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Pharmacology > Beta Blockers > Flashcards

Beta Blockers Flashcards

1
Q

What do selective beta blockers selectively block?

A

Beta-1 (heart chrontropy and inotropy)

No effect on beta-2

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2
Q

What effect do non-selective beta blockers have on the heart and lungs?

A

Decrease heart rate, decrease blood pressure, bronchoconstrict, vasoconstrict

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3
Q

What does it mean for a beta blocker to have intrinsic sympathomimetic activity (ISA)?

A

Beta blockers with some beta agonistic effects (blocks yet occasionally stimulates receptor)-generally less effective

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4
Q

When are beta blockers with ISA used?

A

When a patient is at risk of bottoming out

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5
Q

What is MSA?

A

Membrane stabilizing activity – has numbing affects due to inhibition of myocardial fast sodium channels

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6
Q

What type of medicine contains MSA?

A

Eyedrops used to treat glaucoma

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7
Q

Describe problems stemming from high lipophilicity of some beta blockers

A

Can penetrate blood brain barrier causing seizures and delirium

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8
Q

Name a beta blocker with ISA

A

Pindolol (has an “i” in it)

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9
Q

Name two beta blockers with MSA

A

Acebutolol, propranolol

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10
Q

List three lipophilic beta blockers

A

Carvedilol, nebivolol, penbutolol

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11
Q

Name two beta blockers with alpha-1 antagonism

A

Carvedilol, labetalol (do not end in “olol”)

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12
Q

Which type of beta blockers are the more potent antihypertensives?

A

Beta blockers with alpha-1 antagonism (recognized by “ilol” or “alol” ending)

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13
Q

Name a beta blocker with nitrous oxide release

A

Nebivolol (starts with N)

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14
Q

Name 3 beta-1 selective beta blockers

A

Atenolol, metoprolol, nebivolol, Acebutolol, betaxolol, esmolol…

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15
Q

Which patients should be careful to avoid nonselective beta blocker’s?

A

Patients with lung conditions due to beta blocker’s potential for bronchoconstriction

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16
Q

Describe the mechanism of action of beta blockers

A

Blockade of epinephrine and norepinephrine effects on beta adrenergic receptors, can be beta-1 selective or nonselective

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17
Q

What is the correct way to taper off of a beta blocker?

A

There is no correct way, just withdraw slowly due to receptor up regulation

18
Q

What is the concern if a patient on beta blockers goes into anaphylaxis?

A

They require higher doses of epinephrine to mediate anaphylaxis

19
Q

Why should diabetic patients be careful on beta blockers?

A

Beta blockers mask symptoms of hypoglycemia – sweating, tremor, headaches, tachycardia

20
Q

How can beta blockers negativelycontribute to heart failure?

A

Beta blockers are negative inotropes that increase fill time but decrease contractility

21
Q

What are three neurologic side effects of beta blockers

A

Depression, fatigue, sexual dysfunction

the higher the lipophilicity, the higher the risk

22
Q

List 3 beta blockers that decrease mortality in congestive heart failure

A

Metoprolol, carvedilol, Bisoprolol

23
Q

List a beta blocker that is renally eliminated

A

Atenolol

24
Q

List a beta blocker that is IV only

A

Esmolol

25
Q

List a beta blocker that is eliminated via plasma esterases

A

Esmolol (has nine minute half life, metabolized in blood, given IV only)

26
Q

List a beta blocker that can be used in hypertensive emergency

A

Labetalol (more potent alpha blocker than carvedilol)

27
Q

What medication should be used to treat Prinzmetal’s angina?

A

Calcium channel blockers (vascular specific) – beta blockers worsen vasospasm

28
Q

Which is a more potent form of labetalol (nonselective beta blocker with alpha-1 blockade), PO or IV?

A

PO Labetalol is a more potent alpha blocker than IV

29
Q

Name a beta blocker that can be given in a cocaine overdose

A

Labetalol – blocks alpha-1, beta-1 and beta-2

30
Q

What form of metoprolol is indicated for CHF?

A

XL (oral)

Also comes IV and IR PO, but only XL is for CHF patients

31
Q

What are some indications of propanolol?

A

Since propranolol is lipophilic and contains MSA, it can be used to treat many conditions including angina, a fib, tremor, hypertension, migraine, pheochromocytoma, AMI, aggression, anxiety, thyroid storm, portal hypertension…

32
Q

Give an example of when to use sotalol

A

Atrial and ventricular arrhythmias, angina, hypertension – it is a nonselective beta blocker with antiarrhythmic activity

33
Q

Which nonselective beta blocker is commonly used for open angle glaucoma?

A

Timolol

34
Q

Describe the different functions of alpha-1 receptors on postsynaptic and presynaptic neurons

A

Postsynaptic – mediate vasoconstriction

Presynaptic – inhibit release of neurotransmitters

35
Q

Which alpha-1 blockers are used to treat postural hypotension?

A

Doxazosin, prazosin, terazosin (all end in zosin)

36
Q

Which alpha-1 blockers are bladder specific and used in BPH to increase urine flow?

A

Afluzosin, sildosin tamsulosin

37
Q

List the only alpha-2 agonist that decreases blood pressure

A

Clonidine

38
Q

Which alpha-2 agonist is commonly used for sedation in Neurosurgery?

A

Dexmedetomidine (Precedex)

39
Q

Why does Precedex make a good sedative? (as opposed to Fentanyl or morphine)

A

Lipophilic, CNS specific, causes very little respiratory depression

Fentanyl and morphine require mechanical ventilation

40
Q

What kind of medication is Sudafed and how does it work?

A

Alpha-1 agonist – vasoconstrict capillaries to relieve nasal congestion

41
Q

What form of Sudafed is best for patients with hypertension?

A

Nasal spray – it is location specific

Pharmacology (9 decks)

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