Pharm 10.1

Question 1

irreversible alpha antagonists

Answer 1

phenoxybenzamine

Question 2

reversible non selective alpha antagonists

Answer 2

phentolamine, ergotamine, tolazoline

Question 3

reversible selective alpha 1 antagonist

Answer 3

prazosin, terazosin, doxazosin, tamsulosin

Question 4

reversible selective alpha 2 antagonist

Answer 4

yohimbine

Question 5

nonselective beta blockers without sympathomimetic activity

Answer 5

propranolol, timolol, sotalol, nadolol

Question 6

nonselective beta blockers with sympathomimmetic activity

Answer 6

acebutolol, pindolol

Question 7

nonselective beta blockers with alpha blocking property

Answer 7

labetalol, carvedilol

Question 8

selective (caridoselective) beta 1 blocker

Answer 8

atenolol, acebutolol?, esmolol, metoprolol

Question 9

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

Answer 9

Nevibolol

Question 10

selective beta 2 blocker

Answer 10

butoxamine

Question 11

alpha blockers on TPR

Answer 11

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

Question 12

alpha blockers on postural reflex

Answer 12

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

Question 13

Dale’s vasomotor reversal

Answer 13

epinephrine reversal

Question 14

alpha blockers on trigone and sphincter

Answer 14

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

Question 15

alpha blockers on nasal stuffiness

Answer 15

dialates vessles so helps with nasla stuffines and miosis?

Question 16

alpha blockers on intestinal motility

Answer 16

increase intestinal motility leading to diarrhea

Question 17

alpha blockers on ejaculation

Answer 17

failure of ejaculation

Question 18

Phenoxybenzamine

Answer 18

noncompetitive irreversible nonselective alpha blocker

Question 19

Phenoxybenzamine actions

Answer 19

prevents vasoconstriction, causes inc reflex tachycardia

Question 20

Phenoxybenzamine is used in

Answer 20

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

Question 21

Epinephrine reversal –> vasomotor reversal of Dale

Answer 21

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)

Question 22

Phentolamine

Answer 22

competitive reversible nonselective alpha blocker

Question 23

Phentolamine causes

Answer 23

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

Question 24

Phentolamine duration of action

Answer 24

4 hours ( on the shorter side)

Question 25

Phentolamine adverse effects

Answer 25

can trigger arrhythmias and anginal pain

Question 26

Phentolamine is contraindicated in

Answer 26

patients with decreased corronary perfusion

Question 27

therapeutic uses of alpha blockers

Answer 27

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

Question 28

adverse effects of alpha blockers

Answer 28

postural hypotension, nasal stuffiness, inhibition of ejaculation, tachycardia

Question 29

contraindications of alpha blockers

Answer 29

decreased coronary perfusion

Question 30

alpha 1 selective blockers

Answer 30

prazosin, terazosin, doxazosin (long acting), Tamsulosin

Question 31

Tamsulosin and Silodosin unique bc

Answer 31

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

Question 32

prazosin duration of action

Answer 32

6 hrs

Question 33

terazosin duration of action

Answer 33

20 hrs

Question 34

doxazosin duration of action

Answer 34

30 hrs

Question 35

alpha 1 blockers are used as

Answer 35

antihypertensive agents, in BPH

Question 36

adverse effects of alpha 1 blockers

Answer 36

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

Question 37

first dose effect

Answer 37

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

Question 38

adverse drug interactions with alpha 1 blockers

Answer 38

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

Question 39

selective alpha 2 blockade

Answer 39

yohimbine, mirtazapine

Question 40

yohimbine

Answer 40

selective competitive alpha 2 blocker

Question 41

Yohimbine and sex

Answer 41

yohimbine is a sexual stimulant (aphrodisiac)

Question 42

Yohimbine use

Answer 42

postural hypotension and sexual impotence --- but no clinical utility

Question 43

Mirtazapine

Answer 43

antidepressant in pts with alzheimers

Question 44

alpha blockers are used in

Answer 44

pheochromocytoma, hypertension, BPH, and Raynaud's disease