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113 Cards in this Set
- Front
- Back
bb have ---- inhbition of cardiac B- receptors
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competitive
B1 |
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this competitive inhibition o f b1 receptors will decrease ----, and increase
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decrease CO
increase acute reflex TPR |
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bb will impair --- tolerance
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exercise
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bb have block b1 that mediate ---- release
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renin
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blocking renin release will also block -----
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ang 2
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bb will also block--- receptors in the lungs
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b2
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blocking b2 in the lungs will decrease
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bronchial smooth muscles reelaxation
can lead to bronchospasm in asthma |
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why's there impaired exercise tolerance w/ bb
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decrease co, decrease bl tissue O2 and glucose
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blockade of ---- b2 receptors will block ----- release
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presynaptic
NE |
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bb will affect the cns by?
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decreasing SNS activity
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the more ----- soluable the more cns effects
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lipid
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bb can cause ---
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depression
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t/f
bb used durin pt's migraine |
f
used prophylactically to treat migraines |
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bb will alter the ----reflex response
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baro
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differences in bb
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selectivity
metabolism isa membrane stabilizing activity direct vasodilation |
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metabolism of bb thru
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hepatic
renal |
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t/f
bb has bad gi absorption |
f
good gi absorption goes thru 1st pass |
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t1/2 life of bb
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low
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--- soluable bb has poor absorption renally
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water
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isa:
inherant --- activity how's this useful |
agonist
partial agonist useful w/ asthmatics, chf, bradycardia |
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bb has ---- stabilizing activity
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membrane
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lidocaine has both antiarrhytmic and ----- activity
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anesthetic
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bb have -- anesthetic activity
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local
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bb have enchanced ------- activity
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anti arrhythmic
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membrane stability acitivty seen ---- therapeutic conc
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above
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bb inhibit -- channels and activity of ----
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Na
neurons that's why: membrane stabilizing activity |
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directe vasodilation of bb thru
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no production
alpha 1 antagonist beta 2 agonist ca entry blockade k channel opening antioxidant acitivity |
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which nonselective has the most membrane stabilizing acivity
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propranolol
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which nonselective bb has he most lipid soluability
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penbutalol
propranolol |
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which nonselective bb has the least lipid solubility
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nadolol
pindolol sotolol |
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which nonselective bb has mod lipid solubility
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timolol
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which nonselective will cause vivid dreams
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penbutolol and pindolol
cuz of high lipid solubility, will cross bbb |
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which nonselective has the highest isa
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pindolol
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which nonselective has the least isa
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penbutolol
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selective b1 blockers w/ membrane stabilizing ability
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acetutolol
metoprolol (at high doses) |
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selective b1 blockers w/ lipid solubility
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metoprolol
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3rd generation bb that are b1 selective
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betaxolol
nebivolol |
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3rd gen bb w/ membrane stabilizing ability
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carvedilol
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3rd gen bb w/ mod bb solubility
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carvedilol
betaxolol nebivolol |
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3rd gen bb w/ low lipid solubility
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cartelol
labetalol |
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when is bb a first line med
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angina
mi a fib |
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focus of htn according aha
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bp <130/80
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first line meds for htn
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acei
arb thiazide like ccb (usu takes 2 drugs) |
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bb used in uncomplicated ----
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htn
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bb used in htn used best in which pop of pts
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young pt
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why are bb best in young pts
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cuz of resting tachycardia
increase in catecholamines increase in renin |
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t/f
bb not useful in the elderly for htn |
f
still useful |
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bb works best in high/low renin htn
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high
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which pop usu have high renin htn
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caucausians
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thru which receptors will bb decrease co and ang 2
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b1
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thru which receptors will bb decrease ne release
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b2
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t/f
bb works to decrease sns peripherally |
f
centrally |
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bb have an altered ----
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baroreflex
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how will bb control glaucoma
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decrase aq humor production
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t/f
bb will increase outflow of aq humor |
f
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bb used in glaucoma
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timolol
betaxolol cartelol |
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bb used in migraines
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propranolol
timolol |
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how do bb work in prophylactic use of migraines
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prevent vasodilation that cause migraines
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bb will decrease --- and severity of ha if used prophylactically
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frequency
severity |
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bb used in hyper----
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thyroidism
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how will bb help w/ hyperthyroidism
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decrease symptoms
decrease conversion of t4 to t3 peripherally |
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how can bb increase bp w/ hyperthyroidism
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when hr slowed the sv will increase
this will increase bp |
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bb used in angina ---
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pectoris
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ischemia due to an increase in ---/---
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NE/EPI
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bb results when there's increased ---- or increased myocardial ----- beyond specific threshold
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HR
contractility |
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ischemia associated w/
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activity
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how do bb relieve symptoms
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increase time to hr associated w/ angina
prolong time to reach threshold to symptoms |
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why have exercise intolerance w/ bb
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prevents vasodilation in muscles/vessels/lungs
bb prevent increase in HR |
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w/ acute mi which bb do you use
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ISA
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bb protect ischemic mycocardiam from ----
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NE/EPI
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bb protects from --- mi
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recurrent
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how do bb protect against mi
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decrease contractility
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bb decrease --- ---- and decrease workload
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O2 demand
decrease workload allows repair |
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bb indicated for ------ arrhythmias
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supraventricular
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for supraventricular arrhythmias bb blocks --- node and --- transmission
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AV
slows slows slows contractions and increases filling and increase pumping |
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why does the av node have a slower rate
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to allow time to contract
push blood out of ventricles |
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bb extends --- period
why |
refractory (time where you can't generate action potential)
bb extends the refractory period to slow # of impulse that reach the AV node. . . gives timeto accomadate |
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how do bb work w/ panic attacks
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works to eliminate s/s
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how do bb work in benign essential tremors
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block b2 receptor on skeletal muscle
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why are bb not used in parkinson's
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cuz tremors in parkinson's are central
bb work peripherally. . . golfers use |
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bb used in benign essential ----
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tremors
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bb used in chf
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carvidilol
metoprolol bisoprolol nebivelol |
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in hf bb will --- co, -- tpr, --- hr
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increase co
decrease tpr decrease hr |
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bb will initially worsen symptoms start w/ --- dose and---- slowly
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low
increase |
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bb will --- qol of a pt and their ability to tolerate more ----
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increase
exertion |
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bb cause broncho-----
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constriction
asthma exacerbation 1/3 of copd pts have brochospasm ci |
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which bb would you use in asthmatic, copd
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b1 selective
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bb have cardio------ actions
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depressive
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bb have negative ---- and ---- actions
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inotropy
chronotropy |
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neg inotropy lead to --- and ----
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fatigue
chf |
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neg chronotropy lead to -----
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bradycardia
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bb can lead to --- block
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av
1st, 2nd, 3rd degree heart block |
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bb will separate rate in --- and --
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atria
ventricles so they have separate beats: heart block |
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bb will cause ---glycemia in type 1 dm
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hypo
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bb will cause ---glycemia in type 2 dm
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hyper
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how will bb cause hypoglycemia in type 1
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bb prevent glycogenolysis which will prolong hypoglycemia and mask symptoms
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how will bb cause hyperglycemia in type 2
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decrease insulin and increase glucose
wil also prolong hypoglycemia and mask symptoms |
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which bb increase insulin sensitivity in type 2 dm
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3rd gen
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because bb block b2 receptors in bl vessels what can happen
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cold extremities (raynaud's)
skeletal muscle fatigue pad (intermittent claudication) |
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how do you get skeletal muscle fatigue w/ bb
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due to contraction there's a block on O2 and glucose
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sudden stop of bbs you can have
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sudden withdrawal syndrome
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sudden withdrawal syndrome can lead to
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acute angina
mi marked increase in bp |
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blockade of beta can lead to --- of receptors
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upregulaation
so wil abrupt withdrawal of bb you have too many beta: increased bp, hr, workload |
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t/f
you slowly withdrawal bb |
t
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due to lipid soluabilty of bb a pt can have ----
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depression
nightmares vivid dreams hallucinations fatigue |
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t/f
fatigue due to central actions |
f
central and cv actions |
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bb may increase ldl, --- and decrease ---
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increase LDL and TG
decrease HDL |
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which beta's improve lipid profile slightly
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3rd generation
slighly |
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if you're borderline depressed --- can lead to depression
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bb
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drug interactions w/ bb
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ccb
clonidine |
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which two meds should you not abruptly stop
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bb
clonidine |
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what drug interaction w/ ccb
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synergictic effects:
decrease bp, hr, contractility (both thru av node) |
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both bb and clonidine will --- bp
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decrease
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