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TL Beta Blockers

Beta Blockers

Where are beta 1 receptors located? mainly in the heart
Where are beta 2 receptors located? bronchi, blood vessels, uterus
Say carteolol Car Tea oh lol
Say carvedilol Car VED eh-lol
Say Labetalol Leh BET eh-lol
Say Levobunolol lee voe byoo' noe lole
Say metipronolol met-eh-PRAN-oh-lol
Say pinbutolol pen byoo' toe lole
Say sotalol sew tah lol
Say nadolol Nay Dull lol
Say propanolol pro pan oh-lol
Say timolol Time oh lol
Name several non-selective beta blockers (ccllmppsnpt). Carteolol, carvedilol, labetalol, levobunolol, metipronolol, pinbutolol, sotalol, nadolol, propanolol, timolol
Which of the non-selective beta blockers will also block alpha 1 receptors? carvedilol, labetalol
Say acebutolol Ass-eh BUTE oh lol
Say atenolol A TEN oh lol
Say betaxolol Bet TAX oh lol
Say bisoprolol BUY Sew PRO lol
Say esmolol Es Moe lol
Say metropolol Met TOE pro lol
Name some selective beta blockers (aabbem). Acebutolol, atenolol, betaxolol, bisoprolol, esmolol, metropolol
Which beta receptor sites do selective beta blockers affect primarily? beta 1
What is a partial agonist beta blocker? A beta blocker that attaches to beta receptors and stimulates them
Name a couple of partial agonist beta blockers. pindolol and acebutolol
Discuss the absorption and PO administration of beta blockers and food. beta blockers are usually absorbed well from the GI tract, somewhat protein-bound. Food does not inhibit (may even enhance) absorption
Discuss the distribution of beta blockers throughout the body. widely distributed with highest concentrations found in the heart, liver, lungs and saliva
How are beta blockers metabolized? in the liver
How are beta blockers eliminated? mostly in urine unchanged or as metabolites, but also in feces, bile, and to some degree in breast milk
Why is it that beta blockers can have widespread effects in the body? because they affect the adrenal medulla as well as andrengic nerve endings
How do beta blockers work? they block catecholamines (epinephrine and norepinephrine) from occupying and stimulating receptor sites
What are the effects of beta blockers on the heart? Reduced heart rate, automaticity, and excitability (reduces possibility to produce arrhythmias), slowed conduction of impulses from the atria to the ventricles via the AV node, reduce oxygen consumption and cardiac output = reduced BP
What are the effects of beta blocker on the lungs? constriction of bronchioles
What are the effects of beta blockers on the blood vessels? constriction of peripheral blood vessels
Why would a lower dose cardio-selective beta blocker be better for a patient with COPD? blockade of beta 2 receptors would cause bronchoconstriction (even some cardioselective drugs will cause beta 2 activation in high doses)
Name several conditions for which beta blockers may be therapeutic. prevention of a 2nd heart attack; tx of angina, heart failure, HTN, cardiomyopathy, supraventricular arrhythmias; Anxiety, cardiovascular symptoms of thyrotoxicosis, essential tremor, migraine headaches, open-angle glaucoma, pheochromocytoma
What drugs could intensify the effects of beta blockers leading to toxicity (CDCv)? cimetidine, digoxin, CCBs (primarily verapamil)
What drugs could decrease the effects of beta blockers? rifampin, antacids, cacium salts, barbiturates, anti-inflammatories (like indomathacin), and salicylates
What is the problem with mixing lidocaine with beta blockers? increases the risk of lidocaine toxicity
What does the nurse need to know about the diabetic patient and beta blockers? insulin requirements and oral diabetic drug doses may be altered when the patient is taking beta blockers
What is the problem with taking beta blockers and theophylline at the same time? Non selective beta blockers will interfere with Theophylline’s ability to cause bronchodilation
What is clonidine? How does it work? a centrally acting alpha agonists used to treat HTN. It decreases the heart rate and relaxes the blood vessels. One of the adverse effects is rebound HTN with sudden cessation
Why do we need to talk about clonidine with beta blockers? Clonidine (Catapres) taken with a nonselective beta blocker can cause life-threatening HTN during clonidine withdrawal. These concerns are especially prevalent when weaning the patient from one drug or the other, or from clonidine to a beta blocker.
What could result from the combination of beta blockers and sympathomimetics? hypertension and reflex bradycardia
What are the adverse effects that may be experienced with beta blocker therapy (HBPAHFBDNAAFRFSR)? hypotension, brady cardia, peripheral vascular insufficiency, AV block, heart failure, fatigue, bronchospasm, diarrhea/constipation, N&V, abdominal discomfort, anorexia, flatulence, rash, fever/sore throat, spasm of the larynx, respiratory distress