Most benefits of alpha blockers result from blockage of alpha1 receptors where?

on blood vessels.

How do alpha1 blockers help with bph?

blocks alph1 receptors in bladder neck and prostatic capsule, which causes smooth muscle at those sites to relax. 

Major adverse effects of alpha1 blockers are:

1.  hypotension - blocking alpha1 in veins

2.  reflex tachycardia - blocking alpha1 in arterioles

3.  nasal congestion

4.  inhibition of ejaculation

What is the "first-dose effect?"

First dose of alpha1 blockers can cause fainting from profound orthostatic hypotension.

The selective alpha1 blockers used most frequently are:

1. Prazosin

2.  Doxazosin

3. Terazosin

What groups of drugs end in "oson?"

alpha blockers

BB's produce most of the beneficial effects by blocking beta 1 receptors where?

In the heart, thereby reducing HR, force of contraction, and AV conduction.

What are the principal indications for the beta blockers are cardiovascular.  What are they?

1.  hypertension

2.  angina pectoris

3.  HF

4.  SVT

What are the potential adverse effects from beta1 blockade?

1.  bradycardia

2.  reduced CO

3.  AV block

4.  precipitation of HF - even though they are used to treat HF.

What are the 2 potential adverse effects from beta2 blockade?

1.  Bronchospasm

2.  Reduced glycogenolysis

What are the 3 groups of beta blockers?

Nonselective - propanolol - block beta1 and beta2

Selective - metropolol - block beta1 only

Vadodilating BB - cardioselective and nonselective

What group of medications often end in "olol"

Beta Blockers

What is the other name for BB's?

Beta Adrenergic Receptor Antagonists

Name 2 drugs that are beta 1 antagonists

Atenolol, Metroopolol

Name 2 drugs that are beta 1 and beta 2 antagonists.

Propanolol, timolol (glaucoma)

What is the name of an Intrinsic Sympathomimetic Activity agent?

Pindolol

What are the actions of BB's?

Dec HR

Dec AV cond

Dec Contractility

Inhibits renin release by blocking beta2 in kidneys

Contricts bronchioles by blocking beta2 in lungs

Common uses for BB's?

HTN

Angina

Dysrythmias

MI

With what comorbidities do you need to be cautioius when using nonselective BB's?

Asthma

DM

Can you give BB's with antacids?

No, decreases absorption due to binding when acts as a chelator

What is the newest BB that is selective for beta1?

Bystolic - Nebivolol

What are the two unique SE's of nonselective BB's that are of particular concern with diabetics?

Mask tachycardia - early sign of hypoglycemia

Suppress glycogenolysis - can't fix hypoglycemia

Can you give a BB with a CCB?

Not recommended as both have the same effects and can cause too much cardiosuppression.

How do you determine dosage of BB's?

Must rely on response because it depends on sympathetic activity.  If high activity, higher dose is needed.  If low activity, lower dose is needed.

What is metoprolol preferred for pt's with DM and asthma?

Because it is a second generation drug and is selective for beta 1 only at normal doses; therefore does not have beta2 effects on lungs or beta2 effects on liver

What are 2 prominent features of the lipid soluble drugs - propanolol and metropolol?

1.  Penetrate the blood-brain barrier

2.  Eliminated by hepatic metabolism

What other receptors do both labetolol and carvdilol effect?

alpha adrenergic receptors

What is Esmolol used for?

IV for SVT

What is Satalol used for?

Vent Dysrhoythmias

Why can BB's be hazardous to patients with severe allergies?

Because BB's can block beneficial actions of epinephrine.