye, pancreatic beta cells, skeletal muscle, liver, lipoprotein lipase enzyme

26
Q

What’re the effects of the B-adrenergic blockade on smooth muscles?
-Vasculature
-Bronchioles

A

-Vasoconstriction
-Bronchoconstriction

27
Q

What is the effect on the ciliary body of the eye from the beta adrenergic blockade?

A

Causes decreased aqueous humor production resulting in decreased intraocular pressure

28
Q

What’s the effect of the beta adrenergic effect on the beta cells of the pancreas?

A

Decreased insulin release resulting in hyperglycemia and new onset diabetes

29
Q

What effect does the beta-adrenergic blockade have on skeletal muscle?

A

Decreased glucose uptake (decreased insulin sensitivity)

30
Q

What effect does the beta-adrenergic blockade have on the liver?

A

Decreased hepatic glycogenolysis causing hypoglycemia (esp. in diabetic patients)

31
Q

What effect does the beta-adrenergic blockade have on lipoprotein lipase enzyme?

A

Inhibits lipoprotein lipase causing hyperlipidemia (increased triglycerides, reduced HDL)

32
Q

What is the main site of action of the B3 receptor?

A

Adipose tissue

33
Q

What effect does the beta-adrenergic blockade have on adipose tissue?

A

Reduced lipolysis causing weight gain

34
Q

Beta blockers competitively ______ adrenergic substances at B receptors

A

Inhibit

35
Q

Adverse effects of: NS and selective B-Blockers on:

  • Cardiac
A

Bradycardia, bradyarrhythmia (AV block),

ventricular tachyarrhythmia (torsades),

worsening HF,

worsened vasospasm due to propranolol use

Orthostatic hypotension

36
Q

Adverse effects of: NS and selective B-Blockers on:

-CNS

A

Fatigue/lethargy

Sleep disorders

Depression, hallucinations

Siezures

37
Q

Adverse effects of: NS and selective B-Blockers on:
-Cutaneous

A

Psoriasis

38
Q

Adverse effects of: NS B-Blockers on:
-Pulmonary

A

Bronchoconstriction (esp. patientd with asthma and reactive airway disease)

39
Q

Adverse effects of: NS B-Blockers on:
-Perioheral vasculature

A

Peripheral vasoconstriction:
- Erectile dysfunction
- Secondary raynaud phenomenon

40
Q

Adverse effects of: NS B-Blockers on:
-Metabolic

A

Hypertriglyceridemia
Hyper/hypo glycemia
Weight gain

41
Q

Beta blockers should be introduced _______ with _____ increases in dosage and ______ tapered off when no longer needed

A

Gradually with slow increased

Slowly tapered off

42
Q

Beta blocker withdrawal is caused by?

A

Sudden termination of beta blockers

43
Q

How to prevent beta blocker withdrawal?

A

Taper dose over 7-10 days

44
Q

What’re some indications of beta blockers?

A

HTN, CAD, Heart failure, and Arrhythmias

45
Q

What’re the specific indications for propranolol?

A

Essential tumor, migraine prophylaxis, portal HTN, hyperthyroidism and thyroid storm, infantile hemangioma, and akathisia

46
Q

What drug would be given for hypertensive crisis?

A

IV labetolol

Cardiovascular Diseases (36 decks)

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