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27 Cards in this Set
- Front
- Back
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Selective Alpha1
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Alfuzosin- BPH
Doxazosin- HTN BPH Prazosin- HTN BPH Tamsulosin(Flomax)- BPH Terazosin- HTN BPH |
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Non Selective Alpha 1
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Phentolamine- HTN caused by pheochromocytoma, Prevention of tissue necrosis due to vasoconstrictor extravasation (dopamine), impotence (ED)
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What is Alpha 1 Adrenergic Antagonist Prototype?
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Prazosin/Minipress
peak plasma [C] 1-3 hrs, lasts 4-6 hrs, 1/2 life 2-3 hrs |
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What is the first Alpha 1 designed to tx BPH?
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Tamulosin/Flomax
causes less orthostatic HTN Can be started at recomm doses can cause abnorm ejac & dizziness |
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What type drug would you use to treat Raynauds Disease
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Non Selective Alpha Blocking such as Phentolamine
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Which drugs treat BPH
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Alfuzosin, Tamulosin, Doxazosin, Terazosin
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What is goal of therapy with Alpha adrenergic Blocking drugs (selective for Alpha 1)
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dilation of arterioles and veins (block alpha mediated vasoconstriction of skin mucosa, intestines, lungs and kidneys)
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What do Antiadrenergics do
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decrease or block the fx of symp nerve stim, endogenous catecholamines and adrenergic drugs
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what do Antiadrenergics Tx?
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HTN, BPH, can decrease hypoglycemia by decreasing insulin prod
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Phenylephrine is what class of drug and what does it treat?
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Alpha receptor agonist/Adrenergic that is used in many cold medicines to reduce nasal congestion, treats hypotension/shock, reduces CO and renal perfusion, increases peripheral resistance. it is a vasoconstrictor that is similar to ephinephrine
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What do you need to know about Sudafed?
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Targets Alpha 1 and Beta receptors, r/t ephedrine, is a bronchodilator and nasal decongestant, Used to make meth, 30-60 mg PO q 4-6 hrs do not exceed 240 mg/24 hrs
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What are the three types of adrenergic drug mechanisms?
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Direct- Drug-Receptor complexes (Epi, isoproterenol, norepi, phenylephrine) has direct effects
Indirect- increases the amount of norepi released/inhibit reuptake of norepi (Tricyclic anti depres, cocaine, stim symp by blocking reuptake of norepi) Mixed- Direct and Indirect, i.e., ephedrine, pseudoephedrine |
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what are the targets of Adrenergic drugs
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Heart, Blood vessels and Lungs
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Alpha 2 receptors
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stimulation of Alpha2's actually have a DECREASED sympathetic response; by activating the Alpha 2's, a negative feedback system blocks further release of norepi, useful in tx of HTN
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Clonidine/Catapres
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Alpha 2 agonist. Txs HTN, severe pain
in CA pts, BBW-Hypotn PO 0.1 mg bid initially, ave mnt 0.2-0.8 mg/d decreases BP c n 1 hr, pks 3-5 hrs, 1/2 life 12-16 hr avail transdermal patch, wear for 7 days. |
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Norepinephrine
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The neurotransmitter and neurohormone involved in most sympathetic nervous system-post synaptic ganglion.
nerve fibers secreting norepi are called adrenergic fibers Norepi conversion to epi occurs in adrenal medulla |
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Methyldopa
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Alpha 2 Agonist that decreases norepi to reduce BP. Hepatoxic, may cause hemolytic anemia
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Adrenergic Receptors
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Respond to sympathetic neruotransmitters norepi and epi (catecholamine stimulation). These are alpha and beta receptors. Norepi ax on mnly alpha receptors but epi ax on both
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Contraindications for Adrenergics
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Cardiac arrhythmias, angine pectoris, HTN, hyperthyroidism, cerebrovascular disease, allergies to sulfites (in some of the meds), second stage of labor, anxiety, insomnia, psychiatric disorders, older adults.
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Mixed Adrenergic Blockers
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Labetalol and Carvedilol (Coreg) block alpha 1, beta 1 and beta2 receptors. the may cause less bradycardia but more postural hypotn, less reflex tachycard than other BABA's
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Coreg
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Cardio selective alpha-beta blocker for mild to mod HF, decreases risk of sudden death by 38%
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Metroprolol
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cardioselective beta blkr, + ACE+ Diuretic+ Digoxin
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Antiadrenergics in Ethnic groups
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African Americans more responsive to combined therapies, Caucasions more apt to do well on monotherapies when compared to AA
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Adverse Effects of Alpha Adrenergics (Agonists and Blockers)
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edema, tachcardia (c alpha agonists), bradycardia, congestive HF, bronchoconstriction
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First Dose Syncope
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When alpha blking agent (doxazosin, prazosin, terazosin) is given for HTN, this may occur due to resultant HypoTN
The decreased BP may stim reflex mechs to raise BP and a diuretic may be necc |
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Antiadrenergics contraindicated in Renal impairment
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Acebutolol (if creat < 50 ml/min)
Atenolol (if creat < 35 ml/min) Nadolol (if creat < 50 ml/min) |
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Antiadrenergics contraindicated in Liver imprmt
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Clonidine and Methyldopa, prazosin, alfuzosin, terazosin, doxazosin, tamulosin.
Use Atenol or Nadolol |
