Beta blocker tutorial Flashcards

1
Q

Name 4 organs/organ systems involved in blood pressure control.

A

Kidneys, Heart, Vasculature, Brain.

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2
Q

What are the effects of B1 receptor stimulation on the nodes and atrial cells.

A

Nodes - chronotropic effect.

Atria - ionotropic effect.

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3
Q

What receptors are responsible for VSMC contraction and dilation during exercise.

A

B2 - dilation in skeletal muscle.
A1 - constriction where not needed, e.g. digestive system.
(both NA).

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4
Q

Is constriction or dilation during exercise more responsible for rise in TPR?

A

Constriction since variation in viscera blood supply has a great effect on BP and TPR.

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5
Q

What stimulates renin secretion?

A

NA via B1 receptors at the kidney.

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6
Q

What are the effects of renin.

A

Stimulate AGT II secretion and aldosterone.

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7
Q

What are the effects of AGT II and aldosterone and why?

A

Aldosterone - increased BP due to increased blood volume (increased salt retention).
AGT II - increased BP due to vasoconstriction via AE1 receptor on blood vessels.

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8
Q

How is AGT II secreted?

A

Renin stimulates conversion of Angiotensinogen to AGT I in liver. ACE from lungs converts AGT I to AGT II.

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9
Q

What is the effect of beta blockers on hypertension.

A

Blocked B1 receptors on heart reduce cardiac output so reduce BP.
Blocked B1 receptors on kidneys reduce AGT II production (via renin-angiotensin system).
(no longer first line treatment).

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10
Q

How do beta blockers treat tachycardia?

A

Blocked B1 receptors on SA node reduce heart rate.

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11
Q

Name some common arrhythmias

A

Atrial flutter

Atrial fibrillation

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12
Q

Why are beta blockers used to treat arrhythmias?

A

Beta blockers have a negative dromotropic effect - reduce speed of conduction through the bundle of His

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13
Q

How does an atrial flutter arise?

A

HR generated by SA node = approx. 110-120, reduced by AV node to 60. In atrial flutter SA nodes overwhelms this.

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14
Q

What is a cardioselective beta blocker

A

Refers to drugs that are B1 selective.

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15
Q

What conditions are beta blockers contraindicated for?

A

Hypotension
Asthma
Diabetes.

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16
Q

why can beta blockers be problematic for asthmatic patient?

A

B receptors in airways cause bronchodilator. Blocking those can inhibit relaxation - net constriction effect.

17
Q

Why can beta blockers be dangerous for diabetic patients?

A

Body fails to detect hypoglycaemic trough since SNS is inhibited by beta blockers. Body less likely to display the danger signals associated with hypoglycaemic troughs.

18
Q

What is a crossover trial?

A

Each intervention is repeated in each group, with one variable being changed between groups.