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CDM 1 Exam 1 > Hypertension - Lecture 2 ( A1 blocker, A2 agonist, Beta Blockers) > Flashcards

Hypertension - Lecture 2 ( A1 blocker, A2 agonist, Beta Blockers) Flashcards

1
Q

a1 stimulation results in….

A

vasoconstriction (reflex bradycardia)
Bladder sphincter contraction
Reduced Lipolysis

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2
Q

a2 stimulation results in….

A

decreased pre-synaptic NE release (reduced sympathetic outflow)

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3
Q

A1 blockers MOA

A

selectively block a1 receptors on smooth muscle cells of peripheral vasculature

Lowers BP via vasodilation, decrease PVR

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4
Q

Doxazosin (Cardura) Dose and Frequency

A

1-8mg, daily

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5
Q

Orthostasis…

A

when stand up BP drops but doesn’t go back up = dizziness

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6
Q

A1 Blockers Clinical considerations

A

No benefit in prevention of MI or CHD

“Last line”

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7
Q

A1 Blocker special considerations

A

2nd line agent in men with BPH

improves urine flow and decrease frequency with some drop in BP

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8
Q

ADE of A1 blocker

A 
Orthostatic hypotension
1st dose syncope
Dizziness
Reflex tachycardia
Peripheral Edema
Sexual Dysfunction
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9
Q

a2 agonist MOA

A

stimulate a2 presynaptic receptors in the brain

increase inhibitory neuron acitivty decrease sympathetic outflow

Lower BP primarily via decrease PVR

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10
Q

Clonidine (Catapress) Dose and Frequency

A

0.1-0.8 mg, BID

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11
Q

Clonidine (Catapress - TTS) Dose and Frequency

A

0.1-0.3 mg, Weekly

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12
Q

Benefits of TTS

A

decreased rebound HTP with abrupt withdrawal

reduces side effects

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13
Q

A2 agonist Clinical considerations

A

Not 1st line

Avoid in pt with HF

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14
Q

A2 agonist possible indications

A 
Resistant HTN (Clonidine)
Pregnancy (Methyldopa)
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15
Q

ADE of A2 agonist

A 
Significant CNS ADE
Orthostatic Hypertension
Dry mouth
Depression
Rebound HTN w/ abrupt stop
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16
Q

B1 Location

A

Heart

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17
Q

B2 Location

A

Lungs and Periphery

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18
Q

B1 receptor stimulation….

A

increase HR

increase Renin Secretion

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19
Q

B2 receptor stimulation…..

A

Smooth muscle relaxation
peripheral vasodilation
Skeletal muscle stimulation
Glycogenolysis & gluconeogenesis

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20
Q

Beta Blocker MOA

A

Competitively inhibit catecholamine NT at B1 and B2 receptor

reduce CO leading to decrease BP

21
Q

Non-selective Beta blockers

A

B1 and B2 activty

22
Q

Cardioselective Beta Blockers

A

B1 activity only

23
Q

Non-selective Beta Blockers MOA

A

antagonist at B1/B2 receptors

24
Q

Propranolol (Inderal) Dose and Frequency

A

160-480mg, BID

25
Q

Propranolol long-acting (Inderal LA) Dose and Frequency

A

80-320 mg, Daily

26
Q

Non-selective Beta Blockers Clinical Considerations

A

Avoid pt with reactive airway disease

27
Q

Non-selective Beta Blockers Clinical uses…

A 
Angina
Post MI CV event prevention
Atrial fibrillation/flutter
supraventriclar arrhythmias
migraine prophylaxis
Tremors
28
Q

Atenolol (Tenormin) Dose and Frequency

A

25-100, Daily

29
Q

Which Beta blocker should someone with asthma take?

A

B1 blocker

30
Q

Metoprolol Succinate (Toprol XL) Dose and Frequency

A

50-400mg, Daily or BID

31
Q

Metoprolol Tartrate (Lopressor) Dose and Frequency

A

50-200mg, BID

32
Q

B1 Selective Blockers Clinical indications

A 
Angina
Post MI CV event prevention
Atrial fibrillation/flutter
HF
migraine prophylaxis
33
Q

Carvedilol (Coreg) Dose and Frequency

A

6.25-50mg, BID

34
Q

Carvediolol (Coreg CR) Dose and Frequency

A

20-80mg, Daily

35
Q

Labetalol (Normodyne) Dose and Frequnecy

A

200-800mg,BID

36
Q

Mixed A1/Beta Blockers

A

Carvediolol

Labetalol

37
Q

Mixed A1/Beta Blockers Clinical Considerations

A

Carvedilol = mortality benefit in HF after stabilized

Labetalol = increased safety data in pregnancy, hypertensive emergency (IV)

38
Q

Are Beta Blockers 1st line for uncomplicated HTN?

A

no

39
Q

Who should use Beta Blockers?

A

pt with HTN plus compelling co-existing condition (HF, Post-MI, Angina)

40
Q

B1 selective blockers

A

Atenolol

Metoprolol

41
Q

Non-selective Beta Blockers

A

Propranolol

42
Q

Beta Blocker Clinical Considerations

A

abrupt discontinuation can cause rebound HTN
Can cause fatigue
ppl with Asthma should avoid (use cardioselective if have to)
caution use with COPD

43
Q

ADE Beta Blockers

A

Bronchspasm, worsen asthma

Cold hands, feet

Bradycardia

Fatigue

masked signs and symptoms of hypoglycemia except sweating

insomnia, sex dysfunction

44
Q

Beta Blocker contraindications

A

SA or AV node dysfunction
Decompensated HF
Severe bronchospastic disease

45
Q

Beta Blocker Drug interactions

A

Non-DHP CCBs

46
Q

what to monitor when on Beta Blockers

A

BP
HR
BG if have diabetes
Signs and symptoms of asthma/COPD

47
Q

What drug is Alpha-1 blocker?

A

Doxazosin

48
Q

What drug is Alpha-2 Agonist?

A

Clonidine

CDM 1 Exam 1 (14 decks)

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