Beta Adrenergic Drugs

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Beta Adrenergic Blocking Drugs

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Prevent Beta adrenergic receptors from responding to adrenergic nerve impulses, neurotransmitters or catecholamines

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Beta Receptor Blockade

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has an inhibitory effect on the cardiovascular system;, resulting in decreased HR, decreased force of myocardial contraction,and slowed electrical conductivity thru AV node, decreased automaticity of ectopic pacemakers, decreased CO at rest and exercise, decreased BP in supine and standing positions, esp ppl having HTN

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Chronic use of Beta Adrenergic Blockers

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associated c increased VLDL and decreased HDL. Poses a threat to ppl having cardiovas diseases. Beta Blkade also results in decreased renin secretion, decreased aqueous humor producton and portal vein pressure

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Adverse Effects of Beta 2 blockers

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bronchoconstriction, less effective glucose metab, tachycardia caused by hypoglycemia may be masked, increased tone of smooth muscles in GI tract, urinary bladder and uterus

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Levolbunolol/ Betagan
Metripranolol/ Optipranolol

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The only beta blockers used to tx Glaucoma

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Propranolol/Inderal

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prototype for Beta adrenergic Blocking drugs. The oldest and most extens studied beta blkr. Tx HTN, dysrhythm, angina pectoris, MI hypertrophic obstructive cardiomyopathy, pheochromocytoma, disecting aortic aneurysms, hyperthyroidism. Also used for Migraines, but unknown mech of axn. Good for alcoholics

Front 7

Isoproterenol/Isuprel

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Ax only on Beta receptors. Synthetic Catecholamine. Usage: Card stim n Hrt Blk, and cardiogenic shk. Bronchodilator (altho beta 2 preferred), card dysrhym, shk

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Non Selective Beta Blkrs

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Levobunolol, metipranolol, penbutolol, nadolol, pindolol, propranolol, solatol, timolol (beta 1&2 blkd so adverse effects wld be bronchoconstriction,and interference with glycogenisis- not good for DM)

Front 9

Cardioselective (Beta 1)

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Acebutolol, atenolol, betaxolol, bisoprolol, esmolol, metoprolol

Preferred with asthma, periph disorders

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Sotalol

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Exerts and Antidysrhym effect by blking K+ channel in cell membranes, thereby prolonging repolarization and refractory period of the HRT. Used to tx life threatening ventric dysrhytm and mntn norm sinus.
BBW strict cardiac monit for 3 days aft initiation. Creat clear necc before use

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Esmolol

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Recomm BABA of choice for perioperative period. It is cardioselective, can be given IV and has rapid onset of axn. Reduces CO, controls postop and intraop tach and HTN

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When to use BABA's (-olols)

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Cardiovasc disorders- angina pectoris, cardiac tachy, dysrhym, HTN, MI, HF, Hypertropic subaortic stenosis, migraines and glaucoma

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BABA's

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Levobunolol, metripranolol, propranolol, pindolol, nadolol, sotalol, timolol, Acebutolol, Atenolol, Betaxolol, bisoprolol, esmolol, metaprolol (lopress- MI)

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Ephedrine
Mixed Acting Adrenergic- Alpha and betas= release of norepi

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axn less potent but longer acting than epinephrine. produces more cns stim than other adrenergics. orally OR parentarally. Oral- fx in 1 hr, duration 3-5; SQ fx in 20 min, duration 60 min; IM fx 10-20 mins, duration less than 60 min

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Epinephrine

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Adrenergic Prototype (Adrenalin)targets Alpha 1 and all betas. at high doses, alpha 1 fx predom. drug of choice for relieving acute bronchospasm and laryngeal edema of anaphylactic shk. For cardiac arrest (cpr)
NOT given PO
Rapid but short acting. syncope in inf and chldn

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What do Alpha 1 receptors do

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Vasoconstrict
bld vess, kidney, intest smooth mus, liver, GU smooth mus, Eye, preg uterus.
pressor efct- incr BP

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Beta receptors, where are they

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dilation
beta 1- heart and Kidney
beta 2 bronchioles, bld vss, gi tract (decrease motility) liver, UGT/bldr, preg uterus (relaxation)
beta3 adipose tiss Gi tract

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Beta2 Adrenergic

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bronchodilation, vasodilation, increased bld flw to hrt, brain, skeletal muscles. Glycogenolysis in liver, decreased pancreatic insulin secretion, resulting in hyperglycemia. relaxation of uterus smooth muscle (activation can prevent prem labor), urinary bldr and GI tract relaxation

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Beta 1 axn

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increased everything on heart
(inotropic, chronotropic and dromotropic) and increased renin secretion

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sweat glands

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are under sympathetic control, but the postganglionic neurotransmitter is ACETYLCHOLINE

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Neurotransmitter in Parasympathetic Nervous system

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Acetylcholine, -cholinergics
neurotrans in brn, ans, and neuromusc jxns

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nicotinic receptors

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nicotinic N -located in autonomic ganglia and adrenal medulla. enhanced nerve impulse at all para and symp ganglia and release of epi frm adren medulla.
nicotinic M- at neuromusc jxns- cause musc contrac
nicotinic CNS at presynaptic nrv fibers n brain and spinal cord, promotes release of acetylcholine n cerebral cortex