Beta Blockers Flashcards Preview

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Flashcards in Beta Blockers Deck (41):
1

What do selective beta blockers selectively block?

Beta-1 (heart chrontropy and inotropy)
No effect on beta-2

2

What effect do non-selective beta blockers have on the heart and lungs?

Decrease heart rate, decrease blood pressure, bronchoconstrict, vasoconstrict

3

What does it mean for a beta blocker to have intrinsic sympathomimetic activity (ISA)?

Beta blockers with some beta agonistic effects (blocks yet occasionally stimulates receptor)-generally less effective

4

When are beta blockers with ISA used?

When a patient is at risk of bottoming out

5

What is MSA?

Membrane stabilizing activity – has numbing affects due to inhibition of myocardial fast sodium channels

6

What type of medicine contains MSA?

Eyedrops used to treat glaucoma

7

Describe problems stemming from high lipophilicity of some beta blockers

Can penetrate blood brain barrier causing seizures and delirium

8

Name a beta blocker with ISA

Pindolol (has an "i" in it)

9

Name two beta blockers with MSA

Acebutolol, propranolol

10

List three lipophilic beta blockers

Carvedilol, nebivolol, penbutolol

11

Name two beta blockers with alpha-1 antagonism

Carvedilol, labetalol (do not end in "olol")

12

Which type of beta blockers are the more potent antihypertensives?

Beta blockers with alpha-1 antagonism (recognized by "ilol" or "alol" ending)

13

Name a beta blocker with nitrous oxide release

Nebivolol (starts with N)

14

Name 3 beta-1 selective beta blockers

Atenolol, metoprolol, nebivolol, Acebutolol, betaxolol, esmolol...

15

Which patients should be careful to avoid nonselective beta blocker's?

Patients with lung conditions due to beta blocker's potential for bronchoconstriction

16

Describe the mechanism of action of beta blockers

Blockade of epinephrine and norepinephrine effects on beta adrenergic receptors, can be beta-1 selective or nonselective

17

What is the correct way to taper off of a beta blocker?

There is no correct way, just withdraw slowly due to receptor up regulation

18

What is the concern if a patient on beta blockers goes into anaphylaxis?

They require higher doses of epinephrine to mediate anaphylaxis

19

Why should diabetic patients be careful on beta blockers?

Beta blockers mask symptoms of hypoglycemia – sweating, tremor, headaches, tachycardia

20

How can beta blockers negativelycontribute to heart failure?

Beta blockers are negative inotropes that increase fill time but decrease contractility

21

What are three neurologic side effects of beta blockers

Depression, fatigue, sexual dysfunction
(the higher the lipophilicity, the higher the risk)

22

List 3 beta blockers that decrease mortality in congestive heart failure

Metoprolol, carvedilol, Bisoprolol

23

List a beta blocker that is renally eliminated

Atenolol

24

List a beta blocker that is IV only

Esmolol

25

List a beta blocker that is eliminated via plasma esterases

Esmolol (has nine minute half life, metabolized in blood, given IV only)

26

List a beta blocker that can be used in hypertensive emergency

Labetalol (more potent alpha blocker than carvedilol)

27

What medication should be used to treat Prinzmetal's angina?

Calcium channel blockers (vascular specific) – beta blockers worsen vasospasm

28

Which is a more potent form of labetalol (nonselective beta blocker with alpha-1 blockade), PO or IV?

PO Labetalol is a more potent alpha blocker than IV

29

Name a beta blocker that can be given in a cocaine overdose

Labetalol – blocks alpha-1, beta-1 and beta-2

30

What form of metoprolol is indicated for CHF?

XL (oral)
(Also comes IV and IR PO, but only XL is for CHF patients)

31

What are some indications of propanolol?

Since propranolol is lipophilic and contains MSA, it can be used to treat many conditions including angina, a fib, tremor, hypertension, migraine, pheochromocytoma, AMI, aggression, anxiety, thyroid storm, portal hypertension...

32

Give an example of when to use sotalol

Atrial and ventricular arrhythmias, angina, hypertension – it is a nonselective beta blocker with antiarrhythmic activity

33

Which nonselective beta blocker is commonly used for open angle glaucoma?

Timolol

34

Describe the different functions of alpha-1 receptors on postsynaptic and presynaptic neurons

Postsynaptic – mediate vasoconstriction
Presynaptic – inhibit release of neurotransmitters

35

Which alpha-1 blockers are used to treat postural hypotension?

Doxazosin, prazosin, terazosin (all end in zosin)

36

Which alpha-1 blockers are bladder specific and used in BPH to increase urine flow?

Afluzosin, sildosin tamsulosin

37

List the only alpha-2 agonist that decreases blood pressure

Clonidine

38

Which alpha-2 agonist is commonly used for sedation in Neurosurgery?

Dexmedetomidine (Precedex)

39

Why does Precedex make a good sedative? (as opposed to Fentanyl or morphine)

Lipophilic, CNS specific, causes very little respiratory depression

Fentanyl and morphine require mechanical ventilation

40

What kind of medication is Sudafed and how does it work?

Alpha-1 agonist – vasoconstrict capillaries to relieve nasal congestion

41

What form of Sudafed is best for patients with hypertension?

Nasal spray – it is location specific