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Cardiovascular > Sweatman Beta Blockers > Flashcards

Sweatman Beta Blockers Flashcards

1
Q

Name the Beta Blockers

A

Propanolol

–>all others end in -LOL…not gonna type them

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2
Q

Beta blocker sites of action

A

Heart directly

Juxtaglomerular apparatus in the kidney–>inhibiting renin release

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3
Q

Beta 1 and 2 receptors in the heart physiologically work to

A

accelerate SA node
accelerate ectopic pacemakers
increase contractility

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4
Q

Beta blockers in the heart have their effects by

A

preventing SA node and ectopic pacemaker acceleration

decreasing contractility of the myocardium

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5
Q

physiologic activation of blood vessel smooth muscle in skeletal muscle works by

A

acting on beta 2 receptors to vasodilate (relax vascular smooth muscle)

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6
Q

beta relax–>epi

A

alpha constrict–>norepi

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7
Q

how is renin released

A

there are beta 1 receptors on the JGA cells–> in the presence of beta 1 agonsits–> they release renin
*therefore beta blokers inhibit renin release

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8
Q

pretratment by a beta blocking agent doe not affect

A

rise in BP produced by NE

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9
Q

BP increases due to NE are primary

A

alpha adrenergic stimulation

*beta blocker has no effect on this–>no change in increase in blood ressure with pre tx of beta blocker and NE

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10
Q

effects of epinephrine in the context of beta blockers

A

no effect

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11
Q

effects of E in context of alpha blockers

A

decreased blood pressure

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12
Q

effects of Isoproterenol in presence of beta blockers–>

A

almost completeley diminished

*beta 2 blockage–> prevents skeletal muscle vasodilation–>therfore there is no reduciton in BP

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13
Q

beta 1 specificity

A

metoprolol, acebutolol, alprenolol, atenolol, betaxolol, celiprolol, esmolol, nebivolol

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14
Q

*NONSPECIFIC BETA BLOCKERS

beta1=beta2

A

propanolol, cartelol, penbutolol, pindalol, timolol

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15
Q

FIRST GEN BETA BLOCKERS

A

NON SPECIFIC
B1=B2
NPPPT

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16
Q

SECOND GEN BETA BLOCKERS

A

BETA 1 SELECTIVITY

*METOPROLOL

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17
Q

THIRD GEN>

NON-SPECIFIC WITH ADDITIONAL ACTIONS

A

CERTELOL, CARVEDILOL, LABETOLOL

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18
Q

THIRD GEN>

B1 SPECIFIC WITH ADDITONAL ACTIONS

A

betaxolol

nebivolol

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19
Q

worst half life 0.15

A

esmolol–> second gen

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20
Q

administration of esmolol

A

IV infusion because half life sucks

–>given to hospitalized pt.’s

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21
Q

drug used for close monitoring and hour by hour control

A

esmolol

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22
Q

membrane stabalizing activity

A

propanolol
acebutolol
cervedilol

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23
Q

class 1 antiarrythmic compounds

A

propanolol
acebutolol
cervedilol

24
Q

class 1 antiarrythmic agents work by

A

binding to and stabalizing fast CA channels in cardiac tissue–>prevent such rapid depolarization
*decreased slop of phase 0

25
Q

ISA=

A

intrinsic sympathomimetic activity

26
Q

beta blocking agents work mostly in

A

active heart

–>resting heart largely under PS control

27
Q

pts who need ISA drugs

A

profpound bradycardia–>negative entropy in the resting heart–> need sympathomimetic action

28
Q

which drugs have ISA

A

labetolol, pindolol, acebutolo

*partial agonist effect stimulating resting heart that gives relief from bradycardia

29
Q

nitric oxide production

A

cartelol

nebivolol

30
Q

b2 receptor antagonism

A

certelol

31
Q

alpha 1 receptor antagonism

A

cervedilol

lebetolol

32
Q

Ca2+ entry blockade

–>vasodilation of smooth muscle

A

cervedilol

betaxilol

33
Q

antioxidant activity

A

cervedilol

34
Q

NO is a potent

A

vasodilation agent

35
Q

when you give a beta blocker what happens

A

BP drops and the periphery (reflexively) vasocontstricts immediately after beginining a beta regimen

36
Q

will beta blockers reduce BP in a normotensive pt?

A

NO

but will in hypertensives

37
Q

most effective beta blocker in pt.’s with high renin in plasma

A

propanolol

38
Q

most effective in pt.’s with no renin plasma level

A

pindolol

39
Q

long term beta blockade=

A

fall in peripheral resistance–>after initial vasoconstriction
–>mech unknown

40
Q

adverse effects of beta blockers

A

–>CHF in the predisposed (relying in sympathetic stim to maintain cardiac
output
–>bradycardia, bradyaryhthmias–>AV heart block
–>changes in periph vasc. flow
–>abrupt cessation of therapy–> rapid increase in BP and angina=death

41
Q

off target pulmonary effects with beta blockers results from

A

blockade of bronchial beta 2 (usual bronchodilators

–>COPD and ASTHA rely on bronchodilatory effect during flares in order to BREAK–>relaxation of smooth muscle

42
Q

pt.’s with asthma or COPD cannot be put on

A

NON specific beta blockers (GEN 1)

43
Q

Pt.’s with asthma and COPD should be given

A

metoprolol, avoid if at all possible

->acebutolol, alprenolol, atenolol, betaxolol, celiprolol, esmolol, nebivolol

44
Q

asthma and on nonspecific beta blockade

A

life-threatening increase in airway resistance

45
Q

CV–>clinical uses of beta blockage

A 
HTN
Acute MI (beneficial when used post MI)
46
Q

NON CV clinical uses of beta blockade

A 
tremor
thryotoxicosis
anxiety
prophylaxis of migraines
preventing bleeding in esophageal vericies
treament of glaucoma
47
Q

Lipophillic beta blockers can cause

A

cns depression, intense dreams, mental disorders, fatigue,

48
Q

Off target glucose effects of beta blockade

A

hypoglycemia

masking tachycardia in warning sign of insulin induced hypoglycemia

49
Q

non specific beta blockers will cause

A

hypoglycemia–>b2 receptors usually stimulate hepatic glycogenolysis–>blockage lowers glycogenolysis and plasma glucose levels

50
Q

Blockage of beta 1 receptors in diabetics=

A

masks the tachycardia with serves as a warning sign for insulin induced
hyPOglycemia

*use cautiously

51
Q

lipid profile changes seen in beta blockers

A

> ISA’s or Beta 1 selectivity have less effect on trigs and HDL
both ISA and Beta1= reduce total cholesterol and LDL

52
Q

In general beta blocker cause what changes in lipid profile

A

little effect on LDL, increased Trigs, decreased HDL

53
Q

beta blocker toxicity-

A

most commonly in children accessing, suicidal attemps, accidental overdose

54
Q

symptoms of beta blocker overdose

A 
bradycardia
hypotension
arrhythmias
hypothermia
hyoglycemia
seizures-->lipophillic>hydrophillic
55
Q

lipophillic beta blockers that gain access to CNS

A

penbutolol high
propanolol high

mod–>CARVEDILOL, BETAXOLOL, timolol, metoprolol,

Cardiovascular (6 decks)

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