Exam 4, Chs. 31, 33, 35, 37, 38 Key Points for Review
Missing Answers to Questions are Highlighted
Ch. 31 Adrenergic Antagonists
1.Most beneficial responses to alpha blockers, including reduction of blood pressure in patients
with hypertension, result from blockade of alpha1 receptors on blood vessels.
2.Alpha blockers reduce symptoms of BPH by blocking alpha1 receptors in the bladder neck
and prostatic capsule , which causes smooth muscle at those sites to relax.
3.The major adverse effects of alpha blockers are orthostatic hypotension (caused by blocking
alpha1 receptors on veins); __Reflex Tachycardia_(caused by blocking alpha1 receptors on
arterioles); nasal congestions (caused by blocking alpha1 receptors in blood vessels of the nasal
mucosa); and inhibition of ejaculation (caused by blocking alpha1 receptors in male sex
organs).
4.The first dose of an alpha blocker can cause Fainting from profound orthostatic hypotension,
also known as the first-dose effect.
5.The 3 alpha blockers used most frequently—prazosin, doxazosin, and terazosin—produce
selective blockade of alpha1 receptors.
6.Beta blockers produce most of their beneficial effects by blocking Beta1 receptors in the heart,
thereby reducing Heart Rate, Force Of Contraction, and AV Conduction.
7.Principal indications for the beta blockers are cardiovascular: hypertension, angina pectoris,
heart failure, and supraventricular tachydysrhythmias
8.Therapeutic goal of Beta-Adrenergic Antagonists are to assist with hypertension, _Angina
Pectoris, Heart Failure and Supraventricular Tachydysrhythmias; these drugs usually end in
-olol (suffix_
9.Potential adverse effects from beta1 blockade are _Bradycardia_, _Reduce Cardiac Output,
AV block, and precipitation of heart failure (even though some beta blockers are used to treat
heart failure).
10. Potential adverse effects from beta2 blockade are Bronchoconstriction(a concern for people
with asthma) and Reduced Glycogenolysis (a concern for people with diabetes).
11.Beta blockers can be divided into three groups: (1) first-generation agents (i.e., nonselective
beta blockers, such as propranolol, which block beta1 and beta2 receptors); (2) second-
generation agents (i.e., cardioselective beta blockers, such as metoprolol , which block beta1
,receptors only at usual doses); and (3) third-generation agents (i.e., vasodilating beta blockers,
which may be cardioselective or nonselective).
12.Beta blockers can be hazardous to patients with severe allergies because they can block
beneficial actions of Epinephrine, the drug of choice for treating anaphylactic shock.
13.Beta blockers can be detrimental to diabetic patients because they suppress Glycogenolysis
(an important mechanism for correcting insulin-induced hypoglycemia), and they suppress
Tachycardia, tremors and perspiration which normally serve as early warning signals that
glucose levels are falling too low.
14.Combining a beta blocker with a calcium channel blocker can produce excessive
Cardiosuppression
Cardioselective beta blockers are preferred to Nonselective beta blockers for patients with
asthma or diabetes.
Drugs to know: Bisoprolol, propranolol, metoprolol, atenolol, timolol; nonselective vs selective
alpha blockers and beta blockers-what are the indications
Bisoprolol: Bisoprolol works on specific receptors located in the
heart (called beta1 receptors) to slow the heart rate.
Bisoprolol works on specific receptors located in the heart
(called beta1 receptors) to slow the heart rate.
May be preferred for people with co-existing chronic obstructive
pulmonary disorder (COPD) because it is less likely than
nonselective beta-blockers to cause bronchoconstriction
(narrowing of the airways)
Propranolol is a beta-blocker. Beta-blockers affect the heart and
circulation (blood flow through arteries and veins).
Propranolol is used to treat tremors, angina (chest
pain), hypertension (high blood pressure), heart rhythm
disorders, and other heart or circulatory conditions. It is also used
to treat or prevent heart attack, and to reduce the severity and
frequency of migraine headaches.
You should not use propranolol if you are allergic to it, or if you
have:
, asthma;
history of slow heart beats that have caused you to faint;
severe heart failure (that required you to be in the hospital); or
a serious heart condition such as "sick sinus syndrome" or heart
block (2nd or 3rd degree, unless you have a pacemaker).
Metoprolol is a beta-blocker that affects the heart and circulation
(blood flow through arteries and veins).
Metoprolol is used to treat angina (chest pain) and hypertension (high
blood pressure).
Metoprolol injection is used during the early phase of a heart attack
to lower the risk of death.
You should not use metoprolol if you have a serious heart problem
(heart block, sick sinus syndrome, slow heart rate), severe circulation
problems, severe heart failure, or a history of slow heart beats that
caused fainting.
Atenolol is a beta-blocker that affects the heart and circulation (blood
flow through arteries and veins).
Atenolol is used to treat angina (chest pain) and hypertension (high
blood pressure).
Atenolol is also used to lower the risk of death after a heart attack.
You should not use this atenolol if you have a serious heart condition
such as "AV block," very slow heartbeats, or heart failure.
Timolol is used to treat hypertension (high blood pressure). Timolol is
sometimes given with other blood pressure medication.
Timolol is also used to lower the risk of death after a heart attack, or to
lower the risk of having another heart attack.
Timolol is a beta-blocker that also reduces pressure inside the eye.
, Timolol ophthalmic (for the eyes) is used to treat open-
angle glaucoma and other causes of high pressure inside the eye.
You should not use timolol if you are allergic to it, or if you have:
asthma, chronic obstructive pulmonary disease (COPD), or other
breathing disorder;
a serious heart condition such as "AV block" (second or third
degree);
very slow heartbeats;
heart failure; or
if your heart cannot pump blood properly.
Beta-blockers are one of the most common medications and are
prescribed by doctors to help with an irregular heartbeat (arrhythmias),
chest pain (angina), and high blood pressure (hypertension).
Selective Beta-Blockers
Selective beta-blockers are cardioselective. In other words, they
“select” the beta receptors located in the heart tissue, known as your
beta1 receptors.
This type of beta-blocker decreases activity around the heart and can
help reduce your heart rate and your systolic pressure, the pressure
your blood vessels experience when your heart beats.
They’re often used to help people experiencing conditions like chest
pain, irregular heart rate, and high blood pressure.