Adrenergic Antagonists - Drug

Question 1

What are the classes of adrenergic antagonist

Answer 1

Alpha and beta blocker
Alpha receptor blocker
Beta blocker

Question 2

Alpha blocker types?

Answer 2

• alpha1 selective , alpha2 selective and non selective blockers

Question 3

What are the two main non selective alpha blocker

Answer 3

• phenoxybenzamine

- phetolamine

Question 4

Uses of phenoxybezamine

Answer 4

Pheochromocytoma (DOC)
Antidote of cocaine, amphetatime

Raynaud’s dx
Automatic dysreflexia

Question 5

S/e is phenoxybenzamine

Answer 5

Reflex tachycardia
Orthostatic Hypotension
Stuffy nose
Sexual dysfunction: ejaculation

Question 6

Is pheoxy benzamine a reversible or irreversible blocker

Answer 6

Irreversible blocker

Question 7

Phentolamine is a _________ blocker

Answer 7

Reversible non selective adrenergic blocker with a short half life.

Used for short term management of phecromocytoma, tx of impotence (rarely used)

Question 8

Examples of A1 selective blocker

Answer 8

‘osins’

Note that doxaosin is long acting

Question 9

Uses of A1 selective blocker

Answer 9

BPH (DOC) :tamsulosin
PTSD: Prazosin
Urinary hesitancy
HTN: all except tamsulosin

Question 10

Side effects of selective alpha blocker

Answer 10

Headache dizziness fatigue
First dose syncope 
Reflex tachycardia
Orthostatic hypotension
NASAL stuffiness 
Ejaculation problem

Question 11

Tx of bph

Answer 11

Tamsulosin selective A1 blocker

Question 12

Different A1 receptors

Answer 12

A1 a : urethra, urinary bladder, prostrate 
A1b: blood vessels, prostrate 
A1 c
A1d  urinary bladder
A1e

Question 13

Types of beta blocker

Answer 13

Selective and non selective

olols

Question 14

NonSelective beta blocker

Answer 14

TPN

Timolol
Propanolol
Nadolol
Pindolol (non-selective)

Question 15

Cardio selective b1 blocker

Answer 15

Acebutolol (partial agonist)
Metoprolol
Esmolol
Atenolol

MAE

Question 16

What b blocker is given during emergency

Answer 16

Esmolol cardio selective

It has a short half life

Question 17

Effects of non selective beta blocker in non diabetic pts

Answer 17

Type 2 dm due to insulin resistant

Question 18

Effects of non selective beta blocker in diabetic pts

Answer 18

Hypoglycemia due to lowered glycogenolysis

Question 19

Non selective beta blocker effect : LIPOLYSIS explain

Answer 19

No insulin so LPL Is not stimulated and can’t convert VLDL to ILDL

insulin is known to activate LPL in adipocytes and its placement in the capillary endothelium. By contrast, insulin has been shown to decrease expression of muscle LPL. Muscle and myocardial LPL is instead activated by glucagon and adrenaline.

Question 20

Uses of bb

Answer 20

Angina (doc) 
HTN
Arrhythmia 
Migraine 
Thyrotoxicosis 
Anxiety dx

Question 21

Side effects of propranolol

Answer 21

Bronchconstriction
Na retention 
Arrhythmia 
Sexual impairment 
Fasting hypoglycemia 
Fatigue and exercise intolerance (not caused by alpha blocker) 

CNS effects cus it crosses bbb( atenolol doesn’t)

Question 22

What beta blocker drugs are useful for the tx of glaucoma

Answer 22

Timolol

They prevent ne from binding to the B2 receptor so low camp and low aqueous humor formation

Question 23

Tx of glaucoma

Answer 23

• epinephrine
• bb: Timolol
• pilocarpine

Question 24

Beta1 selective blocker

Answer 24

Same effects as bb non selective but safe for cop dp d and asthma pts

Question 25

Esmolol

Answer 25

Tx of acute supraventricular arrhythmia Also with METOPROLOL (s/e- dyslipidemia)

Question 26

How can bb mask insulin induced hypoglycemia

Answer 26

It suppresses cathecolamines and the normal symptoms of hypoglycemia is not seen ( tremors, sweating and palpitations)

Question 27

Bb with intrinsic sympathomimmetic action

Answer 27

Pindolol | Acebutolol

Question 28

Alpha and better blockers

Answer 28

Labetol | Carvidilol

Question 29

Uses of A&B blocker

Answer 29

HTN in elderly black pt Cocaine induced HTN Pregnancy with HTN S/e Orthostatic HTN and dizziness

Question 30

Other uses of phenolamine

Answer 30

- second line drug for cocaine induced HTN - given to pts on MAO inhibitors who take tyramine containing foods - to treat NE extravasation

Question 31

An example of an A2 selective blocker

Answer 31

Mirtazapine

Question 32

Uses of mirtazapine

Answer 32

Depression

Question 33

S/e of mirtazapine

Answer 33

Sedation Increase serum cholesterol Increase appetite

Question 34

Symptomatic tx of hyperthyroidism

Answer 34

Propranolol

Question 35

B blocker for variceal bleeding

Answer 35

Nadolol, propranolol, carvedilol

Question 36

Nebivolol

Answer 36

A beta blocker which combines cardiac selective B1 adrenergic blockage + B3 Cause increase of NO as it activates NO synthase in the blood vessel