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Pharmacology I > Lecture 16 - Adrenergic blocking agents > Flashcards

Lecture 16 - Adrenergic blocking agents Flashcards

1
Q

What are the alpha-receptor blockers? (two)

A

Phentolamine

Phenoxybenzamine

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2
Q

What are the Alpha1 blockers? (one)

A

Prazosin

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3
Q

What is the alpha2 blocker?

A

Yohimbine

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4
Q

What are the beta blockers? (three)

A

Propranolol
Timolol
Sotalol

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5
Q

What are the beta1 blockers?

A

Metoprolol

Atenolol

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6
Q

What is the general distribution of alpha receptors?

A

Blood vessels

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7
Q

What does alpha 1 cause?

A

Mydriasis
Vasoconstriction
Contraction of genitourinary muscle
Ejaculation

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8
Q

What does alpha2 cause?

A

decrease NE release

Suppress insulin secretion

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9
Q

What does alpha blockade do you cardiovascular system?

A

Decrease peripheral resistance = Decrease D pressure
= decrease BP
Decrease venous return = othrostatic hypotension

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10
Q

What does alpha blockade do to the eyes?

A

Miosis (via lack of radial muscle stimulation)

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11
Q

What happens to the nasal passages with alpha blockade?

A

Nasal congestion due to decreased vasoconstriction

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12
Q

What happens to urinary flow with alpha blockade?

A

urine flow increases

Base of bladder + urinary sphincter + prostate relax

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13
Q

What happens to sexual reproduction with alpha blockade?

A

Ejaculation inhibited

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14
Q

What do alpha2 blocking agents do?

A

Increase NE release

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15
Q

What is the basic distribution of beta receptors?

A

Heart

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16
Q

What does the B1 receptor do? (two things)

A

Increase heart rate and force

Increase renin secretion

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17
Q

What does B2 stimulation cause? (four things)

A

Relax bronchioles
Dilate BV supplying skeletal muscles
Increase glycogenolysis
Increase aqueous humor + intraocular pressure

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18
Q

What does B2 stimulation cause?

A

Lipolysis

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19
Q

What are the basic three things that occur with beta blockade in the heart and kidney ?

A

Decrease in HR and force
Decrease in CO and O2 demand
Decrease in renin secretion

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20
Q

What will happen overtime with beta blockade?

A

Decrease in BP in patients with hypertension

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21
Q

What does beta blockade cause with metabolism?

A

Decrease glycogenolysis + lipolysis

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22
Q

What is the behavior of a competitive antagonist?

A

If enough agonist is present can reach Emax

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23
Q

What is the behavior of a non-competitive antagonist?

A

Emax is lowered, no matter the concentration of the agonist

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24
Q

What are the competitive, reversible alpha antagonists?

A

Phentolamine + Prazosin

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25
Q

What is the irreversible, non-competitive alpha antagonists?

A

Phenyoxybenzamine

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26
Q

What are the six major things that occur with alpha blockade?

A 
Reduced vasoconstriction 
Reflex tachycardia 
Miosis 
Nasal stuffiness 
Decreased resistance to urinary flow 
Inhibition of ejaculation
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27
Q

What occurs once vasoconstriction is reversed with an alpha blocker?

A

Baroreceptors sense decrease in BP and increase SNS output

28
Q

Why does reflex tachycardia occur with an alpha blocker?

A

Decreased BP
Stimulates baroreceptors = increase NE release
NE –> Beta = Increased HR

29
Q

What happens when you block the alpha effects of epinephrine?

A

Drop in BP due to lack of vasocontriction

Heart rate increase

30
Q

What receptors does phentolamine target?

A

Alphas

31
Q

What does phentolamine do?

A

Decrease diastolic BP + Peripheral resistance

Reflex tachycardia

32
Q

What are the side effects of phentolamine?

A

Tachycardia + Arrythmia + Myocardial ischemia + Hypotension

33
Q

When is phentolamine used?

A

Hypertensive crisis from pheochromocytoma or MAO inhibitors

Prevents necrosis after accidental injection of alpha agonist

34
Q

What are the side effects of phenoxybenzamine?

A

Postural hypotension + Tachycardia

Nasal congestion + no ejaculation

35
Q

When is phenoxybenzamine used?

A

NE/EPI levels are too high and can overcome the effects of a drug that was a competitive agonist

36
Q

When is phenoxybenzamine used?

A

Small animals with detrusor areflexia

37
Q

What is a pheochromocytoma?

A

Adrenal neoplams that secretes NE/EPI

38
Q

What is the treatment of a pheochromocytoma?

A

treat with phenoxybenzamine then surgery

39
Q

What is a sign there is a pheochromocytoma?

A

Sudden onset of severe hypertension + tachycardia + arrhythmia

40
Q

What do you test for in the urine to see if a pheochromocytoma is a possibility?

A

VMA

41
Q

What does prazosin target?

A

Alpha 1

42
Q

What does prazosin do?

A

Relax arterial + venous SM = decreased peripheral resistance

Decrease venous return = decrease preload

43
Q

What is an upside to using prazosin?

A

no alpha2 so less tachycardia

44
Q

What are side effects of prazosin?

A

Dizziness + Lethargy

45
Q

When is prazosin used?

A

CHF

Functional urethral obstruction

46
Q

What does yohimbine target?

A

Alpha2

47
Q

What does Yohimbine do?

A

Increase NE release = increase BP and HR

Increased motor activity

48
Q

What is a side effect of yohimbine?

A

tremors

49
Q

What can yohimbine be used for in animals?

A

Reverse effects of xylazine

50
Q

What does beta blockade cause in the lungs?

A

Bronchoconstriction

51
Q

Where should you never use a beta blocker?

A

Horses with RAO

52
Q

What does a B blocker do in the eye?

A

Decrease formation or aqueous humor

53
Q

What does chronic use of a beta blocker do in regards to metabolism?

A

increase VLDL + decrease HDL

54
Q

What beta blockers have the ability to be a local anesthetic?

A

Proranolol + Metoprolol

55
Q

How does metoprolol + propranolol have local anesthetic capabilities?

A

Membrane stabilizing via sodium channel blockade

56
Q

What are the effects of propranolol?

A

Decrease HR + Contractility

Decrease renin + lipolysis + glycogenolysis

57
Q

What are the pharmokinetic characteristics of propranolol?

A

Low bioavalibility

Lipid soluble = CNS activity = sedation

58
Q

What is the major side effect of propranolol?

A

Bronchoconstriction

59
Q

What is another medication similar to proprananol?

A

Timolol

60
Q

How does timolol differ from proprananol?

A

No local anesthetic affect

= can be used in eye

61
Q

What other symptoms are seen with proprananol use?

A 
Bradycardia 
Increase symptoms seen with CHF 
Lethargy 
Decrease excercise tolerance (B2 blockade, muscles sad)
Increase glucose levels
62
Q

What happens with abrupt discontinuation of propranaol

A

Tachycardia + Arrhythmia

63
Q

What are your two Beta1 selective blockers?

A

Metoprolol + Atenolol

64
Q

What is the effect of metoprolol + atenolol?

A 
Heart mostly 
Decrease HR + Contractility 
Decreased O2 demand 
Decreased renin secretion 
= DECREASE BP
65
Q

What is metoprolol + atenolol used for?

A

Hypertension + Tachycardia + Arrhythmia

Pharmacology I (21 decks)

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