Beta Blockers
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| Where are beta 1 receptors located? | mainly in the heart
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| Where are beta 2 receptors located? | bronchi, blood vessels, uterus
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| Say carteolol | Car Tea oh lol
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| Say carvedilol | Car VED eh-lol
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| Say Labetalol | Leh BET eh-lol
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| Say Levobunolol | lee voe byoo' noe lole
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| Say metipronolol | met-eh-PRAN-oh-lol
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| Say pinbutolol | pen byoo' toe lole
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| Say sotalol | sew tah lol
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| Say nadolol | Nay Dull lol
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| Say propanolol | pro pan oh-lol
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| Say timolol | Time oh lol
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| Name several non-selective beta blockers (ccllmppsnpt). | Carteolol, carvedilol, labetalol, levobunolol, metipronolol, pinbutolol, sotalol, nadolol, propanolol, timolol
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| Which of the non-selective beta blockers will also block alpha 1 receptors? | carvedilol, labetalol
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| Say acebutolol | Ass-eh BUTE oh lol
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| Say atenolol | A TEN oh lol
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| Say betaxolol | Bet TAX oh lol
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| Say bisoprolol | BUY Sew PRO lol
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| Say esmolol | Es Moe lol
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| Say metropolol | Met TOE pro lol
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| Name some selective beta blockers (aabbem). | Acebutolol, atenolol, betaxolol, bisoprolol, esmolol, metropolol
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| Which beta receptor sites do selective beta blockers affect primarily? | beta 1
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| What is a partial agonist beta blocker? | A beta blocker that attaches to beta receptors and stimulates them
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| Name a couple of partial agonist beta blockers. | pindolol and acebutolol
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| 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
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| Discuss the distribution of beta blockers throughout the body. | widely distributed with highest concentrations found in the heart, liver, lungs and saliva
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| How are beta blockers metabolized? | in the liver
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| How are beta blockers eliminated? | mostly in urine unchanged or as metabolites, but also in feces, bile, and to some degree in breast milk
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| 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
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| How do beta blockers work? | they block catecholamines (epinephrine and norepinephrine) from occupying and stimulating receptor sites
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| 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
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| What are the effects of beta blocker on the lungs? | constriction of bronchioles
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| What are the effects of beta blockers on the blood vessels? | constriction of peripheral blood vessels
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| 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)
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| 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
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| What drugs could intensify the effects of beta blockers leading to toxicity (CDCv)? | cimetidine, digoxin, CCBs (primarily verapamil)
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| What drugs could decrease the effects of beta blockers? | rifampin, antacids, cacium salts, barbiturates, anti-inflammatories (like indomathacin), and salicylates
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| What is the problem with mixing lidocaine with beta blockers? | increases the risk of lidocaine toxicity
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| 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
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| 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
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| 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
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| 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.
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| What could result from the combination of beta blockers and sympathomimetics? | hypertension and reflex bradycardia
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| 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
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