Antiadrenergic Drugs

Question 1

effect of alpha antagonists on genitourinary system

Answer 1

• relaxation of smooth muscle in prostate

- decreased resistance to flow of urine

Question 2

what cardiac arrhythmias can be treated with beta blockers

Answer 2

• a flutter and a fib

- ventricular ectopic beats

Question 3

effects of beta blockers on eye

Answer 3

reduce production of aqueous humor –> reduces intraocular pressure

Question 4

adverse effects of alpha antagonists

Answer 4

• postural hypotension
• tachycardia
• retention of fluid and salt
• impaired ejaculation
• nasal stuffiness

Question 5

if pt is having hypoglycemic episodes, instead of a beta blocker what should you switch to

Answer 5

beta1-selective

Question 6

effect of alpha antagonists on cardiovascular system

Answer 6

• decreased peripheral vascular resistance
• decreased BP
• postural hypotension
• reflex tachycardia

Question 7

adverse effects of beta blockers on the CNS system

- what drug should you switch to?

Answer 7

• sedation
• sleep disturbances
• depression

–> switch to more hydrophilic drug

Question 8

effect of alpha antagonists on eye

Answer 8

• relaxation of pupillary dilator muscle - miosis (constricted pupils)

Question 9

are beta blockers indicated in acute congestive heart failure

Answer 9

no

Question 10

effects of beta blockers on respiratory system

Answer 10

increase airway resistance

Question 11

what beta blockers are used to treat chronic heart failure

Answer 11

• metoprolol

- carvedilol

Question 12

effects of beta blockers on blood vessels

Answer 12

• initial rise in PVR

- chronic use –> decrease in PVR (lowers BP in hypertensive pts)

Question 13

what alpha antagonist would you use to treat BPH

Answer 13

tamsulosin
(greater selectivity for alpha1A than alpha1B)
- alpha1A is the most important alpha receptor subtype mediating prostate smooth muscle contraction

Question 14

what alpha antagonists would you use to treat chronic (essential) hypertension

Answer 14

prazosin
doxazosin
(both alpha1 selective)

Question 15

effects of beta blockers on cardiovascular system

Answer 15

• negative inotropic effect
• negative chronotropic effect
• slow AV node conduction

Question 16

benefits of using beta blockers with ISA

Answer 16

• less risk for bradycardia

- increase in VLDL/HDL

Question 17

describe beta blockers with intrinsic sympathomimetic activity (ISA)

Answer 17

partial agonists at beta adrenergic receptors that block sympathetic effects BUT have submaximal effects of their own = a bunted sympathetic response

Question 18

effects of beta blockers on metabolism

Answer 18

• inhibit lipolysis
• increase VLDL and decrease HDL, reducing the HDL cholesterol/LDL cholesterol ratio
• inhibits glycogenolysis and gluconeogensis in liver

Question 19

what beta blockers are used in long term use post MI

Answer 19

• propranolol

- metoprolol

Question 20

adverse effects of beta blockers on the CV system

Answer 20

• depression of HR, cardiac contractility, and excitability

- exacerbation of peripheral vascular dz

Question 21

what alpha antagonists would you use to treat erectile dysfunction

Answer 21

combination of phentolamine and a nonspecific vasodilator papaverine (injected into penis)

Question 22

what beta blockers is used to treat hyperthyroidism

Answer 22

propranolol

Question 23

adverse effects of beta blockers on the respiratory system

- what drug should you switch to?

Answer 23

• increase airway resistance
• trigger bronchospasm and asthma attack

–> switch to beta-1 selective

Question 24

what type of inhibitor is metyrosine

Answer 24

a synthesis inhibitor (inhibits synthesis of tyrosine hydroxylase)
- indirect

Question 25

what beta blocker is used to treat glaucoma

Answer 25

betaxolol

Question 26

are beta blockers safer for type I or type II DM patients

Answer 26

type 2, since they do not usually have hypoglycemic episodes

Question 27

adverse effects of abrupt discontinuation of beta blockers

Answer 27

• enhanced cardiac stimulation and arrhythmias

- increased risk in pts with ischemic heart dz

Question 28

compare phentolamine and phenoxybenzamine in terms of binding to receptor and its effects

Answer 28

phentolamine: covalent, short acting
phenoxybenzamine: non-covalent, long acting

Question 29

adverse effects of beta blockers on lipid profile

- what drug should you switch to?

Answer 29

• chronic use increases VLDL and decreases HLD

–> switch to partial agonist drug

Question 30

what is the adverse effect of using prazosin and doxazosin to treat BPH

Answer 30

drop in BP

Question 31

which alpha receptor is the most important subtype mediating prostate smooth muscle contraction

Answer 31

alpha1A

Question 32

what type of antagonist is phenoxybenzamine

Answer 32

non-competitive irreversible alpha antagonist

Question 33

effects of beta blockers on renin-angiotensin system

Answer 33

inhibits renin release

Question 34

what alpha antagonists would you use to treat pheochromocytoma

Answer 34

phentolamine

phenoxybenzamine

Question 35

what part of the synapse does guanethidine work at

Answer 35

pre-synaptic neuron

Question 36

what type of antagonist is phentolamine

Answer 36

reversible competitive alpha antagonist

Question 37

how do beta blockers help treat angina pectoris

Answer 37

• decrease cardiac work and reduce O2 consumption

- reduce frequency of anginal episodes and improve exercise tolerance