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Pharmacology 2 > E1- Adrenergic Blocking Agents > Flashcards

E1- Adrenergic Blocking Agents Flashcards

1
Q

What are possible effects of alpha blockers?

A 
Decrease BP
Reflex tachycardia
Miosis
Make it easier to urinate
Inhibit ejaculation
EPI reversal
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2
Q

What are possible effects of beta blockers?

A 
Decrease rate and force of contraction in the heart
Decrease O2 demand of heart
Decrease renin secretion
Cause bronchoconstriction
Decrease glycogenolysis and lipolysis
Inhibit insulin secretion
Decrease intraocular pressure
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3
Q

Why should beta blockers and EPI never be given to someone with pheochromocytoma without concomitant administration of an alpha blockers?

A

Beta blockers will inhibit the vasodilation caused by B2 receptors, increasing the pressor effect of EPI

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4
Q

What should not be used in they eye because they will anesthetize the cornea?

A

Beta blockers

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5
Q

What is the only noncompetitive irreversible alpha blocker?

A

Phenoxybenzamine

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6
Q

What type of antagonist shifts the dose-response curve to the right, but the maximum effect is the same?

A

Competitive

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7
Q

What type of antagonist shifts the dose-response curve to the right, and the maximum effect is diminished?

A

Non-competitive

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8
Q

What are the two drugs classified as non-selective alpha receptor blockers?

A

Phentolamine

Phenoxybenzamine

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9
Q

What is Phentolamine used for?

A

Rarely used for short-term tx of HTN crisis
-Pheochromocytoma
-Pts on MAOIs who ingest tyramine
-After abrupt withdrawal from clonidine
To prevent necrosis if vasoconstrictor like NE is accidentally injected into tissues

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10
Q

What are contraindications of Phentolamine?

A

Caution in pts with CAD

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11
Q

What are side effects of Phentolamine?

A

Hypotension
Tachycardia
Arrhythmias
MI

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12
Q

What is Phenoxybenzamine used for?

A

DOC for prevention of severe hypertension in pheochromocytoma before surgery

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13
Q

What are side effects of Phenoxybenzamine?

A

Orthostatic hypotension
Tachycardia
Inhibit ejaculation

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14
Q

What are the two drugs classified as selective alpha 1 receptor blockers?

A

Prazosin

Tamsulosin

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15
Q

What is Prazosin used for?

A

1st choice for men with BPH and HTN

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16
Q

What are contraindications for Prazosin?

A

Combination with ED drugs and nitrates can lead to severe HTN

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17
Q

What are side effects of Prazosin?

A

Orthostatic hypotension
- Dizziness
- “First dose phenomenon”
Tachycardia

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18
Q

What are the two drugs classified as non-selective beta receptor blockers?

A

Propranolol

Timolol

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19
Q

What is propranolol metabolized by?

A

P450s

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20
Q

What is propranolol used for?

A 
Post MI
Increase exercise tolerance in angina pts
Arrhythmias
Heart failure (early stages only)
Control hyperthyroidism sxs
Migraine prevention
Decrease catecholamine-induced tremor and stage fright
HTN (chronic use)
21
Q

What are contraindications of propranolol?

A

Acute HF, asthma, AV block, bradycardia, cardiogenic shock, pheochromocytoma

22
Q

In which pts should you caution propranolol use?

A

COPD

Diabetics

23
Q

What are side effects of propranolol?

A 
Bronchoconstriction in asthma and COPD
Exacerbate HF in late stages 
Bradycardia
Sedation/fatigue
Recovery from hypoglycemia more difficult/masks sxs
24
Q

What is Timolol used for?

A

Glaucoma

25
Q

In which pts should you caution Timolol use?

A

Athmatics

26
Q

What are the four drugs cardio-specific beta 1 receptor blockers?

A

Metoprolol
Betaxolol
Esmolol
Nebivolol

27
Q

What is the most selective beta 1 blocker/antagonist?

A

Nebivolol

28
Q

What is Metoprolol used for?

A 
Decrease rate and force of contraction of heart 
HTN
Post-MI
Angina
Heart failure
Migraine prophylaxis
29
Q

What are contraindications of Metoprolol?

A

Acute HF, AV block, bradycardia, cardiogenic shock, pheochromocytoma

30
Q

What medication is similar to Propranolol but has better exercise tolerance in angina and is safer in diabetics and asthmatics?

A

Metoprolol

31
Q

What are side effects of Metoprolol?

A

Dizziness, bradycardia, hypotension

32
Q

What is Betaxolol used for?

A

Glaucoma

33
Q

In which pts should you caution Betaxolol use?

A

Asthmatics

34
Q

What is Esmolol used for?

A

Used in critically ill pts where you don’t want the risk of lasting Beta blocker effects

Emergency situation where rapid effect is needed

35
Q

What is Nebivolol used for?

A

Direct vasodilation (release NO from endothelial cells)

36
Q

What are the two drugs classified as combined alpha 1 and beta blockers?

A

Carvedilol

Labetalol

37
Q

What is Carvedilol used for?

A

Vasodilation w/o reflex tachycardia
HTN
Heart failure (especially after MI)

38
Q

What are side effects of Carvedilol?

A

Orthostatic hypotension

Bronchoconstriction (don’t use in asthmatics)

39
Q

What is Labetalol used for?

A

Vasodilation w/o reflex tachycardia
Lower BP in HTN emergency
HTN in pregnancy

40
Q

What are side effects of Labetalol?

A

Orthostatic hypotension
Bronchoconstriction (don’t use in asthmatics)
Hepatotoxicity

41
Q

What is the order of glaucoma tx?

A
  1. Prostaglandin analogues – initial DOC
  2. Beta blockers
    •Timolol
    •Betaxolol
  3. Selective alpha 2 agonist
  4. Carbonic anhydrase inhibitors
  5. Cholinergic agonist
    •Pilocarpine (last choice b/c blurs vision)
42
Q

What are the main 4 responses to alpha blockade?

A
  • Decreased vasoconstriction
  • Reflex tachycardia
  • Orthostatic hypotension
  • Epinephrine reversal
43
Q

What is the DOC is pheochromocytoma?

A

Phenoxybenzamine

44
Q

What is the first dose phenomenon and what drug is it associated with?

A
  • Bad orthostatic hypotension and syncope 30-90 minutes after first dose
  • Associated with Prazosin
45
Q

What are the cardiovascular effects of B blockade?

A
  • Decreased chronotropy, inotropy, and dromotrpy
  • decreased renin
  • decreased O2 demand
  • Decreeased CO2
  • Decreaed BP when used chronically
46
Q

How does beta blockade affect the endocrine system?

A
  • inhibits glycogenolysis
  • inhibits insulin secretion
  • May cause hyperglycemia
47
Q

What are the CYP50 inactivating drugs that you shouldn’t give with propranolol?

A

Cimetidine and chlorpromazine

48
Q

What are the CYP450 inducers that you shouldn’t give with propranolol?

A

Barbiturates, phenytoin, and rifampin

Pharmacology 2 (12 decks)

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