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Definition
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Definition
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Term
Selective Alpha1 Blocker: MOA
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Definition
- binds to post-synpatic alpha1 receptors (competitive)
- inhibits vasoconstriction induced by endogenous catecholamines
- lowers blood pressure by:
- reducing tone in arteriolar resistance vessels
- dilating venous capacitance vessels, which reduces venous return and therefore cardiac output
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Term
Selective Alpha1 Blocker: Adverse Effects
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Definition
- postural hypotension: especially with first dose
- lethargy, headache, dizziness
- palpitationfrom reflex cardiac stimulation
- nausea
- impotence
- diarrhea
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Selective Alpha1 Blocker: Drug Interactions
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Definition
- alcohol: additive hypotension activity
- sildenafil: can lead to symptomatic hypotension
- sympathomimetics: can decrease hypotensive activity
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Term
Selective Alpha1 Blocker: Other Considerations
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Definition
- it is recommended that the initial dose be small and administered at bedtime for a few days to avoid orthostatic hypotension
- reduced efficacy can follow chronic administration due to Na and water retention
- not recommended as monotherapy for hypertensive patients
- used primarily in conjunction with diuretics, beta blockers, and other antihypertensive agents
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Term
Selective Alpha1 Blocker: Indications
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Definition
- hypertension
- benign prostatic hyperplasia
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Term
| Phenoxybenzamine: MOA, Adverse Effects, and Indications |
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Definition
Non-Selective Alpha Blocker
- long acting, non-competitive (irreversible) antagonist at both alpha1 and alpha2 receptors
- decreases PVR and BP
- Venodilation is prominent
- cardiac stimulation: cardiovascualr reflexes and enhanced NE release due to alpha2 antagonism
Adverse Effects:
- postural hypotension
- reflex tachycardia
- arrhythmia
- fatigue, headache, dizziness
- nasal congestion
- ejaculation dysfunction
Indication:
hypertension due to pheochromocytoma |
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Term
| Phentolamine: MOA, Adverse Effects, and Indications |
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Definition
Non-Selective Alpha Blocker
- short-acting, competitive antagonist at both alpha1 and alpha2 receptors
- decreases PVR and BP
- Venodilation is prominent
- cardiac stimulation: cardiovascualr reflexes and enhanced NE release due to alpha2 antagonism
Adverse Effects:
- postural hypotension
- reflex tachycardia
- arrhythmia
- fatigue, headache, dizziness
- nasal congestion
- ejaculation dysfunction
Indication:
hypertension due to pheochromocytoma
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Term
| Treprostinil: MOA and Indication |
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Definition
- a prostacyclin analogue
- indicated for pulmonary arterial hypertension
- administered via Subcu or IV
- longer half life than epoprostenol: 2-4 hrs as opposed to 3-5 min
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Term
| Pulmonary Arterial Hypertension: MOA and Symptoms |
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Definition
- high BP in the bloods vessels in the lung
- makes it harder for the right ventricle to pump blood into the lungs
- less oxygenated blood in the systemic circulation
Symptoms:
- dizziness/fainting (syncope)
- shortness of breath (dyspnea)
- chest pain (angina)
- swollen ankles and legs (edema)
- feeling tired and worn out (fatigue)
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Term
| Tadalafil: MOA and Indications |
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Definition
- a PDE inhibitor
- indicated for erectile dysfunction (5, 10, 20 mg)
- increases concentration of cGMP in the corpus cavernosum
- the "weekend pill": 36hr effectiveness
- also indicated for pulmonary arterial hypertension (40 mg)
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