Beta Adrenergic Blockers Overview

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Questions and Answers

Which of the following drugs is classified as a non-selective beta adrenergic blocker?

Propranolol (correct)

Esmolol

Metoprolol

Atenolol

What is one of the therapeutic applications of beta blockers?

Treat dysrhythmias (correct)

Enhance secretion of renin

Increase cardiac workload

Induce hypertension

Which of the following is an advantage of beta blockers?

Requires multiple doses daily

Promotes water retention

Low incidence of side effects (correct)

Causes postural hypotension

What is a common adverse effect associated with beta blockers?

Hypoglycemia Signup and view all the answers

Which beta blocker is preferred for young non-obese patients experiencing hypertension?

Carvedilol Signup and view all the answers

Which statement about alpha adrenergic blockers is true?

They are less effective at reducing serious cardiovascular events than diuretics. Signup and view all the answers

Which condition can beta blockers effectively treat?

Heart failure Signup and view all the answers

Which of the following scenarios describes a contraindication for non-selective beta blockers?

Asthma exacerbation Signup and view all the answers

What is the primary therapeutic use of specific alpha-1 blockers like prazosin?

Hypertension management Signup and view all the answers

What adverse effect is specifically associated with prazosin?

Postural hypotension Signup and view all the answers

How do calcium channel blockers primarily function in the body?

They prevent calcium movement into cardiac and smooth muscle cells. Signup and view all the answers

Which of the following is a side effect associated with calcium channel blockers?

Edema Signup and view all the answers

Which alpha blocker is specifically mentioned as effective against benign prostatic hypertrophy?

Tamsulosin Signup and view all the answers

What distinguishes calcium channel blockers from diuretics in terms of adverse metabolic effects?

Calcium channel blockers have no adverse metabolic effects. Signup and view all the answers

Which of the following alpha blockers should be titrated to avoid postural hypotension?

Prazosin Signup and view all the answers

What is one of the benefits of using specific alpha-1 blockers for diabetics?

They improve carbohydrate metabolism. Signup and view all the answers

Study Notes

Beta Adrenergic Blockers

Beta-blockers are used to treat hypertension, angina, dysrhythmias, heart failure, MI and migraine.
Beta-blockers inhibit the secretion of renin and the formation of angiotensin I.
Beta-blockers can be divided into non-selective and cardioselective blockers.
Non-selective beta-blockers affect both beta-1 and beta-2 receptors.
Cardioselective beta-blockers primarily affect beta-1 receptors in the heart.
Non-selective beta-blockers include propranolol, nadolol, timolol, pindolol, labetolol, and carvedilol.
Cardioselective beta-blockers include metoprolol, atenolol, esmolol, and betaxolol.
Non-Cardiovascular Uses of Beta Blockers: migraine, anxiety, glaucoma, hyperthyroidism, pheochromocytoma, alcohol withdrawal, and esophageal varices.

Advantages of Beta Blockers

No postural hypotension.
No salt and water retention.
Low incidence of side effects.
Low cost.
Once-a-day regimen.
Preferred in young non-obese patients.
Preferred in post-infarction patients to prevent sudden cardiac death and the progression of CHF.

Side Effects

Fatigue, lethargy, or decreased work capacity.
Loss of libido or impotence.
Cognitive defects like forgetfulness

Adverse Effects

Bronchoconstriction.
Bradycardia
Cold extremities.
CNS Side Effects
Heart failure.
Hypoglycemia.
Rebound hypertension.

Advantages of Cardioselective Over Non-selective

Safe for use in asthma, diabetes mellitus, and peripheral vascular disease.
Preferred in young non-obese hypertensive angina pectoris and post-angina patients.
Post-MI patients: useful in preventing mortality.
For older adults, carvedilol is preferred due to its vasodilatory action.

Alpha Adrenergic Blockers

Lower BP directly by blocking the sympathetic receptor in arterioles causing the vessels to dilate.
Not the first-line drugs for HTN because long-term clinical trials have shown them to be less effective at reducing the incidence of serious cardiovascular events than diuretics.
Non-selective alpha blockers like phenoxybenzamine and phentolamine are not used in chronic essential hypertension but only in pheochromocytoma.
Specific alpha-1 blockers like prazosin, terazosin, and doxazosine are used in chronic essential hypertension.
Tamsulosin is effective against benign prostatic hypertrophy (BPH).

Therapeutic Uses

Reduction in mean BP.
Does not produce tachycardia since presynaptic auto or alpha-2 receptors are not inhibited.
Autoregulation of Na+ release remains intact.

Adverse Effects

Prazosin causes postural hypotension so start with 0.5 mg at bedtime with increasing doses and up to 10 mg daily.
Fluid retention in monotherapy.
Headache, dry mouth, weakness, blurred vision, rash, drowsiness, and failure of ejaculation in males.

Current Status

Improvement of carbohydrate metabolism so beneficial for diabetics since it lowers LDL and increases HDL.
Not used as the first-line agent.
Used in addition to other conventional drugs that are failing, such as diuretics or beta-blockers.

Calcium Channel Blockers

Prevent the movement of calcium into the cardiac and smooth muscle cells when the cells are stimulated.
Blocking of calcium interferes with the muscle cell’s ability to contract, leading to a loss of smooth muscle tone, vasodilation, and a decrease in peripheral resistance.
Calcium channel blockers are effective in the treatment of angina.

Examples of Calcium Channel Blockers Available in the Philippines

Amlodipine (Norvasc)
Felodipine (Plendil ER)
Nifedipine (Adalat, Calcibloc)
Diltiazem (Dilzem)
Nicardipine (Cardepine)

Potential Side Effects:

Dizziness or lightheadedness.
Low blood pressure.
Heart rhythm problems.
Dry mouth.
Edema (swelling of ankles, feet, or lower legs).
Headache.
Nausea.
Fatigue.
Skin rash.
Constipation or diarrhea.
Gastroesophageal reflux disease (GERD).

Advantages

Unlike with diuretics, there are no adverse metabolic effects only mild adverse effects like dizziness, fatigue, etc.

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Description

This quiz covers the essential aspects of beta-adrenergic blockers, including their uses, types, and advantages. It explores non-selective and cardioselective blockers, detailing their applications in various medical conditions. Test your knowledge of their mechanisms and benefits in treatment.