Beta-Adrenergic Receptor Antagonists

Question 1

3 main categories of beta blockers

Answer 1

1. non selective (B1 and B2)
2. cardioselective (B1)
3. partial agonists (B1 and B2)
   (**blocker=antagonist)
   **ALL HAVE SAME CV EFFECTS

Question 2

Non-selective BETA blockers (B1 and B2)-Who are you

Answer 2

PROPRANOLOL, NADOLOL, TIMOLOL (PiNT)

Question 3

Non-selective BETA blockers (B1 and B2)-General

Answer 3

potentially harmful side effects for patients with respiratory disease

Question 4

Non-selective BETA blockers (B1 and B2)-CV

Answer 4

-reduced HR and contractility, reduced renin release–>reduced angiotensin II release–>REDUCED vasoCONSTRICTION

Question 5

Non-selective BETA blockers (B1 and B2)-Bronchioles

Answer 5

bronchiole constriction in those with asthma or COPD

Question 6

Non-selective BETA blockers (B1 and B2)-Therapeutic Use

Answer 6

HypErtension, angina, glaucoma, heart failure, arrythmia, (thyrotocixosis, anxiety)

Question 7

Non-selective BETA blockers (B1 and B2)-Toxicity

Answer 7

Bronchospasm, masks symptoms of hypOglycemia, CNS effects including insomnia and depression (most significant with lipid soluble drugs), some can raise triglycerides, bradycardia

Question 8

Non-selective BETA blockers (B1 and B2)-Contraindications

Answer 8

Bronchial asthma, sinus bradycardia, 2nd and 3rd degree heart lock, cardiogenic shock

Question 9

Cardioselective beta ONE blockers (B1)-Playas play

Answer 9

METOPROLOL, ATENOLOL, ESMOLOL (AiME)

Question 10

Cardioselective beta ONE blockers (B1)-General

Answer 10

developed for their ability to reduce respiratory side effects

Question 11

Cardioselective beta ONE blockers (B1)-CV

Answer 11

same as for non-selective beta blockers (with limited effects on peripheral resistance)

-reduced HR and contractility, reduced renin release–>reduced angiotensin II release–>REDUCED vasoCONSTRICTION

Question 12

Cardioselective beta ONE blockers (B1)-Therapeutic

Answer 12

HypErtension and angine (M+A)
arrythmia (E-emergent control)

**E has VERY short half life (~9min) so is given iv in hypertensive crisis, unstable angina, or arrythmias when longer acting beta blockers may be problematic

Question 13

Cardioselective beta ONE blockers (B1)-Toxicity

Answer 13

(typically mild and transient) dizziness, depression insomnia, hypOtension, bradycardia

Question 14

Cardioselective beta ONE blockers (B1)-Ci

Answer 14

sinus bradycardia, 2nd or 3rd degree heart block, cardiogenic shock, severe heart failure

Question 15

Partial Agonist-My One and Only

Answer 15

PINDOLOL

Question 16

Partial Agonist-General

Answer 16

• partial agonist activity at both B1R and B@R
• good therapeutic benefits when HTN is due to high sympathetic OUTPUT
• have LESS BRADYCARDIC effects

Question 17

Partial Agonist-CV

Answer 17

-reduced HR and contractility, reduced renin release–>reduced angiotensin II release–>REDUCED vasoCONSTRICTION…***particularly when sympathetic activity is high

Question 18

Partial Agonist-Therapeutic

Answer 18

-HTN in those who are less tolerant of bradycardia and reduced exercise capacity caused by other beta blockers without partial agonist activity

Question 19

Partial Agonist-Toxicity

Answer 19

(typically mild and transient) dizziness, depression insomnia, hypOtension, bradycardia….same as non-selective

Question 20

Partial Agonist-Ci

Answer 20

sinus bradycardia, 2nd or 3rd degree heart block, cardiogenic shock, severe heart failure…same as cardioselective