BETA BLOCKERS

Question 1

2 types of Beta Receptors

Answer 1

Beta-1 and beta 2

Question 2

Beta 1 found primarily in the

Answer 2

Heart

Question 3

Beta 2 found primarily in the

Answer 3

Smooth muscle of the vasculature and bronchi.

Question 4

Beta Blockers MOA

Answer 4

coupled to ADENYLATE CYCLASE, When activated, adenyl cyclase converts adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP), a secondary intracellular messenger, that stimulates protein kinase A to phosphorylate membrane calcium channels, leading to an increase in cytoplasmic Ca2+ level

Question 5

Beta BLOCKERS MOA short

Answer 5

Activate adenylate cyclase

Increase cAMP

Question 6

Main effects of Beta adrenergic stimulation

Answer 6

positive inotropy, chronotropy, dromotropy,

and lusitropic relaxant effect

Question 7

Secondary messenger cAMP is metabolized by phosphodiesterase, phosphodiesterase
inhibitors augment

Answer 7

b1 activity, which is manifested by sympathomimetic effects.

Question 8

Because b-adrenergic receptor blocking agents have _________inotropy and chronotropy—_________myocardial oxygen demand and improving______

Answer 8

negative ; decreasing ;myocardial perfusion

Question 9

Current recommendations for patients with acute

coronary syndromes are for

Answer 9

Beta Blockers agents to be started early
Statins, 
Antiplatelet drugs
ACEis
90% reduction in mortality rates at 6 months following the diagnosis of acute coronary syndrome.

Question 10

Patients with congestive heart failure, even if they are not hypertensive, can benefit from b-blockade; the administration of _______and ________ have been
reported to improve cardiac ejection fraction, reverse abnormal patterns of gene expression toward normal, and decrease mortality rate.

Answer 10

carvedilol and of metoprolol

Question 11

What is Intrinsic Sympathomimetic Activity?

Answer 11

Beta Blockers with intrinsic sympathomimetic activity cause mild peripheral vasodilation without reducing cardiac output.

Question 12

Beta Blockers with no ISA

Answer 12

Beta Blockers without intrinsic sympathomimetic activity lower blood pressure by decreasing cardiac output and inhibiting renin release and central sympathetic outflow.

Question 13

Beta Blockers with Diabetes

Answer 13

They may mask hypoglycemic symptoms in patients
with diabetes and increase triglyceride and reduce high-density lipoprotein
levels.

Question 14

Abrupt discontinuation of b-adrenergic receptor blocking agents is associated with

Answer 14

rebound hypertension and tachycardia, which can result in

myocardial ischemia or infarction.

Question 15

Absolute Contraindications of Beta Blockers

5S O

Answer 15

Severe bradycardia
Sinus node dysfunction or high-grade AV block
Overt ventricular systolic failure
Severe asthma or active bronchospasm
Severe peripheral vascular disease with rest ischemia
Severe depression

Question 16

In patients who have taken an accidental or intentional overdose of b-adrenergic receptor blocking agents, the side effects can be mitigated by which drug?
what dose ______administer IV over _____Then ________

Answer 16

glucagon, 100 mg/kg, administered intravenously over 1 min, then 1 to 5 mg/h

Question 17

NonSelective Cardioselective Beta Blockers

ProTiNaSo

Answer 17

Propanolol
Timolol
Nadolol
Sotalol

Question 18

CardioSelective Beta Blockers

MetEsAtAce

Answer 18

Metoprolol
Atenolol
Acebutalol
Esmolol

Question 19

ISA and additional properties

Answer 19

Labetalol
Pinadolol
Acebutalol

Question 20

Also a class III antiarrythmic

Answer 20

SOTALOL

Question 21

Of particular importance for anesthesia providers, b-adrenergic receptor blocking agents should be used in patients

Answer 21

at high risk for experiencing a coronary event and who are undergoing non-cardiac and vascular operations

Question 22

In men, b-adrenergic receptor blocking agents increase the incidence of

Answer 22

impotence.

Question 23

Side effects of Beta Blockers

Answer 23

Hypotension
Bradycardia
CNS depressants sypmtoms (fatigue, sedation)
hallucinations
Depression

Question 24

Renally Excreted Beta Blockers (BiAtNaSo)

Answer 24

Atenolol
Bisoprolol
Nadolol
Sotalol

Question 25

Hepatic Excreted (MetProCarLa)

Answer 25

Metoprolol
Propranolol
Carvedilol
Labetalol

Question 26

Metabolism of Esmolol

Answer 26

Blood esterases

6-9 min Half life

Question 27

Indications of Beta Blockers

Answer 27

HTN
Dysrhythmias
SVTs
Hypertrophyic Obstructive Cardiomyopathy
Thyroid storm (if LV ok) 
Dissecting aneurysm
MVP,MS