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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

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
Acebutolol is what type of B Blocker?
Selective (B1) with ISA and MSA
26
Atenolol is a ___ B blocker and is ____ eliminated
Selective, renal elimination
27
What B Blocker is approved for CHF?
Bisoprolol Carvedilol Metoprolol (XL) Nebivolol
28
Carvedilol blocks what? which most? Used for what? and available in what form?
B1 B2 A1 (10:1 b to a, more b blocker) First BBlocker for CHF, now mainly used for CHF ONLY available PO
29
Esmolol is metabolized how? given in what form?
metabolized by plasma esterase in the serum IV, gone in about in hour
30
Drugs metabolized by plasma esterase have long or short T1/2?
SHORT
31
Labetalol blocks what? what does it block the most?
B1 B2 A1 (7:1)
32
who is a better alpha 1 blocker-- labetalol or carvedalol?
labetalol
33
What is Labetalol used for?
HTN emergencies and urgency
34
Difference between HTN emergency and urgency?
Emergency = HTN + sign/symptom of end organ damage
35
Why not use carvedalol in emergency/urgency?
Only PO and not as potent
36
Cocaine stimulates what receptors? Give what drug?
A1 B1 B2 do not give metroprolol- create unopposed alpha 1 Give labetalol since A1 B2 oppose each other with blood vessels
37
Prinzmetal Angina is what? Do you give B Blocker?
vasospasm of coronary arteries that causes oxygen deprivation No, B blocker inhibits B2 and makes angina worse Give vascular CCB
38
Metoprolol blocks what? Indicated for what? Comes in what form?
B1 (selective) CHF IV and PO Metoprolol XL for CHF (normal is not)
39
Nadolol blocks what?
B1 B2 (nonselective)
40
Nebivolol blocks what?
B1 | Stimulates NO release
41
Timolol blocks what? used for what?
B1 B2 Glaucoma eye drops, has MSA
42
How do you treat HTN in younger patients?
BBlocker, usually HTN with tachycardia and BBlocker | good at negative chronotropy
43
What do you treat HTN with in older patients?
Diuretics

Pharmacology 2 (8 decks)

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