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Pharmacology Exam 2 > Beta blockers > Flashcards

Beta blockers Flashcards

1
Q

What are non selective beta Adrenergic receptor agonists?

A

Nadolol

Propranolol

Timolol

Dilator

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2
Q

What are beta1 selective beta Adrenergic receptor agonists?

A

Atenolol

Bisoprolol

Metoprolol

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3
Q

What are non selective beta Adrenergic receptor agonists?

A

Carvedilol

Labetalol

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4
Q

What are beta 1 selective 3rd generations agonist?

A

Nebivolol

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5
Q

Beta blockers have what suffix

A

O lol

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6
Q

What is the clinical relevance of Beta 1 receptors?

A

Heart: rate, contractility, automaticity, conduction velocity,

Kidney: Renin release

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7
Q

What is the clinical relevance of beta 2 receptors?

A

Lung: Bronchorelaxation

Skeletal muscle: Vasodilation, Glycogenolysis

Liver: glycogenolysis and gluconeogenesis

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8
Q

What are primary mechanisms of beta agonists?

A

Specifically block beta 1 Adrenergic receptors

They have varying affinity for beta1 and Beta2

None are specific to beta1 in a dose related way

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9
Q

What are the secondary mechanisms for beta 1 agonists?

A

Partial agonists/ intrinsic sympathomimetic activity (ISA)

They inhibit beta receptors when with catecholamines

Local anesthetic

Alpha1 blockers

Vasodilation or antioxidants

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10
Q

What are the effects of beta blockers on the cardiovascular system?

A

Decreases most of the sumpathetically supported cardiac functions.

Depends on sympathetic nervous system.

Lowers BP in hypertension

Decreased cardiac output

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11
Q

See slide 10 about NE release and know mechanism

A

See slide 10 about NE release

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12
Q

How do beta blockers affect the eye?

A

Reduced intraocular pressure

*chronic open angle glaucoma

Beta 2 receptors are on ciliary epithelium

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13
Q

What are the adverse effects of beta blockers on the heart?

A

May cause or exacerbate heart failure.
Bradyarrhythmias
Exacerbate peripheral vascular disease ( Raynauds)
Abrupt discontinuation can cause sudden death)
Exercise intolerance

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14
Q

What are the adverse effects of beta blockers on the pulmonary system?

A

Block beta 2 receptors in the bronchial smooth muscle: COPD patients can have life threatening Vasoconstriction.

Less likely with Beta 1 or Beta agonists with ISA

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15
Q

What are the adverse effects of beta blockers on CNS?

A

Fatigue
Sleep disturbance
Depression

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16
Q

What are the adverse effects of beta blockers on metabolism?

A

Delays recovery from hypoglycemia

Beta2- mediated effects of catecholamines on gluconeogenesis and gluconeogenesis.

Beta1 selective agonist no issue

Blunts the perception of symptoms of hypoglycemia.

17
Q

Non-selective beta blockers first generation:

A

Propranolol( Prototype)

Nadolol

Timolol

Sotalol

18
Q

What are the mechanics of non-selective beta blockers 1st generation propanolol prototype:

A

Competitive reversible antagonist of B1 and B2 receptors.

Rapid and completely absorbed

Substantial first pass metabolism

19
Q

What are the clinical uses of non-selective first generation beta blockers? Propanolol prototype

A

Hypertension

Angina

Cardiac Arrhythmias

Myocardial infarction

Pheochromocytoma

Migraine prophylaxis

20
Q

What are the adverse effects of nonselective first generation beta blockers propanolol protype

A 
Acute heart failure
Bradycardia
Bronchospasm
Blunt recognition hypoglycemia
Abrupt withdrawal
21
Q

What is Timolol?

A

A nonselective first generation beta blocker

Competitive and reversible antagonist of Beta 1 and 2 receptors.

Major use Glaucoma: decreases aqueous humor

Also used similarly as propanolol

22
Q

What are beta 1 selective antagonists second generation:

A

Atenolol

Bisoprolol

Metoprolol (prototype)

23
Q

What is the mechanism for beta 1 selective antagonist metoprolol?

A

Competitive reversible agonist of beta 1 receptors

Cardioselective

A low dose is 10 fold more selective for Beta 1

24
Q

What are the clinical uses for beta 1 selective antagonist metoprolol?

A

Hypertension
Angina
Acute myocardial infarction
Congestive heart failure

Adverse effects: Similar to proranolol less bronchoconstriction

25
Q

What is esmolol?

A

A beta 1 selective antagonist second generation.

Moderately selective

Half-life 8 minutes

Cleaves by esterases i tot be plasma

Prevents tachycardia in surgery

26
Q

What are beta 1 antagonists with additions cardiovascular effects 3rd generation ?

A

Non-selective: Carvedilol and Labetolol

B1 selective: nebivolol

27
Q

What are labetolol and Carvedilol

A

Non selective 3rd generation beta 1 antagonists:

Labetalol: competitive reversible antagonist of a1 and both beta receptors ( Hypertension)

Carvedilol: competitive reversible antagonist of Alpha 1 and beta receptors

( Antioxidant, anti inflammatory, blocks l-type calcium channels, heart failure, hypertension)

28
Q

Clinical use of beta Adrenergic receptor antagonists:

A

Hypertension

  • for under 60s and non smokers
  • Beta blockers without ISA recommended for heart patients.
29
Q

Ischemic heart disease:

A

Decreases cardiac work and reduces oxygen demand
Improves exceed use tolerance

Timolol propanolol metroprolol

Use Beta antagonist without ISA for myocardial infarction.

30
Q

Cardiac arrhythmia:

A

Slows ventricular response rates to atrial flutter and fibrillation

Reduce ectopic beats with catecholamines

Esmolol helps with preoperative Arrhythmias

Sotatol blocks channels

31
Q

Heart failure

A

Reducing mortality in chronic heart failure

Metroprolol bisoprolol Carvedilol

32
Q

Glaucoma:

A

Reduces intraocular pressure

Better tolerated than Epinephrine it pilocarpine

Beta blockers that lack Logan anesthetic properties

Topical administration: Timolol betaxolol metipranolol, carteolol, metipranolol

33
Q

Hyperthyroidism:

A

Beta blockers stop symptoms caused by increased beta tone

Palpitations tachycardia anxiety heat tolerance

34
Q

Other treatments

A

Migraine: propanolol metoprolol Timolol

Essential tremor: propranolol

Performance anxiety: propranolol

35
Q

What comorbidities should always be considered?

A

Beta1 selective antagonists are preferable in patients with:

Bronchospasm
Diabetes
Peripheral vascular disease
Raynaud’s phenomenon

Pharmacology Exam 2 (7 decks)

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