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Questions and Answers
Which of the following drugs is classified as a non-selective beta adrenergic blocker?
What is one of the therapeutic applications of beta blockers?
Which of the following is an advantage of beta blockers?
What is a common adverse effect associated with beta blockers?
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Which beta blocker is preferred for young non-obese patients experiencing hypertension?
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Which statement about alpha adrenergic blockers is true?
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Which condition can beta blockers effectively treat?
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Which of the following scenarios describes a contraindication for non-selective beta blockers?
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What is the primary therapeutic use of specific alpha-1 blockers like prazosin?
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What adverse effect is specifically associated with prazosin?
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How do calcium channel blockers primarily function in the body?
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Which of the following is a side effect associated with calcium channel blockers?
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Which alpha blocker is specifically mentioned as effective against benign prostatic hypertrophy?
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What distinguishes calcium channel blockers from diuretics in terms of adverse metabolic effects?
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Which of the following alpha blockers should be titrated to avoid postural hypotension?
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What is one of the benefits of using specific alpha-1 blockers for diabetics?
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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.
