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Heiman.pharm.HTN.8

Alpha BLockers

QuestionAnswer
Alpha 1 receptors Vasoconstriction Decreased motility and tone of GI tract Increased renin secretion Gluconeogensis in the liver
Alpha 2 receptos Vasoconstriction
Alpha – Blockers Alpha -1 blockers Centrally acting alpha – 2 blockers Peripherally acting alpha – 2 blockers
Alpha – 1 Blockers – Mechanism of Action Blockage of receptors causes: Dilatation of arterioles and veins Relaxation of smooth muscle in prostate and bladder neck
Centrally Acting Alpha – 2 Blockers Mechanism of Action Stimulation of inhibitory alpha receptors in the CNS Leading to: Decreased peripheral vascular resistance Decreased HR Decreased renal vascular resistance
Peripherally Acting Alpha – 2 Blockers Mechanism of Action Inhibit the release of norepinephrine from peripheral nerves Vasodilatation
Alpha – Blockers – Kinetics Variable bioavailability Most are highly protein bound Alpha – 1 blockers are hepatically metabolized and excreted in bile
Alpha – Blockers – Adverse Effects Marked hypotension Especially with first few doses Alpha – 1 blockers Urinary frequency Dry mouth Constipation Headache CNS depression Drowsiness Hallucinations Reserpine
Alpha – Blockers – Drug Interactions Increased levels of alpha – blockers by: Alcohol, beta – blockers, cimetidine, verapamil Increased effects of levodopa by methyldopa
Alpha – Blockers – Cautions Additive hypotensive effects Rebound hypertension with abrupt withdrawal of clonidine Avoid driving or operating machinery until effects known Warn patient of the possibility of syncope
Alpha – Blockers - Names Alpha - 1 blockers Prazosin (Minipress) Terazosin (Hytrin)‏ Doxazosin (Cardura)‏ Alfuzosin (Uroxatral)‏ Tamsulosin (Flomax)‏ Peripherally active alpha – 2 Guanadrel (Hylorel)‏ Reserpine
Alpha – Blockers – Names Centrally active alpha – 2 Clonidine (Catapres)‏ Guanabenz (Wytensin)‏ Guanfacine (Tenex)‏ Methyldopa (Aldomet)‏
Direct Vasodilators – Mechanism of Action Relaxation of arteriolar smooth muscle leading to decreased peripheral vascular resistance Causes reflex increase in HR and renin release
Direct Vasodilators – Kinetics High first pass effect Liver metabolism Renal excretion
Direct Vasodilators – Adverse Effects Tachycardia Headache Constipation Nausea / vomiting Dizziness Angina Minoxidil Hair growth Minoxidil
Direct Vasodilators Drug interactions Increased levels of hydralazine by Beta – blockers and indomethacin Names Hydralzine (Apresoline)‏ IV and PO Minoxidil (Loniten
Created by: DianaB
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