Beta blockers and Alpha blockers

Question 1

what are the beta-one “cardio-selective” antagonists

Answer 1

metoprolol, atenolol, bisoprolol, betaxolol

Question 2

what are the non-selective beta blockers

Answer 2

propranolol, timolol, nadolol, carteolol

Question 3

what are the non-selective beta blockers with alpha blocking activity

Answer 3

labetalol, carvedilol

Question 4

what is a selective beta blocker with nitric oxide-dependent vasodilation

Answer 4

nebivolol

Question 5

which beta blockers have intrinsic sympathomimetic activity- nonselective with some agonist activity

Answer 5

pindolol, acebutolol

Question 6

beta one receptors are located in the ___

Answer 6

heart

Question 7

beta two receptors are located in the ____

Answer 7

lung

Question 8

what is a short acting beta one blocker

Answer 8

esmolol

Question 9

what is special about esmolol

Answer 9

is has an ester linkage susceptible to endogenous esterases; rapidly metabolized and IV only

Question 10

what is a non-selective beta blocker that has potassium channel blocking activity

Answer 10

sotalol

Question 11

what is sotalol used for

Answer 11

to treat arrhythmias such as atrial fibrillation

Question 12

what are some “off label” uses for beta blockers

Answer 12

migraine headache prophylaxis, essential tremor, anxiety disorders/stage fright palpitations, hyperthyroidism

Question 13

what is the mechanism of beta blockers

Answer 13

they block the actions of tonically released norepi on cardiac beta-one receptors which decreases heart rate, contractility, stroke volume, and cardiac output. they block beta one receptors in the kidney, decreasing renin, angiotensin II, and TPR

Question 14

the antihypertensive effect of beta blockers is greatest in those with ___

Answer 14

high renin

Question 15

beta blockers are ____ (more/less) effective than thiazides, ACEis and ARBs

Answer 15

LESS

Question 16

what are the clinical uses of beta blockers

Answer 16

they are used to treat mild-to-moderate hypertension, used alone or in combo, provide benefit for coronary artery disease, and can be useful for CHRONIC STABLE heart failure (NOT unstable)

Question 17

beta blockers ____ peak exercise performance and why

Answer 17

reduce; cardiac output cannot be increased to its max value

Question 18

what are the adverse effects of beta blockers

Answer 18

bronchospasm, withdrawal rebound stimulation, hypoglycemia to insulin, fatigue, CNS effects, sexual function, exacerbation of heart failure

Question 19

why do you have to taper off a beta blocker

Answer 19

beta one receptors are upregulated by cardiac cells when you take beta blockers. when you stop abruptly, the receptors are free to be stimulated by norepinephrine: resulting in rapid heart rate, increased contractility, and palpitations

Question 20

what are the selective alpha one antagonists

Answer 20

prazosin, terazosin, doxazosin

Question 21

what are the non-selective alpha antagonists

Answer 21

phentolamine, phenoxybenzamine

Question 22

relaxation of arteries decreases ___

Answer 22

TPR

Question 23

relaxation of veins decreases _____

Answer 23

venous return

Question 24

which alpha blockers are used for BPH

Answer 24

tamsulosin, alfuzosin, sildosin

Question 25

use of alpha blockers in hypertension

Answer 25

used for mild to moderate hypertension, may be combined with beta blockers, calcium channel blockers, ace inhibitors

Question 26

what is an adverse effect of alpha blockers

Answer 26

first dose hypotension/first dose phenomenon/ orthostatic hypotension

Question 27

what is phentolamine used for

Answer 27

it is an IV agent used in management of extravasation reactions to symathomimetics like norepinephrine

Question 28

what is extravasation

Answer 28

accidental administration of infused meds into the vasculature

Question 29

what is phenoxybenzamine used for

Answer 29

treatment of hypertensive crises associated with pheochromocytoma