Kruse - Sympathoplegic Agents Flashcards Preview

Renal 2 Final - Pharm > Kruse - Sympathoplegic Agents > Flashcards

Flashcards in Kruse - Sympathoplegic Agents Deck (37):
1

When are sympathoplegic drugs most effective?

When used with a diuretic

2

B-adrenoreceptor antagonists are broken into 4 types

A. Non-selective = Non-ISA (intrinsic sympathomimetic activity) + ISA

B. B1 selective = non-ISA + ISA

3

Non-selective b-adrenoreceptor antagonists

Non-ISA = 4 of them (PCNT)

Propranolol
Carvedilol
Nodolol
Timolol

4

Non-selective b-adrenoreceptor antagonists

ISA = 4 of them (LCPP)

Labetolol
Cartelol
Penbutolol
Pindolol

5

B1-selective b-adrenoreceptor antagonists

ISA = 2 (AN)

Acebutaolol
Nebivolol

6

B1 selective b-adrenoreceptor antagonists

Non-ISA = 5 of them (MAEBB)

Metoprolol
Atenolol
Esmolol
Bisoprolol
Betaxolol

7

B-adrenergic antagonists are called

B blockers

8

B-blockers are useful in preventing

Reflex tachycardia --- results from tx with direct vasodilators in severe HTN

- also help reduce mortality after MI + heart failure pts

9

B-blocker prototype is

Propranolol

10

MOA of propranolol

non selective non ISA b-blocker

11

What is the effect of B-blockers like propranolol?

- decrease bp by decreasing CO
- some can vasodilate, but dont cause HTN in healthy normotensive pts
- blocking B1 receptors in kidney inhibits renin release
- some have local anesthetic effect by blocking Na channels

12

All b-blockers are available orally, except

Esmolol

13

5 b-blockers avaialble via IV (parental prep) (AELMP)

Atenolol
Esmolol
Labetalol
Metoprolol
Propranolol

14

Which 2 b-blockers readily cross BBB?

Why?

Propranolol
Penbutalol

Because they are lipophilic

15

Side Effects of B-blockers for asthmatics

- blocking B2 receptors in bronchial smooth muscle = constrict ion

** there are no B1 selective agents that completely AVOID b2 receptors

- benefits may outweight the risk for COPD patients if they have ischemic heart disease

16

Side effects of b-blcokers for diabetics

- glycogenolysis inhibited by blocking B2 receptors = can mask hypoglycemia

- use with caution for insulin-dependent iabetics

***benefits may outwieght costs in diabetics after MI

17

Common side effect of b-blockers

Bradycardia
Fatigue
Sexual dysfxn
Depression

Chronic use = can lead to increased VLDL + decreased HDL = BAD!!
Sudden withdrawal can cause: rebound HTN, angina, MI

18

B-blocker drug-drug interactions

heart block if combined with non-DHP CCBs (verapamil + dilitiazem) --- which slow conduction

19

Clinical uses of b-blockers

HTN
Heart failure
Ischemic Heart disease
Cardiac Arrhythmias
Glaucoma

20

B-blockers with B1 selectivity can be especially helpful for ppl with

Comorbid asthma
Diabetes
Peripheral vasc. Resistance

21

B1 blockers with partial B2-agonist activity can be advantageious in patients with

Bradyarrhythmias or peripheral vasc. Disease

22

Which two b-blockers are widely used for HTN

Metropolol + atenolol

23

b-blockers will make ACUTE congestive heart failure better or worse?

Worse

24

Which 4 b-blockers reduce mortality if used for Heart failure

(CBM)

Carvedilol
Bisoprolol
Metroprolol

25

Which 3 b-blockers prolong survival after MI

(TMP)

Tiolol
Metropolol
Propranolol

26

Which b-blockers help with glaucoma by decrease IOP (intraocular pressure)

Timolol
Betaxolol
Carteolol

**dont use drugs with local anesthetic action On the ey!!

27

A1 blocker prototype? MOA?

Reversible or irreversible?

Prazosin

Reversible antagonist of a1 receptors

28

Effect of a1 blockers?

- prevent vasoconstriction of both arteries + veins
- bp reduced by lowering peripheral vasc resistance
- relax smooth muscle in prostate
- retain Na + H20 if used without a diuretic
- improves plasma lipid profiles (increased HDL) or no change

29

Side effects of a1 blockers

- well tolerated
- orthostatic HTN
- dizziness
- palpitations
- headache
- less incidence of reflex tachycardia than non-selective a1 blockers because a2 receptor inhibition of NE release from nerve endings is not affected

30

Clinical uses of b-blockers

Used in men with HTN + benign prostatic hyperplasia

31

Centrally acting agents are

A2-agonists

32

A2 agonist prototypes

(CM)

Clonidine
Methyldopa

33

MOA of CENTRAL a2 agonists (clonidine + methyldopa)

- Reduce sympathetic flow from vasomotor centers in brainstem
- but still allow these centers to retain or increase sensitivity to baroreceptor control
- clonidine and methyldopa have slight variation in hemodynamic effects

34

Clinical use of CENTRAL a2 agonists

Methyldopa = HTN during pregnancy

Clonidine = lower bp by decreasing CO, decrease peripheral vasc resistance, and decrease HR + relaxation of capacitance vessels

35

Side effects of clonidine

Sedation
Dry mouth
Depression
Sexual dysfxn

**transdermal prep has less sedation than oral intake
**abrupt withdrawal = life threatening HTN crisis

36

Methyldopa effect?

- lowers bp by decreasing PVR, reducing HR + CO
- analog of L-dopa which becomes NE

37

Side effects of methyldopa

Sedation
Dry mouth
Lack of concentration
Sexual dysfxn