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NURS 572 Adrenergic

CH 18 Adrenergic Blockers/antagonists

general MOA of Alpha-blockers they antagonize vasoCON --> vasoDIL
general indications of Alpha-blockers HTN, BPH
general ADRs of alpha-blockers orthostatic hypoTN, activate RAA--> Na retention, compensatory tachy, inhib/retrograde ejacualtion, nasal congestion
Selective Alpha-1 blockers indicated for HTN, BPH prazosin, doxazosin, terazosin, tamsulosin, alfusozin, sildosin
3 selective Alpha-1 blockers indicated for BOTH HTN and BPH prazosin, doxazosin, terazosin
prazosin indication, unique SE short-acting Alpha-1 blocker. Lay down and watch for first-dose effect-->severe hypoTN-->possible LOC
longer acting selective Alpha-1 blockers (2) for HTN and BPH doxazosin, terazosin
what 2 selective Alpha-1 Blockers have unique SE of HA terazosin, tamsulosin
What 3 selective Alpha-1 blockers treat BPH only tamsulosin, alfuzosin, silodosin
tamsulosin shorter acting, BPH only Alpha-1 Blocker
alfuzosin well tolerated, less dizziness, CYP3A4 metabolized BPH only Alpha-1 blocker
sildosin new drug, only BPH, less likely-->hypoTN, selective Alpha-1 Blocker (also CYP3A4)
Indications for non-selective Alpha-1, Alpha-2 blockers pre-op to decrease BP, pheochromocytoma
Non-selective A-1, A-2 given IV for pre-op BP lowering, pheochromocytoma phentolamine
non-selective A-1, A-2 give orally, used ONLY for pheochromocytoma phenoxybenazamine
General MOA of Beta blockers by lowering HR/Force/AV conduction, blood moves slower-->supplying more oxygen to heart -->coronary arteries can more adequately perfuse myocardium-->decreases angina
General indications of Beta Blockers angina, HTN, dysrhythmias, MI, HF
General ADRs of Beta-blockers Beta-1 overshoots --> brady, decreased CO, AV heart block. watch for rebound cardiac excitation when stopped abruptly Beta-2 blockers -->bronchoCON, decreased glycogenolysis
carvedilol non-selective B-1, B-2 blocker that has short-term A-1 blocking
indication of carvedilol CHF (not indicated for HTN as A-1 blocking short term)
labetalol nonselective B-1, B-2 blocker with long term A-1 blocking
indication of labetalol HTN bwo long-acting additional A-1 blocking
propanolol nonselective B-1, B-2 ONLY blockers, lipid soluble-->BBB-->CNS effects/ high first pass effect
unusual SE of propanolol CNS effects - bad dreams, hallucinations, sedation or insomnia, depression
unique MOA of selective B-1 blockers selectivity is lost at high doses, and then it can block B-2 as well
metoprolol B-1 only blocker, less lipid solubility, less CNS effects
atenolol B-1 only blocker, not metabolized in liver (no first pass effect), unusual total renal excretion
nibivolol B-1 only blocker, has nitric oxide releasing properties
nibivolol indications HTN bwo ntric oxide properties which confer the vasoDIL
general MOA of In-direct adrenergic blockers these CENTRALLY ACTING Alpha-2 blockers reduce sympathetic output from brain stem -> periphery
Alpha-2 antagonists can cross BBB. What is their net effect they stimulate A-2 receptors in brain to decrease sympathetic output -->less vasoCON-->decrease blood pressure
clonidine selective A-2 blocker
clonidine indication and preferred route HTN, transdermal patch
clonidine ADRs 40% sedation, can have rebound HTN upon withdrawal
guanabenz + guanfacine clonidine look alikes indicated for HTN
methyldopa not for Parkinsons! hardly ever used A-2 blocker. similar to clondine. used to decrease BP, some pre-eclasmia
Created by: lorrelaws