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alpha 2 receptors work where?
in the smooth muscle of the bv causing vasodilation
alpha 1 receptors cause what??
work in the smooth muscle of bv, stomach and intestine causing vasoconstriction, decreased motility and tone
Beta 1 receptors work where??
what do they cause?
- in the heart...
- cause increased rate and force of contraction
Where do beta 2 receptors work??
- lungs, heart, uterine and skeletal muscle
- cause vasoldilation
Labetalol is different from other Beta Blockers... how is this??
it is actually a alpha and beta blocker mixed.. it ends in alol instead of olol
USED FOR ANGINA AND CHF
Beta blockers are generally used to treat (5)?
- 1. HTN
- 2. arrhythmias
- 3. angina
- 4. HF -- USE CAUTION!!!
- 5. migraines ---prophylaxis
Which Bblockers are used to treat migraines?
propranolol & timolol
What Bblocker is not used to treat HTN but used instead only for arrhythmias?
has epi and norepi qualitites--from SNS
beta blockers block SNS actions
All BB have similar MOA..what is this??
competitive blockade of Beta Adrenergic receptors.
Results in decreased heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand
Effects of Beta Blockade cause what??
decreased CO and HR
Slowing of AV conduction system prevents increase in cardiac automaticity and prolongs refractory period.
BP is lowered by decreasing CO, PVR, venous return, plasma volume, and renin release.
BB also decrease _______damage of the ______?
What kind of arrhythmias are BB good to treat?
BB must be used with caution in what kind of other diseases?
- Any type of heart block
- sinus bradycardia
- cardiogenic shock
Use caution with diabetes!!!! RISK OF DEVELOPING DIABETES IS HIGH!! This is the reason that BB are not considered first line treatment with HTN.
BB are the treatment of choice for _____ and _______?
chronic and unstable angina
Goal is to reduce frequency and severity of signs and symptoms, and to improve exercise capacity without significant side effects.
AHA recommends all patients receive a BB _______?
- Post MI
- Improves survival rate.
BB used for headaches?
- reduce frequency and intensity of headache.
- propranolol, timolol, nadolol, and atenolol.
Do BB cause weight gain??
they reduce the rate of metabolism due to decrease bp and hr (or decrease nutrients to tissues)
they also increase accumulation of body fat
Patient education on BB and impotence???
Inform patient that this will resolve and not to quit taking their medication. Should resolve in 7-10 days.
Impotence occurs with all BP MEDs
Do not give what drug with BB??
NSAIDS- they interact with each other!!!
Atenolol is pregnancy category
Which BB can be given to children??
You should monitor your patient for weight gain and bradycardia!!
What is your concern with giving patients BB with HF?
- decrease CO
- decrease contractility
- but increased ef
What Vaughn Williams class are these drugs?
When should you not prescribe this med?
- uncompensated HF- may further depress cardiac contractility
- cardiogenic shock
- bradycardia or HB
- pulmonary edema
- severe asthma and COPD
- Raynauds disease
- 40 mg bid
- titrate every 3-7 days
- usual dose is 40-160 mg dose in two doses.
- SR is 60-180 mg once daily.
Teach patient to report which SERIOUS symptoms while taking BB???
Name 3 other SE:
leg swelling, SOB, exercise fatigue and nocturnal cough
--bronchoconstrictions, decrease HR and cardiac output
What would your signs of toxicity be?
decreased BP AND HR