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Pharm2 Lect 3

Pharm2 Alpha Blockers

QuestionAnswer
Why would an A1 agonist be beneficial in Paroxysmal SVT? 1.Phenylephrine causes VC. 2.Inc BP. 3.Inc firing rate of baroreceptors. 4.Inc Parasymp outflow. 5.ACh activates M2 on heart. 6.AV node conductance is slowed 7.Re-entry is stopped.
What is the main form of Paroxysmal SVT? AV nodal re-entry
How would you treat an AV block? B1 agonist to Inc AV conductance. **Epi, Isoproterenol, Dobutamine.
What would you use to treat Asthma/COPD? B2 agonists (Any of the 7). **Salmeterol, arformoterol, and formoterol have LONG Bioav while the other 4 are short.
Advantage of albuterol or salmeterol to treat asthma Vs. EPI or Isoproterenol? LESS SIDE EFFECTS since they are only targeting B2 instead of being non-selective
What would you use during premature labor? Terbutaline (B2 selective agonist, parenteral only) b/c it will delay uterine contractions which will give the baby's lungs more time to develope.
When to NOT use parenteral and Oral Terbutaline Parenteral: 1.Prevention of pre-mature labor. 2.treatment of pre-mature labor after 72hrs. Oral: 1.Preterm labor. **At risk of MI, arrhythmia, tachycardia, death.
What is an advantage of using Phenylephrine or A1 selective agonists to dilate the pupil? B/c it will only affect the iris radial A1 receptors, the lens (B2) receptors will be unaffect. **Avoids CYCLOPLEGIA (paralysis of ciliary muscle & blurred vision).
5 main adverse effects of Alpha agonists 1.Reduced peripheral BF. 2.Inc BP can inc work load of heart leading to MI, HF, or ischemia. 3.Excessive contraction of vessels at infusion site can cause necrosis/ischemia. 4.Rebound nasal congestion. 5.Mydriasis
Main adverse effects of Beta agonists 1.Palpitations (Inc HR). 2.Tachycardia (Inc HR). 3.Arrhythmias (Inc HR). 4.Angina (Inc HR & inotropy Inc the work load of heart). 5.Hyperglycemia (liver glycogenolysis & gluconeo). 6.Tremor (skeletol muscle)
Indirect & mixed acting Adrenomimetics: Indirect 1.Tyramine. 2.Amphetamine. 3.Methylphenidate. 4.Atomoxetine. ***2-4 are CNS stimulates used for ADHD
Indirect acting Adrenomimetics: Tyramine 1.Meth of action: Inc release of NE from SNS nerve terminals (Inc BP). 2.Fermented food, gut bacteria. 3.Bioav: Metabolized by MAO in liver. 4.Adverse effects: Used with beer & cheese, can cause hypertensive crisis b/c they inhibit MAO.
Indirect & Mixed acting Adrenomimetics: Mixed 1.Ephedrine. 2.Pseudoephedrine. **activate alpha and Beta receptors
Mixed acting Adrenomimetics: Ephedrine 1.Mech of action: Inc NE from SNS nerve terminals Dec nasal congestion (A1) & Inc Bronchodil (B2). 2.Ephedra plants. 3.Bioav: Mild stimulant, Crosses BBB. 4.used to treat asthma/COPD, nasal congestion. 5.Adverse effects: MI, stroke, death, insomnia.
Mixed acting Adrenomimetics: Psuedoephedrine 1.mech of action: Inc NE from SNS nerve terminal (activates A > B). 2.Oral. 3.Bioav: DOESN'T cross BBB. 4.used to treat nasal congestion.
What 2 classes of drugs are used to treat nasal congestion? 1.Alpha1 agonists. 2.Mixed agents.
Adrenolytic A1 selecive, reversible Antagonists 1.Prazosin. 2.Teraprazosin. 3.Doxazosin. 4.tamsulosin. 5.Alfuzosin. 6.Silodosin.
Adverse effects to ALL Adrenolytic agents 1.Orthostatic hypotension. 2.Reflex tachycardia. 3.Nasal congestion. 4.Na+ & H2O retention. 5.Inh ejaculation. 6.HA, weakness, dizziness.
Adrenolytic A1 selecive, reversible Antagonist: Prazosin 1.Mech of action: A1 reversible antagonist, relaxes sphincter of bladder & blocks cold's effect of vasospasm in fingers. 2.used to treat hypertension, BPH, Raynaud's.
Adrenolytic A1 selecive, reversible Antagonist: Terazosin 1.Mech of action: A1 reversible antagonist, relaxes sphincter of bladder & blocks cold's effect of vasospasm in fingers. 2.used to treat hypertension, BPH, Raynaud's.
Adrenolytic A1 selecive, reversible Antagonist: Doxazosin 1.Mech of action: A1 reversible antagonist, relaxes sphincter of bladder & blocks cold's effect of vasospasm in fingers. 2.used to treat hypertension, BPH, Raynaud's.
Adrenolytic A1 selecive, reversible Antagonist: Tamsulosin 1.mech of action: A1 reversible antagonist, relaxes sphincter of bladder. 2.Used to treat BPH.
Adrenolytic A1 selecive, reversible Antagonist: Alfuzosin 1.mech of action: A1 reversible antagonist, relaxes sphincter of bladder. 2.used to treat BPH.
Adrenolytic A1 selecive, reversible Antagonist: Silodosin 1.Mech of action: A1 reversible antagonist, relaxes sphincter of bladder. 2.used to treat BPH.
Adrenolytic non-selecive, reversible Antagonist: Phentolamine 1.Mech of action: A1 non-selective reversible antagonist that will Dec BP, Dec PVR, counter excess EPI from medullary tumor. 2.used to treat phenochromocytoma (medullary tumor).
Adrenolytic non-selecive, irreversible Antagonist: Phenoxybenzamine 1.Meth of action: A1&2 non-specific irreversible antagonist Dec Bp, Dec PVR, counter EPI from medullary tumor. 2.Used to treat phenochromocytoma (medullary tumor).
What are the 3 A1 selective, reversible anatgonists used to treat Hypertension? 1.Prazosin. 2.Terazosin. 3.Doxazosin. **All 6 can be used to treat BPH
What A1 selective, reversible antagonist is BEST to treat BPH? Tamsulosin b/c it has the highest affinity for A1a (the alpha1 receptor on the prostate).
What are the 3 A1 selective, reversible anatgonists used to treat Raynaud's disease? 1.Prazosin. 2.Terazosin. 3.Doxazosin.
1st dose effecet seen with Alpha antagonists? Orthostatic hypotension & syncope. **BL pools in the veins. Dec VR, CO
Why would you see reflex tachycardia with Alpha antagonists? B/c they will block A1, Dec PVR, and lead to an Inc baroreceptor firing.
Created by: WeeG
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