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Pharmacology 2 > Beta Blockers > Flashcards

Beta Blockers Flashcards

1
Q

What is MOA

A

block EPI/NE effects on B adrenergic receptors

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2
Q

what happens when you stimulate B1 or B2 receptors?

A

B1- increase heart rate, increase BP (on the heart)

B2- bronchodilate, vasodilate (on lungs and vasculature)

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3
Q

What is an ISA?

A

Intrinsic Sympathomimetic Activity- B blocker with some B agonism, like a partial agonist.

Blocks B receptor but sometime stimulates it, so less potent antihypertensive

Use if patient bottoms out with a normal B blocker

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4
Q

What is MSA?

A

Membrane Stabilizing Activity, inhibition of myocardial fast sodium channels

May widen QRS

Stimulates numbing effects, used in eye drops for glaucoma

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5
Q

What is significant about BBlockers lipophilicity?

A

higher penetration through BBB leads to seizures, delirium

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6
Q

Name the B blocker with ISA

A

Pindolol

HAS AN I IN IT

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7
Q

Name the B blocker with MSA

A

Acebutolol

Propranolol

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8
Q

What is the B blocker with alpha 1 antagonism?

A

Carvedilol, labetalol

more potent antihypertensive

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9
Q

What is the B blocker with NO release?

A

Nebivolol, nitrates are vasodilators so more potent anti-HTN

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10
Q

“-olol”

A

B1 and B2 blocker

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11
Q

“-alol”

A

B1 B2 A1 blocker

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12
Q

“-ilol”

A

B1 B2 A1 blocker

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13
Q

All selective drugs become ______ at high doses

A

less selective

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14
Q

Who do you avoid nonselective BBlockers in?

A

patients with pulmonary/ respiratory issues or allergies

because blocking B2 bronchoconstricts
USE CCB!

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15
Q

What is the big caution with B blockers?

A

withdraw therapy slowly due to receptor up regulation, taper them

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16
Q

What is special in patients with allergies

A

require additional epi pen

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17
Q

B blockers may mask symptoms of ___

A

hypoglycemia -

headache, tremor, sweating, tachycardia

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18
Q

T OR F

B blockers better lipid panels

A

FALSE

19
Q

list 3 side effects of B blockers

A

depression
fatigue
sexual dysfunction

20
Q

why caution with B blocker in Heart Failure? why good?

A

negative inotropy is bad

decreased heart rate and increased fill time is good

21
Q

Which is a more potent anti HTN, -olol or -alol

A

-alol, decreases heart rate and vasodilates

22
Q

Most common selective B Blocker?

A

Metoprolol

23
Q

What was the first B Blocker?

A

Propranolol- nonselective

24
Q

What does Propranolol have? What indications for use?

A

MSA (so dirty drug)

  • angina
  • atrial fibrillation
  • essential tremor
  • HTN
  • migraine
  • pheochromocytoma (epi/NE tumor)
  • Acute MI
  • aggression
  • anxiety
  • thyroid storm
  • portal HTN / esophageal varices
25
Q

Acebutolol is what type of B Blocker?

A

Selective (B1) with ISA and MSA

26
Q

Atenolol is a ___ B blocker and is ____ eliminated

A

Selective, renal elimination

27
Q

What B Blocker is approved for CHF?

A

Bisoprolol
Carvedilol
Metoprolol (XL)
Nebivolol

28
Q

Carvedilol blocks what? which most? Used for what? and available in what form?

A

B1 B2 A1 (10:1 b to a, more b blocker)

First BBlocker for CHF, now mainly used for CHF

ONLY available PO

29
Q

Esmolol is metabolized how? given in what form?

A

metabolized by plasma esterase in the serum

IV, gone in about in hour

30
Q

Drugs metabolized by plasma esterase have long or short T1/2?

A

SHORT

31
Q

Labetalol blocks what? what does it block the most?

A

B1 B2 A1 (7:1)

32
Q

who is a better alpha 1 blocker– labetalol or carvedalol?

A

labetalol

33
Q

What is Labetalol used for?

A

HTN emergencies and urgency

34
Q

Difference between HTN emergency and urgency?

A

Emergency = HTN + sign/symptom of end organ damage

35
Q

Why not use carvedalol in emergency/urgency?

A

Only PO and not as potent

36
Q

Cocaine stimulates what receptors? Give what drug?

A

A1 B1 B2
do not give metroprolol- create unopposed alpha 1

Give labetalol

since A1 B2 oppose each other with blood vessels

37
Q

Prinzmetal Angina is what? Do you give B Blocker?

A

vasospasm of coronary arteries that causes oxygen deprivation

No, B blocker inhibits B2 and makes angina worse

Give vascular CCB

38
Q

Metoprolol blocks what? Indicated for what? Comes in what form?

A

B1 (selective)
CHF
IV and PO

Metoprolol XL for CHF (normal is not)

39
Q

Nadolol blocks what?

A

B1 B2 (nonselective)

40
Q

Nebivolol blocks what?

A

B1

Stimulates NO release

41
Q

Timolol blocks what? used for what?

A

B1 B2

Glaucoma eye drops, has MSA

42
Q

How do you treat HTN in younger patients?

A

BBlocker, usually HTN with tachycardia and BBlocker

good at negative chronotropy

43
Q

What do you treat HTN with in older patients?

A

Diuretics

Pharmacology 2 (8 decks)

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