Sympatholytics

Question 1

What receptor action does clonidine have?

Answer 1

alpha 2 agonist

Question 2

What are the applications for clonidine?

Answer 2

HTN urgency (limited - does not increase renal blood flow), ADHD, Tourette’s.

Question 3

What are the sx of clonidine toxicity?

Answer 3

CNS depression, bradycardia, hypotension, respiratory depression, miosis.

Question 4

What receptor action does alpha-methyldopa have?

Answer 4

hypertension in pregnancy

Question 5

What are the sx of alpha-methyldopa toxicity?

Answer 5

Direct Combs + hemolysis, SLE-like syndrome

Question 6

What receptor action does phenoxybenzamine have?

Answer 6

Irreversible non-selective alpha-blocker.

Question 7

What are the applications for phenoxybenzamine?

Answer 7

pheochromocytoma - used preoperatively to prevent catecholamine hypertension crisis.

Question 8

What are the side effects of phenoxybenzamine?

Answer 8

orthostatic hypertension, reflex tachycardia

Question 9

What receptor action does phentolamine have?

Answer 9

Reversible nonselective alpha blocker.

Question 10

What are the applications for phentolamine?

Answer 10

Give to patients on MAOi who eat tyramine-rich foods.

Question 11

What are the side effects of phentolamine?

Answer 11

orthostatic hypertension, reflex tachycardia

Question 12

What receptor action does prazosin, terazosin, doxazosin and tamsulosin have?

Answer 12

Alpha 1 selective blocker.

Question 13

What are the applications for prazosin, terazosin, doxazosin and tamsulosin?

Answer 13

Urinary sx of BPH, PTSD (praz), HTN (except tamsulosin)

Question 14

What are the side effects of prazosin, terazosin, doxazosin and tamsulosin?

Answer 14

1st dose orthostatic hypotension, dizziness, headache

Question 15

What receptor action does mirtazapine have?

Answer 15

alpha 2 selective blocker

Question 16

What are the applications for mirtazapine?

Answer 16

depression

Question 17

What are the side effects of mirtazpine?

Answer 17

Sedation, inc serum cholesterol, inc appetite

Question 18

How do beta blockers treat angina pectoris?

Answer 18

Decrease heart rate and contractility, resulting in decreased oxygen consumption

Question 19

How do beta blockers treat MI?

Answer 19

Decrease mortality (decrease oxygen demand by decreasing heart rate and contractility)

Question 20

How do beta blockers treat SVT?

Answer 20

Metoprolol and esmolol decrease AV conduction velocity; class II anti-arrythmic

Question 21

How do beta blockers treat HTN?

Answer 21

Decrease cardiac output, decrease renin secretion (due to beta blockade on JGA cells)

Question 22

How do beta blockers treat HF?

Answer 22

Decrease mortality in chronic HF (decrease demand)

Question 23

How do beta blockers treat glaucoma?

Answer 23

Timolol. Decrease secretion of aqueous humor.

Question 24

What are the side effects of beta blockers?

Answer 24

Cardiac: bradycardia, AV block, HF
Respiratory: Asthma/COPD exacerbations
CNS: Seizures, sedation, sleep alteration
GU: Impotence

Question 25

Beta blocker use in cocaine users?

Answer 25

No! Unopposed alpha agonism from cocaine –> HTN crisis.

Question 26

Beta blocker use in diabetes?

Answer 26

Not contraindicated. Theoretical concern about risk of masking hypoglycemia. Benefits outweigh risks.

Question 27

Which beta blockers are B1>B2 selective?

Answer 27

Generally, those starting with first half of alphabet (A-M). acebutolol, atenolol, betaxolol, esmolol, metoprolol

Question 28

Which beta blockers are B1=B2?

Answer 28

Generally, those starting w/ second half of alphabet (N-Z). nadolol, pindolol, propanolol, timolol.

Question 29

Which beta blockers are non-selective alpha AND beta antagonists?

Answer 29

Those w/ modified suffixes. CarveDILOL, labetALOL.

Question 30

Which receptors does nebivolol work on?

Answer 30

Cardiac selective beta1 blocker with B3 stimulation; activates NO synthase in the vasculature.