alpha and beta blockers

Question 1

Phenoxybenzamine MoA and use

Answer 1

nonselective, irreversible alpha blocker

Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis

Question 2

Phentolamine MoA and use

Answer 2

nonselective, reversible alpha blocker

Give to patients on MAO inhibitors who eat tyramine-containing foods

Question 3

nonselective alpha blocker side effects

Answer 3

Orthostatic hypotension, reflex tachycardia

Question 4

Prazosin, terazosin, doxazosin, tamsulosin MoA and use

Answer 4

α1 selective (-osin ending)

Urinary symptoms of BPH; PTSD (prazosin); hypertension (except tamsulosin)

Question 5

α1 selective (-osin ending) blocker side effects

Answer 5

1st-dose orthostatic hypotension, dizziness, headache

Question 6

Mirtazapine MoA and use

Answer 6

α2 selective blocker

depression

Question 7

Mirtazapine side effects

Answer 7

Sedation, serum cholesterol, increased appetite

Question 8

Acebutolol, atenolol, betaxolol, carvedilol, esmolol, labetalol, metoprolol, nadolol, nebivolol, pindolol, propranolol, timolol
(-olols)

MoA

Answer 8

β-blockers

Question 9

β-blockers (-olols) clinical use (6)

Answer 9

Angina pectoris 
MI
SVT (metoprolol, esmolol)
Hypertension
HF
Glaucoma (Timolol)

Question 10

Effects of β-blockers on Angina pectoris

Answer 10

decrease heart rate and contractility, resulting in decreased O2 consumption

Question 11

Effects of β-blockers on MI

Answer 11

β-blockers (metoprolol, carvedilol, and bisoprolol)

decrease mortality

Question 12

Effects of Metoprolol, Esmolol on SVT

Answer 12

decrease AV conduction velocity (class II antiarrhythmic)

Question 13

Effects of β-blockers on Hypertension

Answer 13

decrease cardiac output, decrease renin secretion (due to β1-receptor blockade on JGA cells)

Question 14

Effects of β-blockers on HF

Answer 14

decrease mortality in chronic HF

Question 15

Effects of Timolol on Glaucoma

Answer 15

decrease secretion of aqueous humor

Question 16

β-blockers toxicity

Answer 16

Impotence, cardiovascular adverse effects (bradycardia, AV block, HF), CNS adverse effects (seizures, sedation, sleep alterations), and asthma/COPD exacerbations

Question 17

which β-blocker has the side effect of dyslipidemia?

Answer 17

Metoprolol

Question 18

β-blocker should be avoided in which patients due to risk of unopposed α-adrenergic receptor agonist activity?

Answer 18

cocaine users

Question 19

Despite theoretical concern, what condition are β-blockers not contraindicated

Answer 19

Despite theoretical concern of masking hypoglycemia in diabetics, benefits likely outweigh risks

Question 20

acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol have what selectivity?

Answer 20

β1-selective antagonists (β1 > β2)

Question 21

nadolol, pindolol (partial agonist), propranolol, timolol have what selectivity?

Answer 21

Nonselective antagonists (β1 = β2)

Question 22

carvedilol, labetalol have what selectivity?

Answer 22

Nonselective α- and β-antagonists

Question 23

Which β-blocker activates NOS in vasculature and how?

Answer 23

Nebivolol combines cardiac-selective β1-adrenergic blockade with stimulation of β3-receptors, which activate nitric oxide synthase in the vasculature