Adrenergic Antagonists

Question 1

What is a sympathomimetic?

Answer 1

Drug that mimics NE/epi

Question 2

What is a cholinomimetic?

Answer 2

Drug that mimics ACh

Question 3

**olol

Answer 3

Beta-blockers

HTN, MI, angina pain, glaucoma, migraines, hyperthyroidism, performance anxiety

Question 4

What are the ABEAM drugs? What do they do?

Answer 4

Cardio-specific beta-blockers (block B1 primarily)

Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol

Question 5

Labetalol (Trandate) and Carvedilol (Coreg)

Answer 5

a1 blocker (vasodilates) + beta-blocker (prevents increase in HR)

Anti-HTN: decrease PVR and blood pressure without changing HR & CO, so avoids reflex tachycardia

Choice emergency hyper-tensive

Question 6

Can you stop Beta blockers abruptly?

Answer 6

NO - # of receptors increase by up-regulation, so gradually taper patient off of them

Question 7

What are 5 adverse effects of Beta blockers?

Answer 7

1. Bronchoconstriction
2. Bradycardia
3. Low BP - RAAAS is inhibited
4. Hypoglycemia
5. Sexual impairment

Question 8

What are 3 advantages of using partial agonist beta-blockers?

Answer 8

1. Minimizes disturbances in glucose and lipid metabolism
2. Bradycardia is minimized
3. Less bronchoconstriction

Question 9

How do you choose one beta blocker over another?

Answer 9

1. MSA - membrane stabilizing activity (some beta-blockers reduce propagation of action potentials)
2. ISA - intrinsic sympathomimetic activity (or partial agonist activity)

Question 10

Which receptors predominate on smooth muscle around veins?

• Beta 2
• Alpha 1
• Alpha 2
• Beta 1
• Beta 3

Answer 10

Alpha 1

Question 11

What are four adverse effects of alpha-1 blockers?

Answer 11

1. Reflex tachycardia
2. Orthostatic hypotension
3. Nasal congestion
4. Inhibits ejaculation

Question 12

Vascular tone (peripheral vascular resistance) is maintained by activation of:

• Beta 1
• Nicotinic
• Alpha 2
• Alpha 1
• Beta 2

Answer 12

Alpha-1

Question 13

What type of alpha 1 receptors are present in smooth muscle of prostate and involuntary sphincter of the bladder?

Answer 13

alpha1 a subtype

Question 14

Tamsulosin (Flomax)

Answer 14

alpha-1a blocker (specific to prostate/bladder)

Relaxes smooth muscle of prostate and involuntary sphincter of bladder, allowing for stronger urine flow

Treats BPH

Question 15

Phenoxybenzamine (Dibenzline)

Answer 15

Irreversible alpha-1 blocker

Pheochromocytoma

Question 16

Yohimbine (Yobine)

Answer 16

Alpha-2 blocker

Increase blood pressure

Treats erectile dysfunction

Question 17

**azosin (Terazosin)

Answer 17

alpha-1 blocker

Treast HTN and frostbite

Question 18

A patient on spinal anesthesia goes into severe hypotension. Drug of choice to correct this:

A. Propranolol
B. Isoproterenol
C. Phenylephrine
D. Clonidine
E. Albuterol

Answer 18

C - phenylephrine - a1 agonist

Question 19

Propanolol

Answer 19

Blocks Beta-1 and beta-2 equally

HTN

Question 20

Acebutolol

Answer 20

Blocks beta-1»»>beta-2 (cardiospecific)

HTN

Question 21

Pindolol

Answer 21

Blocks B1/B2 - partial agonist

HTN, chest angina