Beta blockers Flashcards
(35 cards)
What are non selective beta Adrenergic receptor agonists?
Nadolol
Propranolol
Timolol
Dilator
What are beta1 selective beta Adrenergic receptor agonists?
Atenolol
Bisoprolol
Metoprolol
What are non selective beta Adrenergic receptor agonists?
Carvedilol
Labetalol
What are beta 1 selective 3rd generations agonist?
Nebivolol
Beta blockers have what suffix
O lol
What is the clinical relevance of Beta 1 receptors?
Heart: rate, contractility, automaticity, conduction velocity,
Kidney: Renin release
What is the clinical relevance of beta 2 receptors?
Lung: Bronchorelaxation
Skeletal muscle: Vasodilation, Glycogenolysis
Liver: glycogenolysis and gluconeogenesis
What are primary mechanisms of beta agonists?
Specifically block beta 1 Adrenergic receptors
They have varying affinity for beta1 and Beta2
None are specific to beta1 in a dose related way
What are the secondary mechanisms for beta 1 agonists?
Partial agonists/ intrinsic sympathomimetic activity (ISA)
They inhibit beta receptors when with catecholamines
Local anesthetic
Alpha1 blockers
Vasodilation or antioxidants
What are the effects of beta blockers on the cardiovascular system?
Decreases most of the sumpathetically supported cardiac functions.
Depends on sympathetic nervous system.
Lowers BP in hypertension
Decreased cardiac output
See slide 10 about NE release and know mechanism
See slide 10 about NE release
How do beta blockers affect the eye?
Reduced intraocular pressure
*chronic open angle glaucoma
Beta 2 receptors are on ciliary epithelium
What are the adverse effects of beta blockers on the heart?
May cause or exacerbate heart failure.
Bradyarrhythmias
Exacerbate peripheral vascular disease ( Raynauds)
Abrupt discontinuation can cause sudden death)
Exercise intolerance
What are the adverse effects of beta blockers on the pulmonary system?
Block beta 2 receptors in the bronchial smooth muscle: COPD patients can have life threatening Vasoconstriction.
Less likely with Beta 1 or Beta agonists with ISA
What are the adverse effects of beta blockers on CNS?
Fatigue
Sleep disturbance
Depression
What are the adverse effects of beta blockers on metabolism?
Delays recovery from hypoglycemia
Beta2- mediated effects of catecholamines on gluconeogenesis and gluconeogenesis.
Beta1 selective agonist no issue
Blunts the perception of symptoms of hypoglycemia.
Non-selective beta blockers first generation:
Propranolol( Prototype)
Nadolol
Timolol
Sotalol
What are the mechanics of non-selective beta blockers 1st generation propanolol prototype:
Competitive reversible antagonist of B1 and B2 receptors.
Rapid and completely absorbed
Substantial first pass metabolism
What are the clinical uses of non-selective first generation beta blockers? Propanolol prototype
Hypertension
Angina
Cardiac Arrhythmias
Myocardial infarction
Pheochromocytoma
Migraine prophylaxis
What are the adverse effects of nonselective first generation beta blockers propanolol protype
Acute heart failure Bradycardia Bronchospasm Blunt recognition hypoglycemia Abrupt withdrawal
What is Timolol?
A nonselective first generation beta blocker
Competitive and reversible antagonist of Beta 1 and 2 receptors.
Major use Glaucoma: decreases aqueous humor
Also used similarly as propanolol
What are beta 1 selective antagonists second generation:
Atenolol
Bisoprolol
Metoprolol (prototype)
What is the mechanism for beta 1 selective antagonist metoprolol?
Competitive reversible agonist of beta 1 receptors
Cardioselective
A low dose is 10 fold more selective for Beta 1
What are the clinical uses for beta 1 selective antagonist metoprolol?
Hypertension
Angina
Acute myocardial infarction
Congestive heart failure
Adverse effects: Similar to proranolol less bronchoconstriction
