Chapter 17 Antiadrenergic Drugs
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- What is the effect of alpha or beta stimulation in the CNS, peripheral postsynaptically or peripheral presynaptically?
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CNS Beta 2 - inhibits SNS -VD;
PPost - alpha 2 VC, Beta 2 VD;
PPre - Beta increase NEpi, alpha 2 decrease NEpi; - Central Adrenergic Inhibitors (alpha 2 agonists) have what effect on the Sympathetic outflow from the medulla?
- Diminished outflow leading to decrease BP and HR.
- What condition is Alpha 2 agonists indicated?
- HTN, but not CHF because not potent enough Vasodilator.
- What are the side effects in Alpha 2 agonists?
- Sedation, dry mouth, bradycardia
- What is the mechanism of action of the sympathetic nerve ending antagonists, guanethidine and guanedrel?
- These drugs are taken up by the NE uptake pump and then by the synaptic vesicles. Here, they prevent the synaptic release of NE.
- What is the mechanism of action of the sympathetic nerve ending antagonist, reserpine?
- Reserpine inhibit NE synaptic vesicle uptake.
- In what condition is reserpine contraindicated?
- History of depression
- Alpha 2 Receptor feedback inhibition blockade results in what? So name (3) Alpha 1 selective antagonists and what they condition they treat.
- Greater Reflex Tachycardia; Prazosin, Terazosin and Doxazosin all treat HTN while T & D treat BPH.
- The nonselective alpha blockers, phentolamine and phenoxybenzamine, are used in treating what condition?
- Pheochromocytoma (tumor that abnormally secretes catecholamines)
- Beta adrenergic Receptor Antagonists are indicated in what conditions?
- IHD, HTN, CHF, Tachy-Arrhythmias
- What are the effects of Beta adrenergic Receptor Antagonists?
- Decreased inotropy, chronotropy, and conduction velocity.
- Toxicities such as AV node blockade, bronchospasm,, arterial vasospasm, or hypoglycemia can be related to what 3 adrenergic drug differences?
- Relative selectivity for specific subtypes of Beta 1 or 2; ISA activity; concomitant effect on alpha receptors
- TRUE/FALSE - Abrupt withdrawal of a Beta blocker can cause an Acute Myocardial Infarction in patients with underlying CAD.
- True
- Toxicities of Beta blockers can cause AV node block, bronchospasm,reduction of HDL, arterial vasospasm, or hypoglycemia recovery. What 3 receptor differences account for this?
- Relative selectivity for specific subtypes of Beta 1 or 2; ISA activity; concomitant effect on alpha receptors