Beta Blockers - RM

Question 1

What receptors do beta blockers act on?

Answer 1

alpha 1 beta 1 beta 2

Question 2

Review: Alpha 1 receptors cause arteries to ______. Beta 1 receptors cause heart to beat ______ & ______. Beta 2 receptors cause bronchial _______.

Answer 2

A1: constrict

B1: faster & stronger

B2: dilation

Question 3

Review: An agonist ______ the receptor. An antagonist ______ the receptor.

Answer 3

Agonist: activates

Antagonist: blocks

Question 4

Name the 3 CARDIOSELECTIVE (B1) beta blockers.

Answer 4

1) atenolol
2) metoprolol tartrate
3) metoprolol succinate

Question 5

Metoprolol tartrate & succinate: which is short-acting; which is long-acting?

Answer 5

tartrate: short acting
succinate: long acting

(Remember: “Succinate lasts So long”)

Question 6

Name the 2 NONSELECTIVE beta blockers.

Answer 6

1) propranolol
2) carvedilol (least selective)

Question 7

Which receptors does propanolol block?

Answer 7

B1 & B2

Question 8

Which receptors does carvedilol block?

Answer 8

A1, B1, & B2

It is the least selective!

Question 9

What is one problem we see with the nonselective beta blockers?

Answer 9

bronchoconstriction, b/c they block B2 receptors

Question 10

Name 5 indications of beta blockers?

Answer 10

• HTN
• Angina pectoris (chest pain)
• A-Fib
• Post MI
• HF (heart failure)

Question 11

Why are beta blockers indicated for HTN?

Answer 11

They decrease cardiac output by decreasing HR (Remember: CO = HR x SV)

Question 12

Why are beta blockers indicated after a heart attack?

Answer 12

can decrease mortality b/c they provide cardioprotection

Question 13

What are the only 2 beta blockers indicated for heart failure?

Answer 13

carvadilol & metoprolol succinate

Question 14

What are 3 additional indications for propranolol?

Answer 14

• migraines
• hemangiomas
• stage fright

Question 15

Can propranolol cross the BBB? What benefit can that have?

Answer 15

Yes! This allows it to have a prophylactic effect on migraines.

Question 16

What type of adrenergic blockers are most likely to cause orthostatic hypotension?

Answer 16

Alpha 1 blockers (Carvedilol)

Question 17

What is it called when the BP drops significantly when a person stands up?

Answer 17

Orthostatic or postural hypotension

Question 18

What causes orthostatic hypotension?

Answer 18

Blood pools in the veins decreasing venous return. This, in turn, decreases cardiac output dropping BP

Question 19

What are adverse effects of beta blockers?

Answer 19

• symptoms of low BP or HR
• fatigue, depression
• bronchospam
• masking hypoglycemia

Question 20

What should you teach a diabetic patient on a BB to look for to identify hypoglycemia?

Answer 20

• hunger
• difficulty concentrating
• unusual fatigue
• check blood sugar often

Question 21

“Cold & clammy, needs some _____; hot & dry, sugar is _____.”

Answer 21

candy

high

Question 22

What is the black box warning regarding BB’s?

Answer 22

Do not abruptly stop a BB unless it’s absolutely necessary. Could cause HR and BP to skyrocket, and in extreme cases could cause death.

Question 23

If heart rate is below 60, should you administer a BB?

Answer 23

No. Hold med and contact physician.

Question 24

What is reflex tachycardia?

Answer 24

A reduction in arterial pressure is sensed by the baroreceptors in the aortic arch and carotid sinus. The brain overcompensates by telling the heart to beat faster.

(Bad because tachycardia puts an added burden on the heart)

Question 25

Why shouldn’t a person with a severe allergy (e.g., peanut) take a BB?

Answer 25

b/c the B1 receptor would be blocked, so adrenalin/epi. won’t work.

Question 26

Why should you never abruptly stop a BB?

Answer 26

The BP and HR may sky rocket. (When you take the foot off the brake, the gas will be pushed down harder.) Someone with angina or CAD could have an MI and die!