Adrenergic Antagonists
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- What are the most prevalent side effects of alpha antagonists
- postural hypotension, reflex tachycardia, nasal stuffiness, inhibition of ejaculation
- This alpha blocker forms a covalent bond, is somewhat selective, and treats pheochromocytoma
- Phenoxybenzamine
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This non-covalent alpha blocker is used to "diagnose" pheochromocytoma and has a rapid onset,
What are its side effects and what are they due to? -
Phentolamine - tachycardia, arrhythmias, angina, diarrhea
NE increase -
This selective blocker is used to treat hypertension by relaxing arterial and venous smooth muscle,
What is its first dose effect? -
prazosin
Fainting w/in 30-90 due to low baroreceptor response and sympathetic outflow -
What are analogs for prazosin?
What is their half life? - Terazosin, and doxazosin. 12 hrs
- What is an additional use for prazosin?
- Urinary retention due to prostatic hypertrophy.
- What other medication with a half life of 9-15hrs is used to treat prostate hypertrophy
- Tamsulosin
- What is Raynaud's syndrome?
- It is a painful disease that causes peripheral vasospasm affecting the extremities
- Name some therapeutic uses for alpha blockers
- hypertension, pheochromacytoma, shock, Raynaud's syndrome, urinary obstruction
- What are 3 uses for Beta-adrenergic blockers?
- hypertension, angina pectoris, cardiac arrhythmias
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How do Beta-adrenergics lower BP?
What is the result in normal individuals? -
Via the heart, blood vessels, renin, or CNS.
No dec. in BP - How do B-adrenergics treat angina?
- They lower the episodes and inc exercise tolerance by lowering cardiac work and oxygen demand
- How are cardiac arrhythmias treated by B-adrenergic drugs?
- Lower the recurrence of MI's, and the size of the infarct
- What are some undesirable effects of B-adrenergic drugs?
- CHF, bronchoconstriction, mask hyperthroidism and hypoglycemia, inc. serum triglycerides, cold extremities, and depression
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What occurs with an abrupt withdrawal of B-blockers?
Why? -
inc. BP, inc angina, and inc MI's
The increase is due to an increased amount of Beta receptors that are hypersensitive - This nonselective B-blocker is used to treat hypertension, angina, and arrhymias
- Propranolol
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What some of the actions of propanolol?
What makes it so effective -
dec. HR, CO, O2 consumption, BP, myocardial contractility, renin release
It can cross the BBB -
This B-blocker treats hypertension, dec. infarct size, and glaucoma.
What are its side effects? -
Timilol
From eye can be absorbed systemically and may cause bronchiolar constriction - This B-blocker is long acting (16hrs), and some of it crosses the BBB and is metabolized. It can treat hypertension, angina, and prevent migraines.
- Nadolol
- This B-blocker has local anesthetic properties and fewer negative lipid changes?
- Pindolol
- These class of drugs are preferred in asthmatics and diabetics
- Beta-1 Selective Blockers
- This B1 blocker is given IV and has a half life of 10mins.
- Esmolol
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These two drugs are both a and B adrenergic antagonists?
Which one treats heart failure, mitogenesis, and causes vasodilation -
Labetalol and Carvedilol
Carvedilol - What is an odd illness that B-blockers are used to treat?
- Ethanol withdrawal
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Name the four antiadrenergic drugs studied that are NOT receptor blockers?
Which one does not cross the BBB?
Which one acts on alpha-2 receptors in the CNS? -
Bretylium, reserpine, guanethidine, alpha methyl dopa
- guanethidine
- alpha methyl dopa - What are the side effects on the non receptor blocker antiadrenergic drugs?
- Postural hypertension, sedation, depression, inc. GI motility, impaired ejaculation, and inc. blood volume
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Name two B-1 blockers that treat hypertension, angina, and MI's.
Which has local anesthetic properties? -
Atenolol, and Metoprolol
Metoprolol