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Naplex > Rx Files Beta Blockers > Flashcards

Rx Files Beta Blockers Flashcards

1
Q

Mechanism of action of BB

A

blockades effects of epinephrine and norepinephrine on beta adrenergic receptors

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2
Q

Beta 1 receptors act on the ______.

A

heart

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3
Q

Beta 2 receptors act on the _______.

A

lungs

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4
Q

Beta 1 blockade causes what?

A

negative chronotropy and inotropy which results in decreased HR and decreased BP

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5
Q

Beta 2 blockade causes what?

A

mild bronchoconstriction and vasoconstriction

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6
Q

What does intrinsic sympathomimetic activity mean?

A

beta blockers with some beta agonism

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7
Q

What does membrane-stabilizing activity mean?

A

inhibition of myocardial fast sodium channels

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8
Q

Potential detriment of membrane-stabilizing activity?

A

widen QRS complex –> potential for dysrhythmias

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9
Q

What BBs have ISA?

A
  • acebutolol
  • carteolol
  • labetalol
  • oxprenolol
  • penbutolol
  • pindolol
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10
Q

What BBs have MSA?

A
  • acebutolol
  • betaxolol
  • carvedilol
  • oxprenolol
  • propranolol
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11
Q

What BBs are lipophilic?

A
  • bisoprolol
  • carvedilol
  • labetalol
  • metoprolol
  • nebivolol
  • oxprenolol
  • penbutolol
  • pindolol
  • timolol
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12
Q

Which BBs are renally cleared?

A
  • atenolol
  • bisoprolol
  • carteolol
  • nadolol
  • sotalol
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13
Q

Which beta blockers have alpha 1 antagonism?

A
  • carvedilol

- labetalol

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14
Q

Which beta blockers have nitric oxide release?

A
  • bisoprolol
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15
Q

Which BBs are beta 1 selective?

A
  • acebutolol
  • atenolol
  • betaxolol
  • bisoprolol
  • esmolol
  • metoprolol
  • nebivolol
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16
Q

What are patient education points to make about BBs?

A
  • withdrawal of therapy must be done slowly due to receptor upregulation
  • caution in pulmonary disease (especially non-selective)
  • higher doses of EPI/NE needed for anaphylaxis
  • may mask signs of hypoglycemia
  • may worsen lipid panel
  • caution in HF (negative inotrope)
  • may cause depression, fatigue, and sexual dysfunction
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17
Q

Acebutolol brand

A

Sectral

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18
Q

Acebutolol is non/selective with what special properties?

A

selective
ISA and MSA
not lipophilic

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19
Q

Acebutolol indications

A
  • HTN

- ventricular arrhythmias

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20
Q

Acebutolol dosage

A

100 - 400 mg PO BID

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21
Q

How is acebutolol eliminated?

A

renal and hepatic

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22
Q

Atenolol brand

A

Tenormin

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23
Q

Atenolol is non/selective with what special properties?

A

selective

no ISA or MSA or lipophilicity

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24
Q

Atenolol indications

A
  • AMI
  • angina
  • HTN
  • migraine ppx
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25
Atenolol dosage
50 - 200 mg PO daily
26
How is atenolol eliminated?
renal
27
Bisoprolol brand
Zebeta
28
Bisoprolol is non/selective with what special properties?
selective | lipophilic
29
Bisoprolol indications
- HTN - migraine ppx - CHF - A.Fib ppx in cardiac surgery
30
Bisoprolol dosage
2.5 - 20 mg PO daily
31
How is bisoprolol eliminated?
renal and hepatic
32
Carvedilol brand
Coreg
33
Carvedilol is non/selective with what special properties?
nonselective alpha 1 blockade MSA lipophilic
34
Carvedilol indications
- HTN - CHF - portal HTN - A.fib
35
Carvedilol dosage
3.125 - 25 mg PO BID
36
How is carvedilol eliminated?
hepatic
37
How is Coreg CR dosed?
daily carvedilol dose x 1.6
38
Esmolol brand
Brevibloc
39
Esmolol non/selective with what special properties?
selective | no ISA, MSA, or lipophilicity
40
Esmolol indications
- intra/post-op HTN - A.fib - aortic dissection (DoC)
41
Esmolol dosage
50 - 300 mcg/kg/min
42
What dosage form is esmolol available in?
IV only
43
How is Esmolol eliminated?
plasma esterases
44
Labetalol brand
Normodyne | Trandate
45
Labetalol is non/selective with what special properties?
nonselective alpha 1 blockade ISA lipophilic
46
What dosage form is labetalol available in?
IV and PO
47
Labetalol indications
HTN HTN emergency and urgency cocaine overdose
48
Labetalol IV bolus dosage
10 - 80 mg IV q10min
49
Labetalol IV infusion dosage
not often used | 0.5 - 2 mg/min
50
Labetalol PO dosage
200 - 2400 mg/day divided in 2-3 doses
51
How is labetalol eliminated?
hepatic
52
Metoprolol brand
Lopressor | Toprolol XL
53
Metoprolol is non/selective with what special properties?
non selective | lipophilic
54
Metoprolol indications
- AMI - HTN - angina - migraine ppx - anxiety - A.fib ppx in cardiac surgery
55
Metoprolol IV bolus dosage
1.25 - 5 mg q2-5 min (max dose 15 mg IV)
56
Metoprolol tartrate dosage
6.25 - 100 mg BID-TID
57
Metoprolol succinate dosage
25 mg daily to 200 mg BID
58
How is Metoprolol eliminated?
hepatic
59
Metoprolol IR to XL dosing
daily IR dose x 0.77
60
Nadalol brand
Corgard
61
Nadalol is non/selective with what special properties?
nonselective
62
Nadalol indications
- angina - HTN - migraine ppx - portal HTN
63
Nadolol dosage
40 - 160 mg PO daily
64
How is nadolol eliminated?
hepatic
65
Nebivolol brand
Bystolic
66
Nebivolol is non/selective with what special properties?
selective stimulates NO release lipophilic
67
Nebivolol indications
- HTN | - migraine ppx
68
Nebivolol dosage
5 - 40 mg daily
69
How is Nebivolol eliminated
hepatic
70
Propranolol brand
Inderal
71
Propranolol is non/selective with what special properties?
nonselective | MSA
72
Propranolol indications
- angina - A. fib - tremor - HTN - Migraine ppx - pheochromocytoma - AMI - aggression - anxiety - thyroid storm - portal HTN - many others
73
Propranolol dosage
10 - 80mg PO BID-QID
74
How is propranolol eliminated?
hepatic
75
Sotalol brand
Betapace
76
Sotalol is non/selective with what special properties?
nonselective | independent antiarrhythmic activity
77
Sotalol indications
atrial and ventricular arrhythmias angina HTN
78
Sotalol dosage
80 - 160mg PO BID
79
Why must sotalol be started inpatient?
risk of Torsades de pointes
80
How is sotalol eliminated?
renal
81
Timolol brand
Betimol | Timoptic
82
Timolol is non/selective with what special properties?
nonselective
83
Timolol indications
- HTN - migraine ppx - ocular HTN - open-angle glaucoma - AMI - angina - anxiety
84
How is timolol eliminated?
hepatic and renal
85
alpha 1 blockers
Doxazosin (Cardura) Prazosin ( Minipres) Terazosin (Hytrin)
86
alpha 1a blockers (bladder specific)
Alfuzosin (Uroxatral) Silodosin (Rapaflo) Tamsulosin (Flomax)
87
alpha 2 agonists
Clonidine (catapres) | Dexmedetomidine ( Precedex)

Naplex (8 decks)

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