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ELM2 - clinical pharmacology > lecture 6 - sympatholytics/adrenergic modulators > Flashcards

lecture 6 - sympatholytics/adrenergic modulators Flashcards

1
Q

What type of receptors are acted on by sympathetic nerves in the heart?

A

Beta-1 receptors

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2
Q

What type of receptors are acted on by parasympathetic nerves in the heart?

A

Muscarinic receptors

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3
Q

What type of receptors are acted on by sympathetic nerves in blood vessels?

A

Alpha receptors

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4
Q

What type of receptors are acted on by sympathetic nerves in the lungs?

A

Beta-2 adrenergic receptors

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5
Q

What is the first line drug treatment for hypertension?

A

ACE inhibitors (can also use calcium channel blocker or thiazide diuretic)

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6
Q

What is a commonly prescribed Alpha 1 blocker/antagonist?

A

Doxazosin

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7
Q

What is the key indication for doxazosin?

A

Hypertension (though generally not to be used as a monotherapy)

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8
Q

What is the mechanism of action of doxazosin?

A

Inhibits alpha-1-adrenoreceptors therefore producing a vasodilatory effect and drop in TPR reducing blood pressure

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9
Q

What are the indications for alpha-2 agonists, such as clonidine?

A

hypertension

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10
Q

What is the receptor specificity of 1st generation Beta blockers?

A

B1 and B2

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11
Q

What is the receptor specificity of 2nd generation Beta blockers?

A

B1

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12
Q

What is the receptor specificity of 3rd generation Beta blockers?

A

B1, B2, a1

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13
Q

What is the pharamacological action of Beta-blockers?

A

They antagonise cardiac and renal Beta-adrenoreceptors

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14
Q

What are the effects of Beta-blockers on the heart?

A

Negative chronotropic (decrease rate of contraction),
Negative inotropic (decreases force of contraction)

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15
Q

What causes the anti-hypertensive effects of Beta-Blockers?

A

Reduced cardiac output, which reduces MABP, also reducing RAAS activation.

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16
Q

How do Beta-Blockers reduce the work of the heart?

A

They have negative inotropic and chronotropic effects, which reduces cardiac oxygen consumption

17
Q

What are the indications for beta-blockers?

A

arrhythmia (A Fib particularly), angina pectoris, MI

18
Q

What condition is contraindicated with Beta-2 blocker?

A

Asthma - due to potential bronchospasm - choose selective B1 blocker

19
Q

What are the contraindications for Beta-Blockers?

A

severe heart failure, MI with bradycardia/hypopotension, heart block, bradycardia

20
Q

Which Beta-Blocker is preferred for treatment of hypertensioon, and why?

A

Carvedilol - has an antagonist effect on alpha-1 receptors, causing vasodilation in blood vessels which results in decreased blood pressure.

ELM2 - clinical pharmacology (20 decks)

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