Nonselective Beta blockers Flashcards
partial beta antagonists used in the presence of a full agonist act as
antagonists
inverse agonists
metoprolol and betaxolol
beta blockers
reduce blood pressure
reduce renin release from kidney
blockage of B2 in skeletal muscle blood vessels
inhibits relaxation –> increased peripheral vascular resistance INITIALLY. returns to normal
pheochromocytoma (increased epi) + beta blocker
requires ADDITION OF AN ALPHA BLOCKER
respiratory effects of blocking B2
bronchoconstriction
avoid beta blockers in
patients with asthma, COPD
you have to give a beta blocker (even topically for glaucoma) to a patient with asthma, which are the best options?
B1 selective blockers (atenolol, metoprolol) or drugs with intrinsic sympathetic activity
glaucoma is treated with beta blockers because
they reduce intraocular pressure by decreasing production of aqueous humor. DOC
blocks both B1 and B2 receptors, often used to treat glaucoma
timololol
better glaucoma tx in asthmatics as its B1 selective
betaxolol
normally, decreased glycogenolysis and gluconeogenesis by beta blockers is easily reversed by
glucagon response
beta blockers can cause hypoglycemia in T1DM because
glucagon response is impaired and hypoglycemia symptoms are masked
T1DM who needs a beta blocker should receive _______ because ______
B1 selective blocker
blockage of glycogenolysis is mediated by B2 receptors
bad lipid effects with beta blockers
due to inhibition of lipolysis by blocking B3 receptors more specific (B1, intrinsic activity) will cause less
contraindicated beta blockers for glaucoma
have local anesthetic activity –> anesthetize cornea, increasing likelihood of scratches
local anesthetic activity of beta blockers is mediated by
membrane stabilizing action through blockage of sodium channels
beta blockers with local anesthetic activity
PPALM Pindolol Propranolol Acebutolol Labetolol Metoprolol
propranolol acts on
B1 and B2
drug which may suppress ventricular arrhythmias
propranolol
side effects of propranolol
gets into CNS –> sedation, depression
propranolol metabolism is decreased by
liver disease
propranolol uses for CV system
- decreased BP
- decreased mortality from MI/CHF
- treat angina
- treat arrhythmia
- treat obstructive cardiomyopathy
other random propranolol uses
- prevent migraine
- hyperthyroidism (causes tachycardia)
- reduce tremor, stage fright
- reduce risk of bleeding in patients with cirrhosis
usually beta blockers help CHF mortality, but in these situations could killa ya
late stage CHF
MI
cardiomegaly
abrupt discontinuation of beta blockers can cause
cardiac arrhythmia due to up regulation of B receptors
drugs that inhibit the metabolism of propranolol
cimetidine
chlopromazine
drugs that increase the metabolism of propranolol
will make it less effective
barbiturates
phenytoin
rifampin
smoking
beta blocker who’s systemic use won’t cause sedation bc it doesn’t enter CNS
nadolol
also okay for glaucoma
beta blocker which blocks potassium channels and has antiarrhythmic activity
sotalol
