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Pharmacology > Pharm 10.1 > Flashcards

Pharm 10.1 Flashcards

1
Q

irreversible alpha antagonists

A

phenoxybenzamine

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2
Q

reversible non selective alpha antagonists

A

phentolamine, ergotamine, tolazoline

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3
Q

reversible selective alpha 1 antagonist

A

prazosin, terazosin, doxazosin, tamsulosin

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4
Q

reversible selective alpha 2 antagonist

A

yohimbine

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5
Q

nonselective beta blockers without sympathomimetic activity

A

propranolol, timolol, sotalol, nadolol

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6
Q

nonselective beta blockers with sympathomimmetic activity

A

acebutolol, pindolol

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7
Q

nonselective beta blockers with alpha blocking property

A

labetalol, carvedilol

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8
Q

selective (caridoselective) beta 1 blocker

A

atenolol, acebutolol?, esmolol, metoprolol

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9
Q

selective (caridoselective) beta 1 blocker with additional actions (NO)

A

Nevibolol

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10
Q

selective beta 2 blocker

A

butoxamine

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11
Q

alpha blockers on TPR

A

dec TPR by blocking vasoconstriction causing hypotention –> reflex tachycardia due to fall in BP along with salt and water retention

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12
Q

alpha blockers on postural reflex

A

blocking vasoconstricion interferes with postrual reflex leading to postrual hypotention. First dose hypertention. - can cause falls and fractures

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13
Q

Dale’s vasomotor reversal

A

epinephrine reversal

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14
Q

alpha blockers on trigone and sphincter

A

relaxation of trigone and sphincter muscles in base of urinary bladder and prostate –> dec resistance to urinary outflow

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15
Q

alpha blockers on nasal stuffiness

A

dialates vessles so helps with nasla stuffines and miosis?

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16
Q

alpha blockers on intestinal motility

A

increase intestinal motility leading to diarrhea

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17
Q

alpha blockers on ejaculation

A

failure of ejaculation

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18
Q

Phenoxybenzamine

A

noncompetitive irreversible nonselective alpha blocker

19
Q

Phenoxybenzamine actions

A

prevents vasoconstriction, causes inc reflex tachycardia

20
Q

Phenoxybenzamine is used in

A

Pheochromocytoma (prior to surgical removal, to preclude hypertensive crisis)

21
Q

Epinephrine reversal –> vasomotor reversal of Dale

A

Epinephrine when given in high dose, increases the blood pressure (vasopressor effect) by acting on the alpha 1 receptors. Epinephrine has effect on beta 2 receptors also (at low doses epinephrine stimulates only beta 2 predominantly). So, when alpha 1 blockers are given before epinephrine (high dose), it will not be able to act on alpha 1 receptor and won’t exhibit vasopressor effect, instead epinephrine will casues drop in BP (vasodepressor effect)

22
Q

Phentolamine

A

competitive reversible nonselective alpha blocker

23
Q

Phentolamine causes

A

reflex tachycardia (lasts >24hrs) , postural hypotension and epinephrine reversal

24
Q

Phentolamine duration of action

A

4 hours ( on the shorter side)

25
Q

Phentolamine adverse effects

A

can trigger arrhythmias and anginal pain

26
Q

Phentolamine is contraindicated in

A

patients with decreased corronary perfusion

27
Q

therapeutic uses of alpha blockers

A

Raynaud’s disease (cold induced vasoconstriction is reversed), opposing catecholamine actions in Pheochromocytoma (nonselective long acting, for 2-3 weeks prior to surgery)

28
Q

adverse effects of alpha blockers

A

postural hypotension, nasal stuffiness, inhibition of ejaculation, tachycardia

29
Q

contraindications of alpha blockers

A

decreased coronary perfusion

30
Q

alpha 1 selective blockers

A

prazosin, terazosin, doxazosin (long acting), Tamsulosin

31
Q

Tamsulosin and Silodosin unique bc

A

its an alpha 1 A antagonists and works more on the bladder than on systemic vessels –> especially helps urine flow in BPH

32
Q

prazosin duration of action

A

6 hrs

33
Q

terazosin duration of action

A

20 hrs

34
Q

doxazosin duration of action

A

30 hrs

35
Q

alpha 1 blockers are used as

A

antihypertensive agents, in BPH

36
Q

adverse effects of alpha 1 blockers

A

first dose effect, orthostatic postural hypotension, headache, dizziness, reflex tachycardia, nasal stuffiness

37
Q

first dose effect

A

syncope (fainting) - a greater hypotensive effect is seen when administerd the first time - may be minimized by lowering the first dose and giving it at bed time

38
Q

adverse drug interactions with alpha 1 blockers

A

ACEI (like enalapril) or Ca channel blockers (like Nifedipine) —> angII and alpha 1 blockers share a signal transduction path involving DAG, IP2 and CA, which are blocked by the combinations –>receptor crosstalk inhibition

39
Q

selective alpha 2 blockade

A

yohimbine, mirtazapine

40
Q

yohimbine

A

selective competitive alpha 2 blocker

41
Q

Yohimbine and sex

A

yohimbine is a sexual stimulant (aphrodisiac)

42
Q

Yohimbine use

A

postural hypotension and sexual impotence — but no clinical utility

43
Q

Mirtazapine

A

antidepressant in pts with alzheimers

44
Q

alpha blockers are used in

A

pheochromocytoma, hypertension, BPH, and Raynaud’s disease

Pharmacology (15 decks)

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