Anti-Adrenergic Drugs

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Author:
blakegoodman08
ID:
159139
Filename:
Anti-Adrenergic Drugs
Updated:
2012-06-17 19:41:31
Tags:
sympathetic SANS autonomic alpha beta blocker USMLE Step review antiadrenergic pharmacology
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Description:
List of different sympathetic ANS antagonists and their effects
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  1. Name the 3 classes and 7 different α blockers (2, 4, 1)
    • Nonselective: phenoxybenzamine, phentolamine
    • α1 selective: all end in -zosin; prazosin, terazosin, doxazosin, tamsulosin
    • α2 selective: mirtazapine
  2. Name the 11 different β blockers and place them in 4 classes (5, 5, 2, 2 repeated).
    • Selective: β1 > β2Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol (A BEAM of β1 blockers, laser beam like selectivity)
    • Non-Selective: β1 = β2; Propranolol, Timolol, Nadolol, Pindolol, Labetalol (all except labetalol start w/ letter in 2nd half of alphabet)
    • Non-selective α-β antagonists: Carvedilol, Labetalol (instead of olol)
    • Partial AgonistsPindolol, Acebutolol
  3. Name the targets, actions, and toxicity of phenoxybenzamine.
    • Irreversible nonselective α antagonist
    • Administer prior to pheochromocytoma removal (phen/pheo) before administering β blockade
    • Can cause orthostatic hypotension and reflex tachycardia
  4. Name the targets, actions, and toxicity of phentolamine.
    • Reversible nonselective α antagonist
    • Administer prior to pheochromocytoma removal (phen/pheo) before administering β blockade
    • Can cause orthostatic hypotension and reflex tachycardia
  5. Name the targets, actions, and toxicity of prazosin.
    • Selective α1 antagonist
    • Used to reverse hypertension and urinary retention due to BPH
    • Can cause 1st dose orthostatic hypotension, dizziness, and headache (often administer in office) 
  6. Name the targets, actions, and toxicity of terazosin.
    • Selective α1 antagonist
    • Used to reverse hypertension and urinary retention due to BPH
    • Can cause 1st dose orthostatic hypotension, dizziness, and headache (often administer in office)
  7. Name the targets, actions, and toxicity of doxazosin.
    • Selective α1 antagonist
    • Used to reverse hypertension and urinary retention due to BPH
    • Can cause 1st dose orthostatic hypotension, dizziness, and headache (often administer in office)
  8. Name the targets, actions, and toxicity of tamsulosin.
    • Selective α1 antagonist
    • Used to reverse urinary retention due to BPH
    • HAS NO EFFECT ON BLOOD PRESSURE
  9. Name the targets, actions, and toxicity of mirtazapine.
    • Selective α2 antagonist
    • Used to ameliorate depression
    • Can cause sedation, increase in appetite and serum cholesterol
  10. List the 7 major indications for β blockers.
    • Hypertension: lowers BP overall as well as slope of rise of BP; works by decreasing cardiac output and renin secretion (receptor blockade at JGA cells)
    • Angina pectoris: decrease of heart rate and contractility lowers O2 consumption
    • Myocardial infarction: only Metoprolol and carvedIlol reduce mortality if given during/after an M I
    • Superventricular tachycardia: all act as Class II antiarrythmics by decreasing AV conduction velocity
    • Congestive heart failure: slows progression of CHRONIC failure; if failure is acute, STOP β blockers!
    • Glaucoma: specifically timolol; decreases secretion of aqueous humor
    • Aortic dissection: β-blockers are drug of choice
  11. List the primary (8) toxicities of β-blockers.
    • Impotence, asthma exacerbation, bradycardia, AV block, acute CHF, sedation, sleep alterations.
    • Can mask symptoms of hypoglycemia, so use with caution in diabetics.
    • Eyedrops can have systemic effects! 
  12. Name the targets and actions of acebutolol.
    • Partial selective β1 antagonist
    • Used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  13. Name the targets and actions of betaxolol.
    • Selective β1 antagonist
    • Used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  14. Name the targets and actions of esmolol.
    • Selective β1 antagonist
    • Short acting; used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  15. Name the targets and actions of atenolol.
    • Selective β1 antagonist
    • Used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  16. Name the targets and actions of metoprolol.
    • Selective β1 antagonist
    • Used for hypertension, angina pectoris, MI mortality reduction, SVT, CHF, and aortic dissection.
  17. Name the targets and actions of propranolol.
    • Nonselective β antagonist
    • Used for thyroid storm, hypertension, angina pectoris, SVT, CHF, and aortic dissection. 
  18. Name the targets and actions of timolol.
    • Nonselective β antagonist
    • Used for glaucoma, hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  19. Name the targets and actions of nadolol.
    • Nonselective β antagonist
    • Used for recurrent varicose bleeding, hypertension, angina pectoris, SVT, CHF, and aortic dissection. 
  20. Name the targets and actions of pindolol.
    • Nonselective β partial antagonist
    • Used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  21. Name the targets and actions of labetalol.
    • Nonselective α-β antagonist
    • Used for hypertension, angina pectoris, SVT, CHF, and aortic dissection.
  22. Name the targets and actions of carvedilol.
    • Nonselective α-β antagonist
    • Used for hypertension, angina pectoris, MI mortality reduction, SVT, CHF, and aortic dissection.

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