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Renal 2 Final - Pharm > Kruse - Sympathoplegic Agents > Flashcards

Kruse - Sympathoplegic Agents Flashcards

1
Q

When are sympathoplegic drugs most effective?

A

When used with a diuretic

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2
Q

B-adrenoreceptor antagonists are broken into 4 types

A

A. Non-selective = Non-ISA (intrinsic sympathomimetic activity) + ISA

B. B1 selective = non-ISA + ISA

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3
Q

Non-selective b-adrenoreceptor antagonists

Non-ISA = 4 of them (PCNT)

A

Propranolol
Carvedilol
Nodolol
Timolol

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4
Q

Non-selective b-adrenoreceptor antagonists

ISA = 4 of them (LCPP)

A

Labetolol
Cartelol
Penbutolol
Pindolol

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5
Q

B1-selective b-adrenoreceptor antagonists

ISA = 2 (AN)

A

Acebutaolol

Nebivolol

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6
Q

B1 selective b-adrenoreceptor antagonists

Non-ISA = 5 of them (MAEBB)

A 
Metoprolol
Atenolol
Esmolol
Bisoprolol
Betaxolol
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7
Q

B-adrenergic antagonists are called

A

B blockers

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8
Q

B-blockers are useful in preventing

A

Reflex tachycardia — results from tx with direct vasodilators in severe HTN

  • also help reduce mortality after MI + heart failure pts
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9
Q

B-blocker prototype is

A

Propranolol

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10
Q

MOA of propranolol

A

non selective non ISA b-blocker

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11
Q

What is the effect of B-blockers like propranolol?

A
  • decrease bp by decreasing CO
  • some can vasodilate, but dont cause HTN in healthy normotensive pts
  • blocking B1 receptors in kidney inhibits renin release
  • some have local anesthetic effect by blocking Na channels
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12
Q

All b-blockers are available orally, except

A

Esmolol

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13
Q

5 b-blockers avaialble via IV (parental prep) (AELMP)

A 
Atenolol
Esmolol
Labetalol
Metoprolol
Propranolol
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14
Q

Which 2 b-blockers readily cross BBB?

Why?

A

Propranolol
Penbutalol

Because they are lipophilic

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15
Q

Side Effects of B-blockers for asthmatics

A
  • blocking B2 receptors in bronchial smooth muscle = constrict ion

** there are no B1 selective agents that completely AVOID b2 receptors

  • benefits may outweight the risk for COPD patients if they have ischemic heart disease
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16
Q

Side effects of b-blcokers for diabetics

A
  • glycogenolysis inhibited by blocking B2 receptors = can mask hypoglycemia
  • use with caution for insulin-dependent iabetics

***benefits may outwieght costs in diabetics after MI

17
Q

Common side effect of b-blockers

A

Bradycardia
Fatigue
Sexual dysfxn
Depression

Chronic use = can lead to increased VLDL + decreased HDL = BAD!!
Sudden withdrawal can cause: rebound HTN, angina, MI

18
Q

B-blocker drug-drug interactions

A

heart block if combined with non-DHP CCBs (verapamil + dilitiazem) — which slow conduction

19
Q

Clinical uses of b-blockers

A 
HTN
Heart failure
Ischemic Heart disease
Cardiac Arrhythmias
Glaucoma
20
Q

B-blockers with B1 selectivity can be especially helpful for ppl with

A

Comorbid asthma
Diabetes
Peripheral vasc. Resistance

21
Q

B1 blockers with partial B2-agonist activity can be advantageious in patients with

A

Bradyarrhythmias or peripheral vasc. Disease

22
Q

Which two b-blockers are widely used for HTN

A

Metropolol + atenolol

23
Q

b-blockers will make ACUTE congestive heart failure better or worse?

A

Worse

24
Q

Which 4 b-blockers reduce mortality if used for Heart failure

(CBM)

A

Carvedilol
Bisoprolol
Metroprolol

25
Q

Which 3 b-blockers prolong survival after MI

TMP

A

Tiolol
Metropolol
Propranolol

26
Q

Which b-blockers help with glaucoma by decrease IOP (intraocular pressure)

A

Timolol
Betaxolol
Carteolol

**dont use drugs with local anesthetic action On the ey!!

27
Q

A1 blocker prototype? MOA?

Reversible or irreversible?

A

Prazosin

Reversible antagonist of a1 receptors

28
Q

Effect of a1 blockers?

A
  • prevent vasoconstriction of both arteries + veins
  • bp reduced by lowering peripheral vasc resistance
  • relax smooth muscle in prostate
  • retain Na + H20 if used without a diuretic
  • improves plasma lipid profiles (increased HDL) or no change
29
Q

Side effects of a1 blockers

A
  • well tolerated
  • orthostatic HTN
  • dizziness
  • palpitations
  • headache
  • less incidence of reflex tachycardia than non-selective a1 blockers because a2 receptor inhibition of NE release from nerve endings is not affected
30
Q

Clinical uses of b-blockers

A

Used in men with HTN + benign prostatic hyperplasia

31
Q

Centrally acting agents are

A

A2-agonists

32
Q

A2 agonist prototypes

CM

A

Clonidine

Methyldopa

33
Q

MOA of CENTRAL a2 agonists (clonidine + methyldopa)

A
  • Reduce sympathetic flow from vasomotor centers in brainstem
  • but still allow these centers to retain or increase sensitivity to baroreceptor control
  • clonidine and methyldopa have slight variation in hemodynamic effects
34
Q

Clinical use of CENTRAL a2 agonists

A

Methyldopa = HTN during pregnancy

Clonidine = lower bp by decreasing CO, decrease peripheral vasc resistance, and decrease HR + relaxation of capacitance vessels

35
Q

Side effects of clonidine

A

Sedation
Dry mouth
Depression
Sexual dysfxn

  • *transdermal prep has less sedation than oral intake
  • *abrupt withdrawal = life threatening HTN crisis
36
Q

Methyldopa effect?

A
  • lowers bp by decreasing PVR, reducing HR + CO

- analog of L-dopa which becomes NE

37
Q

Side effects of methyldopa

A

Sedation
Dry mouth
Lack of concentration
Sexual dysfxn

Renal 2 Final - Pharm (4 decks)

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