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Pharm 3, Test 3 > Beta Blockers > Flashcards

Beta Blockers Flashcards

1
Q

What are the non selective beta blockers?

A

Propanolol, pindolol, nadolol, timolol, carteolol, and sotalol

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2
Q

What do selective beta blockers block?

A

B1

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3
Q

What are the selective beta blockers?

A

Metoprolol, atenolol, acebutolol, betaxolol bisoprolol, esmolol

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4
Q

What drug is a selective b1 antagonist and a selective b2 agonist?

A

Celiprolol

Repeated this slide a lot…. IDK

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5
Q

What are the two beta blockers that also block a1 and b2

A

Labetalol and carvedilol

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6
Q

What broad patient population should we be careful with in beta blockers?

A

Respiratory patients, like asthma or COPD

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7
Q

What can some beta blockers actually do in the absence of Epi/NE?

A

Agonists to beta receptors. Probably not very clinically relevant

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8
Q

What does blocking beta 1 cause?

A

Decreases contractility, making it a negative ionotrope

Decreases heart rate, making it a negative chronotropic

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9
Q

How does beta blockers reduce TPR, despite the body having a compensatory sympathetic outflow to B1 blockage?

A

Multiple theories- This is the most important one

B1 receptors on JG cells getting blocked, leading to decreased renin

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10
Q

Whats the acute phase response of beta blockers? Chronic response?

A

TPR might go up, CO might go down, but chronically BP is reduced r/t B1 blockage in JG cells

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11
Q

What patient population should beta blockers be avoided in?

A

Generally COPD or asthma

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12
Q

What is the metabolic effect of beta blockers?

A

Will promote catecholamines due to activation of SNS< promoting glycogenolysis and mobilization glucose in response to hypoglycemia

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13
Q

What are the ADEs of beta blockers?

A

Increase in airway resistance
CNS- Fatigue, sleep disturbances, depression metabolism- Blunts recognition of hypoglycemia
Sexual dysfunction

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14
Q

What are most beta blockers metabolized by?

A

CYP450

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15
Q

Do beta blockers help everyone?

A

No. Some patients, like some with angina, will not tolerate the decrease in contractility

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16
Q

Are BBs good for MIs?

A

YES

17
Q

Are BBs good for heart failure?

A

Initially were contraindicated, but now they are used commonly

18
Q

How are BBs good for aneurysm?

A

Reduces pressure being exerted against the artery wall by reduction in hr and bp

19
Q

How is BBs good for glaucoma?

A

Reduces aqueous humor production

20
Q

What is the memory tool to memorize non selective bbs?

A 
Previously purple- Propanolol
People- Pindolol
Can-carteolol
Not-nadolol
Take-Timolol
Some-sotalol
21
Q

Which non selective bb is significantly metabolized by CYP450 2D6? And has significant first pass metabolism

A

Propanolol

22
Q

Why is is a problem for propanolols metabolism?

A

Significant genetic variants in metabolism

Like ultra fast metabolizer or poor metabolizer

23
Q

What is the problem with sotalol?

A

Blocks K currents, can cause torsades

24
Q

Whats the memory aid in selective BBs?

A

MAABBE
Metoprolol, atenolol, acebutolol, betaxolol, bisoprolol, esmolol

Cuz maabbe you could use these in pulmonary patients

25
Q

Why is metoprolol first?

A

Significant CYP450 2D6 metabolism, significant genetic variance, first pass metabolism

26
Q

Why is esmolol last?

A

Brief block, rapid blockade used IV in the ICU.

I used this in the guy that was a prisoner and had a ruptured mitral valve

27
Q

Is nebivolol selective or not?

A

Selective

28
Q

What is unique about nebivolol?

A

Causes vasodilation via stimulation of NO release

29
Q

What makes labetalol and carvedilol unique?

A

Blocks a1 at therapeutic concentrations

30
Q

Celiprolol is a selective or not?

A

Selective for B1 and mild B2 AGONIST

31
Q

What is wrong with celiprolol?

A

Increases risk for aortic dissection in Ehlers Danlos syndrome

Pharm 3, Test 3 (5 decks)

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