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Naplex > Rx Files Beta Blockers > Flashcards

Rx Files Beta Blockers Flashcards

1
Q

Mechanism of action of BB

A

blockades effects of epinephrine and norepinephrine on beta adrenergic receptors

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2
Q

Beta 1 receptors act on the ______.

A

heart

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3
Q

Beta 2 receptors act on the _______.

A

lungs

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4
Q

Beta 1 blockade causes what?

A

negative chronotropy and inotropy which results in decreased HR and decreased BP

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5
Q

Beta 2 blockade causes what?

A

mild bronchoconstriction and vasoconstriction

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6
Q

What does intrinsic sympathomimetic activity mean?

A

beta blockers with some beta agonism

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7
Q

What does membrane-stabilizing activity mean?

A

inhibition of myocardial fast sodium channels

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8
Q

Potential detriment of membrane-stabilizing activity?

A

widen QRS complex –> potential for dysrhythmias

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9
Q

What BBs have ISA?

A
  • acebutolol
  • carteolol
  • labetalol
  • oxprenolol
  • penbutolol
  • pindolol
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10
Q

What BBs have MSA?

A
  • acebutolol
  • betaxolol
  • carvedilol
  • oxprenolol
  • propranolol
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11
Q

What BBs are lipophilic?

A
  • bisoprolol
  • carvedilol
  • labetalol
  • metoprolol
  • nebivolol
  • oxprenolol
  • penbutolol
  • pindolol
  • timolol
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12
Q

Which BBs are renally cleared?

A
  • atenolol
  • bisoprolol
  • carteolol
  • nadolol
  • sotalol
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13
Q

Which beta blockers have alpha 1 antagonism?

A
  • carvedilol

- labetalol

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14
Q

Which beta blockers have nitric oxide release?

A
  • bisoprolol
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15
Q

Which BBs are beta 1 selective?

A
  • acebutolol
  • atenolol
  • betaxolol
  • bisoprolol
  • esmolol
  • metoprolol
  • nebivolol
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16
Q

What are patient education points to make about BBs?

A
  • withdrawal of therapy must be done slowly due to receptor upregulation
  • caution in pulmonary disease (especially non-selective)
  • higher doses of EPI/NE needed for anaphylaxis
  • may mask signs of hypoglycemia
  • may worsen lipid panel
  • caution in HF (negative inotrope)
  • may cause depression, fatigue, and sexual dysfunction
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17
Q

Acebutolol brand

A

Sectral

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18
Q

Acebutolol is non/selective with what special properties?

A

selective
ISA and MSA
not lipophilic

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19
Q

Acebutolol indications

A
  • HTN

- ventricular arrhythmias

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20
Q

Acebutolol dosage

A

100 - 400 mg PO BID

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21
Q

How is acebutolol eliminated?

A

renal and hepatic

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22
Q

Atenolol brand

A

Tenormin

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23
Q

Atenolol is non/selective with what special properties?

A

selective

no ISA or MSA or lipophilicity

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24
Q

Atenolol indications

A
  • AMI
  • angina
  • HTN
  • migraine ppx
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25
Q

Atenolol dosage

A

50 - 200 mg PO daily

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26
Q

How is atenolol eliminated?

A

renal

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27
Q

Bisoprolol brand

A

Zebeta

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28
Q

Bisoprolol is non/selective with what special properties?

A

selective

lipophilic

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29
Q

Bisoprolol indications

A
  • HTN
  • migraine ppx
  • CHF
  • A.Fib ppx in cardiac surgery
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30
Q

Bisoprolol dosage

A

2.5 - 20 mg PO daily

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31
Q

How is bisoprolol eliminated?

A

renal and hepatic

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32
Q

Carvedilol brand

A

Coreg

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33
Q

Carvedilol is non/selective with what special properties?

A

nonselective
alpha 1 blockade
MSA
lipophilic

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34
Q

Carvedilol indications

A
  • HTN
  • CHF
  • portal HTN
  • A.fib
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35
Q

Carvedilol dosage

A

3.125 - 25 mg PO BID

36
Q

How is carvedilol eliminated?

A

hepatic

37
Q

How is Coreg CR dosed?

A

daily carvedilol dose x 1.6

38
Q

Esmolol brand

A

Brevibloc

39
Q

Esmolol non/selective with what special properties?

A

selective

no ISA, MSA, or lipophilicity

40
Q

Esmolol indications

A
  • intra/post-op HTN
  • A.fib
  • aortic dissection (DoC)
41
Q

Esmolol dosage

A

50 - 300 mcg/kg/min

42
Q

What dosage form is esmolol available in?

A

IV only

43
Q

How is Esmolol eliminated?

A

plasma esterases

44
Q

Labetalol brand

A

Normodyne

Trandate

45
Q

Labetalol is non/selective with what special properties?

A

nonselective
alpha 1 blockade
ISA
lipophilic

46
Q

What dosage form is labetalol available in?

A

IV and PO

47
Q

Labetalol indications

A

HTN
HTN emergency and urgency
cocaine overdose

48
Q

Labetalol IV bolus dosage

A

10 - 80 mg IV q10min

49
Q

Labetalol IV infusion dosage

A

not often used

0.5 - 2 mg/min

50
Q

Labetalol PO dosage

A

200 - 2400 mg/day divided in 2-3 doses

51
Q

How is labetalol eliminated?

A

hepatic

52
Q

Metoprolol brand

A

Lopressor

Toprolol XL

53
Q

Metoprolol is non/selective with what special properties?

A

non selective

lipophilic

54
Q

Metoprolol indications

A
  • AMI
  • HTN
  • angina
  • migraine ppx
  • anxiety
  • A.fib ppx in cardiac surgery
55
Q

Metoprolol IV bolus dosage

A

1.25 - 5 mg q2-5 min (max dose 15 mg IV)

56
Q

Metoprolol tartrate dosage

A

6.25 - 100 mg BID-TID

57
Q

Metoprolol succinate dosage

A

25 mg daily to 200 mg BID

58
Q

How is Metoprolol eliminated?

A

hepatic

59
Q

Metoprolol IR to XL dosing

A

daily IR dose x 0.77

60
Q

Nadalol brand

A

Corgard

61
Q

Nadalol is non/selective with what special properties?

A

nonselective

62
Q

Nadalol indications

A
  • angina
  • HTN
  • migraine ppx
  • portal HTN
63
Q

Nadolol dosage

A

40 - 160 mg PO daily

64
Q

How is nadolol eliminated?

A

hepatic

65
Q

Nebivolol brand

A

Bystolic

66
Q

Nebivolol is non/selective with what special properties?

A

selective
stimulates NO release
lipophilic

67
Q

Nebivolol indications

A
  • HTN

- migraine ppx

68
Q

Nebivolol dosage

A

5 - 40 mg daily

69
Q

How is Nebivolol eliminated

A

hepatic

70
Q

Propranolol brand

A

Inderal

71
Q

Propranolol is non/selective with what special properties?

A

nonselective

MSA

72
Q

Propranolol indications

A
  • angina
  • A. fib
  • tremor
  • HTN
  • Migraine ppx
  • pheochromocytoma
  • AMI
  • aggression
  • anxiety
  • thyroid storm
  • portal HTN
  • many others
73
Q

Propranolol dosage

A

10 - 80mg PO BID-QID

74
Q

How is propranolol eliminated?

A

hepatic

75
Q

Sotalol brand

A

Betapace

76
Q

Sotalol is non/selective with what special properties?

A

nonselective

independent antiarrhythmic activity

77
Q

Sotalol indications

A

atrial and ventricular arrhythmias
angina
HTN

78
Q

Sotalol dosage

A

80 - 160mg PO BID

79
Q

Why must sotalol be started inpatient?

A

risk of Torsades de pointes

80
Q

How is sotalol eliminated?

A

renal

81
Q

Timolol brand

A

Betimol

Timoptic

82
Q

Timolol is non/selective with what special properties?

A

nonselective

83
Q

Timolol indications

A
  • HTN
  • migraine ppx
  • ocular HTN
  • open-angle glaucoma
  • AMI
  • angina
  • anxiety
84
Q

How is timolol eliminated?

A

hepatic and renal

85
Q

alpha 1 blockers

A

Doxazosin (Cardura)
Prazosin ( Minipres)
Terazosin (Hytrin)

86
Q

alpha 1a blockers (bladder specific)

A

Alfuzosin (Uroxatral)
Silodosin (Rapaflo)
Tamsulosin (Flomax)

87
Q

alpha 2 agonists

A

Clonidine (catapres)

Dexmedetomidine ( Precedex)

Naplex (8 decks)

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