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Pharmacology > Pharm 10.2 > Flashcards

Pharm 10.2 Flashcards

(67 cards)

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1
Q

selective Beta 1 blockers

A

Acebutolol, atenolol, metoprolol

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2
Q

betablockers - ISA - intrinsic sympathomimmetic activity

A

Acebutolol, Pindolol

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3
Q

beta blockers with sedation effects

A

most except Atenolol

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4
Q

beta blockers that increase blood lipids

A

most except Acebutolol and Pindolol

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5
Q

Propanolol administration

A

oral is well absorbed, undergoes extensive first pass metabolism

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6
Q

Propanolol and BBB

A

Propranolol is lipophilic so it inters the BBB

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7
Q

Propanolol excretion

A

excreted in urine as glucuronide metabolites

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8
Q

nonselective beta blockers on inotropy

A

dec force of contration - negative inotropy

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9
Q

nonselective beta blockers on chronotropy

A

dec rate of contraction - negative chronotropy

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10
Q

nonselective beta blockers on SA and AV nodes

A

supress SA and AV nodal activity – bradycardia

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11
Q

overall effect of beta blockers on the heart

A

dec heartrate, SV, and CO, decBP in hypertensiv ppl –>reflex peripheral vasoconstriction

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12
Q

Why is Propranolol useful in angina

A

dec cardiac work so dec O2 consumption

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13
Q

Propranolol on blood vessels

A

blocks B2 mediate vasodialation

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14
Q

nonselective beta blockers and BP

A

does not dec BP in normal ppl, but decreases BP in hypertensive ppl (both systolic and diastolic)

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15
Q

nonselective beta blockers and postural hypotension

A

no postural hypotension because no effect on alpha 1 adrenergic receptors

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16
Q

Propranolol and the Kidney

A

decrease renin release from kidney (beta 1 action) – very useful property in reducing compensatory BP elevation

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17
Q

beta blockers are often combined with

A

a diuretic in treatment of HTN

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18
Q

Propranolol and respiratory tract

A

bronchoconstriction and can precipitate bronchial asthma (Beta 2 action)

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19
Q

Beta 2 blocker contraindications

A

bronchial asthma

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20
Q

beta blockers and the eyes

A

dec IOT due to inc aqueous humor production

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21
Q

Propranolol and the CNS

A

sedation, lethargy, depression, forgetfulness, sleep disturbances (dreams and nightmares) worse in lipophilic agents

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22
Q

Propranolol and skeletal muscle

A

antaganizes the epinephrine induced tremmors (muscle spindle controling tremors is under beta 2 control)

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23
Q

Propranolol metabolic effects

A

blocks epinephrine induced glycogenolysis –> fasting hypoglycemia; decrease insuline release (beta 2 block) after meal causing hyperglycemia

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24
Q

why should propranolol be used with caution in diabetics

A

bc it masks the warning sympathetic signes and symptoms such as swating, palpitations (tachycardia) induced by hypoglycemia

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25
what is a warning sign of hypoglycemia
tachycardia --this is masked by beta blockers
26
therapeutic uses of Propranolol
hypertension, Angina (except Prinzmetal's angina), MI (prophylactic use post-MI), Cardiac arrhythmias (Class II: Propranolol, Acebutolol, Esmolol), Migraine (prophylactically), Hyperthyroidism, Pheochromocytoma, Performance anxiety, Essential tremors, Glaucoma (Timolol), CHF, Hypertrophic cardiomyopathy, marfan syndrome and aneurysms
27
Beta blockers and hyperthyroidism
chance of thyroid storm increases during surgical removal of theyroid so betablockers beore surgery is desirable
28
CHF and beta blockers
dec sympathetic discharge and NE release dec CHF mortality
29
hypertrophic cardiomyopathy and betablockers
dec syncope, arrhythmias, and sudden death
30
Marfan syndrome and aneurysms and betablockers
alone or combined with ACEI/ARB dec aneurismal dialation by dec TGFbeta activity
31
beta blocker adverse CVS effects
bradycardia, AV block, abrupt discontinuation of propranolol can precipitate angina, arrhythmia, and hypertension ---should be withdrwan gradually after long term use
32
beta blockers adverse respiratory effects
causes bronchoconstriction, should not be used in asthmatic and COPD patients
33
beta blockers adverse metabolic effects
fasting hypoglycemia, increases blood lipid levels (LDLs and TGs)
34
beta blockers and other adverse effects
sexual dysfunction, fatigue and exercise intolerance
35
betablockers are contraindicated in
asthmatics, COPD, diabetics, Raynaud's disease, Prinzmetal angina
36
beta blockers with Digitalis and verapamil
additive depression of SA and AV node --> cardiac arrest
37
beta blockers and insuline/oral hypoglycemics
aggravate hypglycemic effects, mask warning signes (tremor and tachycardia)
38
betablockers and indomethacin and other NSAIDs
annul antihypertensive actions of betablockers
39
betablockers and cimetidine
inhibits metabolism of Propranolol
40
Timolol
potent nonselective betablocker, reduces the production of aqueous humor in the eye and hence used topically for the treatment of chronic open-angle glaucoma
41
nadolol
very long duration, same actions as propranolol (nonselective)
42
selective beta 1 antagonists
acebutolol, atenolol, esmolol, metoprolol
43
selective beta 1 antagonists can be used
in hypertensive patients with asthma and COPD bc they do not cause bronchoconstriction at therapeutic doses
44
selective beta 1 antagonists actions
decrease BP in hypertensive pts, inc exercise tolerance in angina, no bronchoconstriction effect, no effect on PR, no effect on CHO metabolism
45
therapeutic uses of beta 1 blockers
HTN (esp if they have pulm dysfuntion or diabetes), Angina, MI
46
beta1 blocker adverse effects
bradycardia
47
Atenolol
selective beta 1 blocker
48
Atenolol properties
lower lipid solubility, less CNS entry, excreted unchanged in the urine
49
Atenolol uses
HTN, Angina, MI
50
Metoprolol administered
orally/ IV for HTN, Angina, MI
51
Vasodialating beta blockers (less adverse effects)
labetalol, carvedilol, nevibolol, celiprolol
52
labetalol
beta blocker with additional alpha 1 blockade
53
carvedilol
nonselective beta blocker, alpha 1 blocker, ca-channel blocker, antioxidant
54
carvedilol halflife
7 hours
55
Nevibolol
cardioselective, anti-oxidant, beta 3 sitmulation causing NO production (effective in black ppl)
56
Celiprolol
Cardioselective, beta 1 blocker, beta 2 agonist, NO production
57
betablocker responsivness and ethnicity
chinese>white>black
58
American SNP asscociated with better survival in CHF patients treated with beta blockers
ADRB1gly389gly > ARDB1arg389gly
59
Esmolol
shortest acting beta 1 blocker, IV administration to treat acute supraventricular tachycardia
60
beta 1 blockers with ISA
pindolol, acebutolol
61
beta1 blockers with ISA cause
less bradycardia (beta1) and slight vasodialation or bronchodialation (beta2), act partial agonists
62
beta 1 blockers with ISA uses
HTN with moderate bradycardia in DM , CHO metabolism is less affected
63
beta blocker with K+ channel block
sotalol - used as antiarrhythmic (class 3)
64
alpha and beta blockers
labetalol, carvedilol
65
actions of Labetalol and carvedilol
peripheral vasodialation dec BP -- used in HTN emergency
66
benefits of labetolol and carvedilol
does not cause reflex bradycardia
67
cons of labetolol and carvedilol
same contraindications as nonselective beta blockers

Pharmacology (15 decks)

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