Chapter 21: Adrenergic Antagonists

Question 1

What are the two major groups of adrenergic antagonists

Answer 1

• alpha-adrenergic blocking agents
• beta-adrenergic blocking agents

Question 2

main therapeutic applications of the alpha blockade

Answer 2

• essential hypertension
• reversal of toxicity of alpha1 agonists
• benign prostatic hyperplasia (BPH)
• phenochromocytoma
• raynauds disease

Question 3

what drug should be used to reverse the toxicity of alpha1 agonists

Answer 3

phentolamine

Question 4

Benign prostatic hyperplasia (BPH) symptoms

Answer 4

dysuria, increased frequency of daytime urination, nocturia, urinary hesitancy, urinary urgency, a sensation of incomplete voiding, a reduction in the size and force of the urinary system

Question 5

pheochromocytoma

Answer 5

• catecholamine secreting tumor (usually located in the adrenal medulla)
• principle cause of hypertension

Question 6

pheochromocytoma treatment

Answer 6

surgery is the best option

Question 7

raynauds disease

Answer 7

• peripheral vascular disorder
• vasospasms in the toes and fingers
• suppress symptoms by preventing alpha mediated vasoconstriction

Question 8

adverse effects of alpha1 blockade

Answer 8

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• inhibition of ejaculation
• sodium retention (increased blood volume)

Question 9

what is the most significant adverse effect associated with the alpha2 blockade

Answer 9

potentiation of reflex tachycardia

Question 10

Prazosin [Minipress]

Answer 10

• competitive antagonist
• selective blockade of alpha1 adrenergic receptors

Question 11

prazosin [Minipress] is administered

Answer 11

orally

Question 12

prazosin [Minipress] antihypertensive effect peak in ______ and persist for ______

Answer 12

1-3 hours
10 hours

Question 13

prazosin [Minipress] is excreted in

Answer 13

the bile
10% in the urine

Question 14

prazosin [Minipress] half life

Answer 14

2-3 hours

Question 15

prazosin [Minipress] adverse effects

Answer 15

• orthostatic hypotension
• reflex tachycardia
• inhibition of ejaculation
• nasal congestion
• ” first dose” effect

Question 16

terazosin [Hytrin] is used for

Answer 16

hypertension and BPH

Question 17

prazosin [Minipress] is used for

Answer 17

hypertension and BPH in men

Question 18

terazosin [Hytrin] peak effects

Answer 18

1-2 hours after oral dosing

Question 19

terazosin [Hytrin] half life

Answer 19

prolonged (9-12 hours)

Question 20

terazosin [Hytrin] is exreted in

Answer 20

the bile and urine

Question 21

terazosin [Hytrin] adverse effects

Answer 21

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• headache
• “first dose” effect

Question 22

Doxazosin [Cardura] is a selective competitive inhibitor of __________ receptors

Answer 22

alpha1 adrenergic receptors

Question 23

Doxazosin [Cardura] is used as a treatment for

Answer 23

hypertension and BPH

Question 24

Doxazosin [Cardura] is administered

Answer 24

orally

Question 25

Doxazosin [Cardura] peak effects develop

Answer 25

2-3 hours

Question 26

Doxazosin [Cardura] half life

Answer 26

22 hours

Question 27

Doxazosin [Cardura] is secreted in the

Answer 27

bile

Question 28

Doxazosin [Cardura] adverse effects

Answer 28

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• ” first dose” effect

Question 29

Tamsulosin [flomax] casues the selective blockade of ______ receptors

Answer 29

alpha1 receptors of smooth muscle of the bladder

Question 30

Tamsulosin [flomax] is approved for

Answer 30

BPH

Question 31

Tamsulosin [flomax] adverse effects

Answer 31

• headache
• dizziness
• abnormal ejaculation
• rhinitis

Question 32

Tamsulosin [flomax] drug interactions

Answer 32

• cimetidine
• hypotensive drugs and phosphodiesterase type 5 inhibitors

Question 33

Tamsulosin [flomax] is administered

Answer 33

CR tablet/SR capsule

Question 34

Phentolamine [Regitine] blocks which receptors

Answer 34

alpha2 and alpha1

Question 35

Phentolamine [Regitine] approved applications

Answer 35

• treatment of pheochromocytoma
• prevention of tissue necrosis after extravastion of drugs
• reversal of soft tissue anesthesia

Question 36

Phentolamine [Regitine] adverse effects

Answer 36

• orthostatic hypotension
• reflex tachycardia
• nasal congestion
• inhibition of ejaculation
• contraindicted in patients with angina pectoris and myocardial infarction
• profound hypotension

Question 37

how do you treat profound hypotension caused by Phentolamine [Regitine]

Answer 37

norepinephrine

Question 38

Beta-Adrenergic Antagonists

Answer 38

propranolol [Inderal]

Question 39

propranolol [Inderal] therapeutic applications

Answer 39

• angina pectoris
• hypertension
• cardiac dysrhythmias
• myocardial infraction (MI)
• heart failure
• hyperthyrodism
• migraine prophyaxis
• stage fright
• pheochromocytoma
• glaucoma

Question 40

what drugs are considered standard therapy for heart failure

Answer 40

• carvedilol
• bisoprolol
• metoprolol

Question 41

adverse effects of beta1 blockade

Answer 41

• bradycardia
• reduced cardiac output
• precipitation of the heart
• AV heart block
• rebound cardiac excitation

Question 42

what are the early signs of heart failure

Answer 42

• shortness of breath, night coughs, swelling of the extremities

Question 43

Adverse effects of beta2 blockade

Answer 43

• bronchoconstriction
• hypoglycemia from inhibition of glycogenolysis