Combined Alpha- and Beta- Agonists and Antagonists Flashcards
1
Q
Carvedilol
Indications and MOA
A
- used for HTN, HF with reduced EF, left ventricular dysfunction following MI
- MOA: nonselective beta receptor blockade and alpha-1 receptor blockade; thereby, decreases BP and peripheral resistance; these combined effects decrease myocardial oxygen demand and lower cardiac workload
2
Q
Carvedilol
Caution and Contraindications
A
- do not abruptly withdraw
- avoid in patients with bronchospasm
- avoid in severe hepatic impairment
- avoid in patients with 2nd or 3rd degree AV block
- avoid in patients with NYHA Class IV HF
- caution in diabetic patients
- caution in HLD
- other agents preferred in pregnancy and lactation
- initiated by cardiologists in pediatrics
- use caution in elderly patients because of orthostatic hypotension
3
Q
Carvedilol
Adverse Drug Effects
A
- hypotension, dizziness, fatigue, weight gain, hyperglycemia, headache, n/v, impotence
- anaphylactic reactions (rare)
4
Q
Labetalol
Indications and MOA
A
- used in HTN, including severe acute
- MOA: nonselective beta receptor blockade and alpha-1 receptor blockade thereby decrease BP and peripheral resistance; these combined effects decrease myocardial oxygen demand and lower cardiac workload
5
Q
Labetalol
Caution and Contraindications
A
- do not abruptly withdraw
- avoid in patients with bronchospasm
- avoid in severe hepatic impairment
- avoid in patient with 2nd or 3rd degree AV block
- avoid in patients with NYHA Class IV HF
- caution in peripheral vascular disease
- caution in diabetic patients
- caution in HLD
- compatible in pregnancy after the first trimester
- caution in lactation
- limited data available in pediatrics
6
Q
Epinephrine
Indications and MOA
A
- used for emergency treatment of type 1 allergic reaction, including anaphylaxis
- MOA: decreases vasodilation and vascular permeability that occur during anaphylaxis; it relaxes smooth muscles, relieves bronchospasm, wheezing, dyspnea, pruritus, angioedema, and urticaria
7
Q
Epinephrine
Caution and contraindications
A
- caution in cardiac disease
- compatible in pregnancy and lactation
- approved in pediatrics
8
Q
Epinephrine
Adverse Drug Effects
A
- apprehensiveness, tremors, anxiety, weakness, headache, palpitations, angina, alterations in blood sugar, disorientation, HTN