Pharm 10.1 Flashcards Preview

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Flashcards in Pharm 10.1 Deck (44)
1

irreversible alpha antagonists

phenoxybenzamine

2

reversible non selective alpha antagonists

phentolamine, ergotamine, tolazoline

3

reversible selective alpha 1 antagonist

prazosin, terazosin, doxazosin, tamsulosin

4

reversible selective alpha 2 antagonist

yohimbine

5

nonselective beta blockers without sympathomimetic activity

propranolol, timolol, sotalol, nadolol

6

nonselective beta blockers with sympathomimmetic activity

acebutolol, pindolol

7

nonselective beta blockers with alpha blocking property

labetalol, carvedilol

8

selective (caridoselective) beta 1 blocker

atenolol, acebutolol?, esmolol, metoprolol

9

selective (caridoselective) beta 1 blocker with additional actions (NO)

Nevibolol

10

selective beta 2 blocker

butoxamine

11

alpha blockers on TPR

dec TPR by blocking vasoconstriction causing hypotention --> reflex tachycardia due to fall in BP along with salt and water retention

12

alpha blockers on postural reflex

blocking vasoconstricion interferes with postrual reflex leading to postrual hypotention. First dose hypertention. - can cause falls and fractures

13

Dale's vasomotor reversal

epinephrine reversal

14

alpha blockers on trigone and sphincter

relaxation of trigone and sphincter muscles in base of urinary bladder and prostate --> dec resistance to urinary outflow

15

alpha blockers on nasal stuffiness

dialates vessles so helps with nasla stuffines and miosis?

16

alpha blockers on intestinal motility

increase intestinal motility leading to diarrhea

17

alpha blockers on ejaculation

failure of ejaculation

18

Phenoxybenzamine

noncompetitive irreversible nonselective alpha blocker

19

Phenoxybenzamine actions

prevents vasoconstriction, causes inc reflex tachycardia

20

Phenoxybenzamine is used in

Pheochromocytoma (prior to surgical removal, to preclude hypertensive crisis)

21

Epinephrine reversal --> vasomotor reversal of Dale

Epinephrine when given in high dose, increases the blood pressure (vasopressor effect) by acting on the alpha 1 receptors. Epinephrine has effect on beta 2 receptors also (at low doses epinephrine stimulates only beta 2 predominantly). So, when alpha 1 blockers are given before epinephrine (high dose), it will not be able to act on alpha 1 receptor and won't exhibit vasopressor effect, instead epinephrine will casues drop in BP (vasodepressor effect)

22

Phentolamine

competitive reversible nonselective alpha blocker

23

Phentolamine causes

reflex tachycardia (lasts >24hrs) , postural hypotension and epinephrine reversal

24

Phentolamine duration of action

4 hours ( on the shorter side)

25

Phentolamine adverse effects

can trigger arrhythmias and anginal pain

26

Phentolamine is contraindicated in

patients with decreased corronary perfusion

27

therapeutic uses of alpha blockers

Raynaud's disease (cold induced vasoconstriction is reversed), opposing catecholamine actions in Pheochromocytoma (nonselective long acting, for 2-3 weeks prior to surgery)

28

adverse effects of alpha blockers

postural hypotension, nasal stuffiness, inhibition of ejaculation, tachycardia

29

contraindications of alpha blockers

decreased coronary perfusion

30

alpha 1 selective blockers

prazosin, terazosin, doxazosin (long acting), Tamsulosin

31

Tamsulosin and Silodosin unique bc

its an alpha 1 A antagonists and works more on the bladder than on systemic vessels --> especially helps urine flow in BPH

32

prazosin duration of action

6 hrs

33

terazosin duration of action

20 hrs

34

doxazosin duration of action

30 hrs

35

alpha 1 blockers are used as

antihypertensive agents, in BPH

36

adverse effects of alpha 1 blockers

first dose effect, orthostatic postural hypotension, headache, dizziness, reflex tachycardia, nasal stuffiness

37

first dose effect

syncope (fainting) - a greater hypotensive effect is seen when administerd the first time - may be minimized by lowering the first dose and giving it at bed time

38

adverse drug interactions with alpha 1 blockers

ACEI (like enalapril) or Ca channel blockers (like Nifedipine) ---> angII and alpha 1 blockers share a signal transduction path involving DAG, IP2 and CA, which are blocked by the combinations -->receptor crosstalk inhibition

39

selective alpha 2 blockade

yohimbine, mirtazapine

40

yohimbine

selective competitive alpha 2 blocker

41

Yohimbine and sex

yohimbine is a sexual stimulant (aphrodisiac)

42

Yohimbine use

postural hypotension and sexual impotence --- but no clinical utility

43

Mirtazapine

antidepressant in pts with alzheimers

44

alpha blockers are used in

pheochromocytoma, hypertension, BPH, and Raynaud's disease