Cardiac Pharma Flashcards
Alpha-1 Adrenergic Blockers
Cautions:
Volume depletion: increased risk of hypotension
Treatment with diuretics, beta-blockers, calcium channel blocker: increased risk of first-dose hypotension/ syncope
Cataract surgery: floppy iris syndrome
Renal impairment: may cause profound first dose effect
Children, elderly, Preg and BF
Alpha-1 Adrenergic Blockers
Mechanics of Action
Block peripheral Alpha-1 receptors —> dilates peripheral blood vessels —> lowers peripheral resistance —> lowers BP
Reduces smooth muscle tone in neck of bladder ad prostate (prazosin)
Alpha-1 Adrenergic Blockers
Side Effects
Blurred vision, Dizziness, drowsiness, fatigue, headache, weakness
First-dose hypotension/ syncope, orthostatic hypotension, palpitations, oedema
Nasal congestion
Dry mouth, nausea other GI disturbances
Urinary frequency, incontinence, impotence, priapism
Alpha-1 Adrenergic Blockers
Indications
Hypertension
Benign prostate hyperplasia - symptom relief
Alpha-1 Adrenergic Blockers:
Medications
Prazosin
Doxazosin
Terazosin
Alpha-1 Adrenergic Blockers
Care Considerations
Monitor HR and BP
Alpha-2 Adrenergic Agonists
Mechanics of action
Selectively agonises central alpha-2 receptors —> reduces sympathetic tone —> reduces BP
Alpha-2 Adrenergic Agonists
Indications
Hypertension
Clonidine specific:
Migraine prophylaxis
Menopausal flushing
ADHD
Management of opioid withdrawal
Adjunct analgesic for acute, chronic, or cancer pain
Alpha-2 Adrenergic Agonists
Adverse Effects
Depression, Dizziness, drowsiness, fatigue, headache sedation, weakness
Bradycardia , rebound hypertension (after last dose), orthostatic hypotension
Nasal congestion
Dry mouth, constipation
Rash
Methyldopa specific:
Haemolytic anemia, thrombocytopenia, leucopenia, hepatic toxicity/ necrosis
Alpha-2 Adrenergic Agonists
Contraindications
Sever bradycardia due to SSS or Heart block (clonidine)
Pheochromocytoma
Active Hepatic disease(methyldopa)
Alpha-2 Adrenergic Agonists
Cautions - Clonidine
Depression - may exacerbate
Diabetes - may cause transient rise
Interactions with verapamil, diltiazem and beta blockers
Peripheral vasospastic diseases - may exacerbate
Renal - start with low dose
Pregnancy and BF
Alpha-2 Adrenergic Agonists
Cautions - Methyldopa
Interactions with: lithium, MAO inhibitors, lipodopa
Renal - may respond to lower dose
Alpha-2 Adrenergic Agonists
Care Considerations
Monitor BP and HR frequently
Angiotensin II Receptor Blockers
Mechanics of Action
Blocks Angiotensin II receptors in blood vessels and adrenal glands; inhibits vasoconstrictive and aldosterone-secreting effects of Angiotensin II
Angiotensin II Receptor Blockers
Indications
Hypertension
Angiotensin II Receptor Blockers
Adverse Effects
Dizziness, drowsiness, headache
Angioedema, hypotension
Hyperkalaemia, hypoglycaemia
Angiotensin II Receptor Blockers
Contraindications
Pregnancy
Angiotensin II Receptor Blockers
Cautions
Hypotension
Hypovolaemia
Hyperkalaemia
Renal or hepatic disease
Angiotensin II Receptor Blockers
Care Considerations
BP and HR
Check bloods regularly
