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37 Cards in this Set
- Front
- Back
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What are adrenolytic agents?
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Alpha or Beta blockers
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What are the alpha 1 selective, reversible agents?
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The 5 member "zosin" family and their "zole" friend.
Prazosin Terasozin Doxasozin Tamsulosin Alfuzosin Dapiprazole |
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What is the alpha,non-selective, reversible agent?
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Phentolamine
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What is the alpha non-selective, and IRREVERSIBLE agent?
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Phenoxybenzamine
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What is the MOA of alpha antagonists (blockers)?
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Block the alpha receptor, thereby preventing the binding of NE or EPI
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How does an alpha blocker work on vascular smooth muscle cells?
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BLocks alpha 1 --> no A1 activity --> vasodilation
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Alpha antagonists
Therapeutic Uses |
Hypertension
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What alpha antagonists are used to treat HTN?
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Prazosin
Terazosin Doxazosin |
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What alpha antagonist agents are not indicated for tx of HTN?
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Tamsulosin and Alfuzosin
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Alpha antagonists
Therapeutic Uses |
Pheochromocytoma
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What alpha antagonists are used to treat Pheochromocytoma?
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The "PH" drugs
Phentolamine Phenoxybenzamine |
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Alpha antagonists
Therapeutic Uses |
Benign prostatic hyperplasia
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What alpha blockers are used to treat BPH?
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Terazosin
Doxasozin Tamsulosin Alfuzosin |
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How does an alpha blocker help BPH?
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Prostate --> blocking alpha 1 --> relaxes smooth muscle in base of bladder and prostate --> improved urine flow
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What is the advantage of using Tamsulosin for the treatment of BPH?
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Less hypotension and has greater affinity for alpha 1A receptors than other subtypes.
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Alpha antagonists
Therapeutic Uses |
Raynaud's disease
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What alpha blocker is used to treat Raynaud's disease?
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Prazosin
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Alpha antagonists
Therapeutic Uses |
Orthostatic hypotension
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Why is constriction of the veins so important?
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Returns blood to the heart
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Why does alpha blockers cause orthostatic hypotension?
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Standup --> decreased BP --> baroreceptor --> CNS --> block alpha 1 --> no vasoconstriction --> blood pools in veins --> doesnt return to heart --> Orthostatic hypotension and syncope
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Alpha antagonists
Adverse effects? |
Reflex tachycardia
Nasal congestion Salt and water retention Inhibition of ejaculation headache, weakness, dizziness |
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How does alpha blockers cause reflex tachycardia?
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Block alpha 1 --> decreased BP --> baroreceptor --> reflex tachycardia
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How does alpha blockers cause nasal congestion?
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Blocks alpha 1 in the nasal mucosa --> nasal congestion
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How does alpha blockers cause inhibition of ejaculation?
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Block alpha 1 on the smooth muscle of the prostate, seminal vesicles, and vas deferens
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Beta antagonist agents
Non-selective, competetive, and reversible |
The "olol's are beta blockers"
Propranolol Nadolol Timolol Pindolol Carteolol Levobunolol |
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Beta antagonist agents
Beta 1 selective, competetive, and reversible |
There is a "BEAM" of B1 selective agents.
Metaprolol Atenolol Acebutolol Betaxolol Levobetaxolol Bisoprolol Esmolol |
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Beta antagonist MOA
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Bind to, but do not activate, beta adrenergic receptors
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Beta antagonist
Therapeutic Uses |
Cardiovascular diseases
--HTN --Ischemia --Arrhythmias --MI --HF |
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Beta blockers
Therapeutic Uses |
Pheochromocytoma--in conjunction with an alpha blocker
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What may happen if you administer propranolol without an alpha blocker in treating pheochromocytoma?
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Unopposed vasoconstriction and increased BP
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Beta blockers
Therapeutic Uses? |
OAG
Migraine Essential tremor |
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How are beta blockers useful in treating migraines?
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--Prophylactic treatment
--Reduce frequency, severity, and duration of migraine attacks Precise mechanism unknown |
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Beta blockers
Cardiac adverse effects? |
Block Beta 1 --> bradycardia, AV block, decrease contractile force --> hypotension --> heart failure
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Beta blockers
CNS adverse effects? |
Nightmares, lassitude, mental depression, insomnia
WIth lipid soluable agents (Propranolol, metoprolol) |
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Beta blockers
Adverse effects? |
NVD
Sexual dysfunction Increased trigylercides, decreased HDL-C Bronchospasm Unopposed vasoconstriction Rebound hypertension |
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Both non-selective and beta 1 selective blockers are contraindicated in asthma. Why?
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The selectivity of beta 1 selective blockers may be lost at higher doses
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How can beta blockers cause rebound hyptertension?
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Chronic therapy up regulates beta 1 receptors --> abrupt withdrawl from beta blocker --> rebound hyptertension, nervousness, tachycardia, angina
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