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Cardiovascular > Sweatman Beta Blockers > Flashcards

Sweatman Beta Blockers Flashcards

1
Q

Name the Beta Blockers

A

Propanolol

–>all others end in -LOL…not gonna type them

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2
Q

Beta blocker sites of action

A

Heart directly

Juxtaglomerular apparatus in the kidney–>inhibiting renin release

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3
Q

Beta 1 and 2 receptors in the heart physiologically work to

A

accelerate SA node
accelerate ectopic pacemakers
increase contractility

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4
Q

Beta blockers in the heart have their effects by

A

preventing SA node and ectopic pacemaker acceleration

decreasing contractility of the myocardium

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5
Q

physiologic activation of blood vessel smooth muscle in skeletal muscle works by

A

acting on beta 2 receptors to vasodilate (relax vascular smooth muscle)

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6
Q

beta relax–>epi

A

alpha constrict–>norepi

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7
Q

how is renin released

A

there are beta 1 receptors on the JGA cells–> in the presence of beta 1 agonsits–> they release renin
*therefore beta blokers inhibit renin release

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8
Q

pretratment by a beta blocking agent doe not affect

A

rise in BP produced by NE

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9
Q

BP increases due to NE are primary

A

alpha adrenergic stimulation

*beta blocker has no effect on this–>no change in increase in blood ressure with pre tx of beta blocker and NE

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10
Q

effects of epinephrine in the context of beta blockers

A

no effect

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11
Q

effects of E in context of alpha blockers

A

decreased blood pressure

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12
Q

effects of Isoproterenol in presence of beta blockers–>

A

almost completeley diminished

*beta 2 blockage–> prevents skeletal muscle vasodilation–>therfore there is no reduciton in BP

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13
Q

beta 1 specificity

A

metoprolol, acebutolol, alprenolol, atenolol, betaxolol, celiprolol, esmolol, nebivolol

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14
Q

*NONSPECIFIC BETA BLOCKERS

beta1=beta2

A

propanolol, cartelol, penbutolol, pindalol, timolol

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15
Q

FIRST GEN BETA BLOCKERS

A

NON SPECIFIC
B1=B2
NPPPT

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16
Q

SECOND GEN BETA BLOCKERS

A

BETA 1 SELECTIVITY

*METOPROLOL

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17
Q

THIRD GEN>

NON-SPECIFIC WITH ADDITIONAL ACTIONS

A

CERTELOL, CARVEDILOL, LABETOLOL

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18
Q

THIRD GEN>

B1 SPECIFIC WITH ADDITONAL ACTIONS

A

betaxolol

nebivolol

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19
Q

worst half life 0.15

A

esmolol–> second gen

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20
Q

administration of esmolol

A

IV infusion because half life sucks

–>given to hospitalized pt.’s

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21
Q

drug used for close monitoring and hour by hour control

A

esmolol

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22
Q

membrane stabalizing activity

A

propanolol
acebutolol
cervedilol

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23
Q

class 1 antiarrythmic compounds

A

propanolol
acebutolol
cervedilol

24
Q

class 1 antiarrythmic agents work by

A

binding to and stabalizing fast CA channels in cardiac tissue–>prevent such rapid depolarization
*decreased slop of phase 0

25
ISA=
intrinsic sympathomimetic activity
26
beta blocking agents work mostly in
active heart | -->resting heart largely under PS control
27
pts who need ISA drugs
profpound bradycardia-->negative entropy in the resting heart--> need sympathomimetic action
28
which drugs have ISA
labetolol, pindolol, acebutolo | *partial agonist effect stimulating resting heart that gives relief from bradycardia
29
nitric oxide production
cartelol | nebivolol
30
b2 receptor antagonism
certelol
31
alpha 1 receptor antagonism
cervedilol | lebetolol
32
Ca2+ entry blockade | -->vasodilation of smooth muscle
cervedilol | betaxilol
33
antioxidant activity
cervedilol
34
NO is a potent
vasodilation agent
35
when you give a beta blocker what happens
BP drops and the periphery (reflexively) vasocontstricts immediately after beginining a beta regimen
36
will beta blockers reduce BP in a normotensive pt?
NO | but will in hypertensives
37
most effective beta blocker in pt.'s with high renin in plasma
propanolol
38
most effective in pt.'s with no renin plasma level
pindolol
39
long term beta blockade=
fall in peripheral resistance-->after initial vasoconstriction -->mech unknown
40
adverse effects of beta blockers
-->CHF in the predisposed (relying in sympathetic stim to maintain cardiac output -->bradycardia, bradyaryhthmias-->AV heart block -->changes in periph vasc. flow -->abrupt cessation of therapy--> rapid increase in BP and angina=death
41
off target pulmonary effects with beta blockers results from
blockade of bronchial beta 2 (usual bronchodilators | -->COPD and ASTHA rely on bronchodilatory effect during flares in order to BREAK-->relaxation of smooth muscle
42
pt.'s with asthma or COPD cannot be put on
NON specific beta blockers (GEN 1)
43
Pt.'s with asthma and COPD should be given
metoprolol, avoid if at all possible | ->acebutolol, alprenolol, atenolol, betaxolol, celiprolol, esmolol, nebivolol
44
asthma and on nonspecific beta blockade
life-threatening increase in airway resistance
45
CV-->clinical uses of beta blockage
``` HTN Acute MI (beneficial when used post MI) ```
46
NON CV clinical uses of beta blockade
``` tremor thryotoxicosis anxiety prophylaxis of migraines preventing bleeding in esophageal vericies treament of glaucoma ```
47
Lipophillic beta blockers can cause
cns depression, intense dreams, mental disorders, fatigue,
48
Off target glucose effects of beta blockade
hypoglycemia masking tachycardia in warning sign of insulin induced hypoglycemia
49
non specific beta blockers will cause
hypoglycemia-->b2 receptors usually stimulate hepatic glycogenolysis-->blockage lowers glycogenolysis and plasma glucose levels
50
Blockage of beta 1 receptors in diabetics=
masks the tachycardia with serves as a warning sign for insulin induced hyPOglycemia *use cautiously
51
lipid profile changes seen in beta blockers
>ISA's or Beta 1 selectivity have less effect on trigs and HDL >both ISA and Beta1= reduce total cholesterol and LDL
52
In general beta blocker cause what changes in lipid profile
little effect on LDL, increased Trigs, decreased HDL
53
beta blocker toxicity-
most commonly in children accessing, suicidal attemps, accidental overdose
54
symptoms of beta blocker overdose
``` bradycardia hypotension arrhythmias hypothermia hyoglycemia seizures-->lipophillic>hydrophillic ```
55
lipophillic beta blockers that gain access to CNS
penbutolol high propanolol high mod-->CARVEDILOL, BETAXOLOL, timolol, metoprolol,

Cardiovascular (6 decks)

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