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Pharmacology > Pharm 10.2 > Flashcards

Pharm 10.2 Flashcards

1
Q

selective Beta 1 blockers

A

Acebutolol, atenolol, metoprolol

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2
Q

betablockers - ISA - intrinsic sympathomimmetic activity

A

Acebutolol, Pindolol

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3
Q

beta blockers with sedation effects

A

most except Atenolol

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4
Q

beta blockers that increase blood lipids

A

most except Acebutolol and Pindolol

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5
Q

Propanolol administration

A

oral is well absorbed, undergoes extensive first pass metabolism

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6
Q

Propanolol and BBB

A

Propranolol is lipophilic so it inters the BBB

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7
Q

Propanolol excretion

A

excreted in urine as glucuronide metabolites

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8
Q

nonselective beta blockers on inotropy

A

dec force of contration - negative inotropy

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9
Q

nonselective beta blockers on chronotropy

A

dec rate of contraction - negative chronotropy

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10
Q

nonselective beta blockers on SA and AV nodes

A

supress SA and AV nodal activity – bradycardia

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11
Q

overall effect of beta blockers on the heart

A

dec heartrate, SV, and CO, decBP in hypertensiv ppl –>reflex peripheral vasoconstriction

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12
Q

Why is Propranolol useful in angina

A

dec cardiac work so dec O2 consumption

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13
Q

Propranolol on blood vessels

A

blocks B2 mediate vasodialation

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14
Q

nonselective beta blockers and BP

A

does not dec BP in normal ppl, but decreases BP in hypertensive ppl (both systolic and diastolic)

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15
Q

nonselective beta blockers and postural hypotension

A

no postural hypotension because no effect on alpha 1 adrenergic receptors

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16
Q

Propranolol and the Kidney

A

decrease renin release from kidney (beta 1 action) – very useful property in reducing compensatory BP elevation

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17
Q

beta blockers are often combined with

A

a diuretic in treatment of HTN

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18
Q

Propranolol and respiratory tract

A

bronchoconstriction and can precipitate bronchial asthma (Beta 2 action)

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19
Q

Beta 2 blocker contraindications

A

bronchial asthma

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20
Q

beta blockers and the eyes

A

dec IOT due to inc aqueous humor production

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21
Q

Propranolol and the CNS

A

sedation, lethargy, depression, forgetfulness, sleep disturbances (dreams and nightmares) worse in lipophilic agents

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22
Q

Propranolol and skeletal muscle

A

antaganizes the epinephrine induced tremmors (muscle spindle controling tremors is under beta 2 control)

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23
Q

Propranolol metabolic effects

A

blocks epinephrine induced glycogenolysis –> fasting hypoglycemia; decrease insuline release (beta 2 block) after meal causing hyperglycemia

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24
Q

why should propranolol be used with caution in diabetics

A

bc it masks the warning sympathetic signes and symptoms such as swating, palpitations (tachycardia) induced by hypoglycemia

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25
Q

what is a warning sign of hypoglycemia

A

tachycardia –this is masked by beta blockers

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26
Q

therapeutic uses of Propranolol

A

hypertension, Angina (except Prinzmetal’s angina), MI (prophylactic use post-MI), Cardiac arrhythmias (Class II: Propranolol, Acebutolol, Esmolol), Migraine (prophylactically), Hyperthyroidism, Pheochromocytoma, Performance anxiety, Essential tremors, Glaucoma (Timolol), CHF, Hypertrophic cardiomyopathy, marfan syndrome and aneurysms

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27
Q

Beta blockers and hyperthyroidism

A

chance of thyroid storm increases during surgical removal of theyroid so betablockers beore surgery is desirable

28
Q

CHF and beta blockers

A

dec sympathetic discharge and NE release dec CHF mortality

29
Q

hypertrophic cardiomyopathy and betablockers

A

dec syncope, arrhythmias, and sudden death

30
Q

Marfan syndrome and aneurysms and betablockers

A

alone or combined with ACEI/ARB dec aneurismal dialation by dec TGFbeta activity

31
Q

beta blocker adverse CVS effects

A

bradycardia, AV block, abrupt discontinuation of propranolol can precipitate angina, arrhythmia, and hypertension —should be withdrwan gradually after long term use

32
Q

beta blockers adverse respiratory effects

A

causes bronchoconstriction, should not be used in asthmatic and COPD patients

33
Q

beta blockers adverse metabolic effects

A

fasting hypoglycemia, increases blood lipid levels (LDLs and TGs)

34
Q

beta blockers and other adverse effects

A

sexual dysfunction, fatigue and exercise intolerance

35
Q

betablockers are contraindicated in

A

asthmatics, COPD, diabetics, Raynaud’s disease, Prinzmetal angina

36
Q

beta blockers with Digitalis and verapamil

A

additive depression of SA and AV node –> cardiac arrest

37
Q

beta blockers and insuline/oral hypoglycemics

A

aggravate hypglycemic effects, mask warning signes (tremor and tachycardia)

38
Q

betablockers and indomethacin and other NSAIDs

A

annul antihypertensive actions of betablockers

39
Q

betablockers and cimetidine

A

inhibits metabolism of Propranolol

40
Q

Timolol

A

potent nonselective betablocker, reduces the production of aqueous humor in the eye and hence used topically for the treatment of chronic open-angle glaucoma

41
Q

nadolol

A

very long duration, same actions as propranolol (nonselective)

42
Q

selective beta 1 antagonists

A

acebutolol, atenolol, esmolol, metoprolol

43
Q

selective beta 1 antagonists can be used

A

in hypertensive patients with asthma and COPD bc they do not cause bronchoconstriction at therapeutic doses

44
Q

selective beta 1 antagonists actions

A

decrease BP in hypertensive pts, inc exercise tolerance in angina, no bronchoconstriction effect, no effect on PR, no effect on CHO metabolism

45
Q

therapeutic uses of beta 1 blockers

A

HTN (esp if they have pulm dysfuntion or diabetes), Angina, MI

46
Q

beta1 blocker adverse effects

A

bradycardia

47
Q

Atenolol

A

selective beta 1 blocker

48
Q

Atenolol properties

A

lower lipid solubility, less CNS entry, excreted unchanged in the urine

49
Q

Atenolol uses

A

HTN, Angina, MI

50
Q

Metoprolol administered

A

orally/ IV for HTN, Angina, MI

51
Q

Vasodialating beta blockers (less adverse effects)

A

labetalol, carvedilol, nevibolol, celiprolol

52
Q

labetalol

A

beta blocker with additional alpha 1 blockade

53
Q

carvedilol

A

nonselective beta blocker, alpha 1 blocker, ca-channel blocker, antioxidant

54
Q

carvedilol halflife

55
Q

Nevibolol

A

cardioselective, anti-oxidant, beta 3 sitmulation causing NO production (effective in black ppl)

56
Q

Celiprolol

A

Cardioselective, beta 1 blocker, beta 2 agonist, NO production

57
Q

betablocker responsivness and ethnicity

A

chinese>white>black

58
Q

American SNP asscociated with better survival in CHF patients treated with beta blockers

A

ADRB1gly389gly > ARDB1arg389gly

59
Q

Esmolol

A

shortest acting beta 1 blocker, IV administration to treat acute supraventricular tachycardia

60
Q

beta 1 blockers with ISA

A

pindolol, acebutolol

61
Q

beta1 blockers with ISA cause

A

less bradycardia (beta1) and slight vasodialation or bronchodialation (beta2), act partial agonists

62
Q

beta 1 blockers with ISA uses

A

HTN with moderate bradycardia in DM , CHO metabolism is less affected

63
Q

beta blocker with K+ channel block

A

sotalol - used as antiarrhythmic (class 3)

64
Q

alpha and beta blockers

A

labetalol, carvedilol

65
Q

actions of Labetalol and carvedilol

A

peripheral vasodialation dec BP – used in HTN emergency

66
Q

benefits of labetolol and carvedilol

A

does not cause reflex bradycardia

67
Q

cons of labetolol and carvedilol

A

same contraindications as nonselective beta blockers

Pharmacology (15 decks)

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