Combined Alpha- and Beta-Adrenergic Antagonists

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What is the primary reason why combined alpha- and beta-adrenergic antagonists are less likely to produce significant reductions in heart rate or cardiac output compared to beta blockers?

The alpha blockade predominates, balancing the tendency of beta blockers to produce reflex vasoconstriction. (correct)
The drugs in this class, such as carvedilol and labetalol, are less potent than traditional beta blockers.
The alpha blockade causes an increase in heart rate and cardiac output, offsetting the effects of beta blockade.
The combination of alpha and beta blockade leads to a more balanced effect on the cardiovascular system.

Which of the following is an off-label use of the combined alpha- and beta-adrenergic antagonist carvedilol?

Reduction of progression of heart failure
Treatment of hypertension
Rate control for atrial fibrillation (correct)
Treatment of left ventricular dysfunction after a myocardial infarction

What is the mechanism of action of epinephrine in the treatment of allergic reactions and anaphylaxis?

Epinephrine is a corticosteroid that reduces inflammation and swelling associated with allergic reactions.
Epinephrine is a combined alpha- and beta-adrenergic agonist, leading to a balance of cardiovascular and respiratory effects. (correct)
Epinephrine is a selective beta2-adrenergic agonist, causing bronchodilation and decreased vascular permeability.
Epinephrine is a selective alpha1-adrenergic agonist, causing vasoconstriction and increased blood pressure.

How do the effects of combined alpha- and beta-adrenergic antagonists compare to the effects of alpha-adrenergic antagonists and beta blockers individually?

Combined antagonists have more balanced effects on the cardiovascular system, with the alpha blockade counteracting the tendency of beta blockers to cause vasoconstriction. (D) Signup and view all the answers

What is the primary advantage of the Auvi-Q brand of epinephrine auto-injectors compared to other formulations?

Auvi-Q is designed with voice instructions to guide users through the injection process. (A) Signup and view all the answers

Which of the following is a key difference between combined alpha- and beta-adrenergic antagonists and traditional beta blockers?

Combined antagonists are less likely to cause significant reductions in heart rate and cardiac output. (B) Signup and view all the answers

Which of the following is a contraindication for the use of alpha-beta blockers during pregnancy?

Their beta-blocking activity (D) Signup and view all the answers

Which of the following is a common cause of nonadherence to a treatment regimen with an alpha-beta blocker?

Inhibition of ejaculation and impotence (A) Signup and view all the answers

What should a patient do if they experience inhibition of ejaculation or impotence while taking an alpha-beta blocker?

Report it to their health-care provider (D) Signup and view all the answers

Which of the following is a potential adverse reaction associated with the use of epinephrine?

Rapid rises in blood pressure leading to cerebral hemorrhage (C) Signup and view all the answers

What lifestyle management is recommended for patients with a history of severe allergic reactions?

Avoid allergens and carry an epinephrine injector at all times (C) Signup and view all the answers

Which of the following is a potential adverse reaction associated with the use of alpha-beta blockers?

Inhibition of ejaculation and impotence (A) Signup and view all the answers

Which of the following statements about alpha and beta blockers is correct?

They decrease myocardial oxygen demand and lower cardiac workload. (A) Signup and view all the answers

Which of the following statements about labetalol is true?

It has no significant effect on sinus rate or intraventricular conduction. (C) Signup and view all the answers

Which of the following statements about carvedilol is correct?

It reduces orthostatic hypotension and exercise-induced reflex tachycardia. (C) Signup and view all the answers

What is the primary mechanism of action of epinephrine in treating anaphylaxis?

It decreases the vasodilation and vascular permeability present during anaphylaxis. (D) Signup and view all the answers

Which of the following statements about the metabolism and excretion of carvedilol and labetalol is correct?

Carvedilol undergoes more excretion in bile and feces than labetalol. (B) Signup and view all the answers

In which of the following conditions should epinephrine be used with caution?

All of the above (D) Signup and view all the answers

Which of the following is a contraindication for the use of alpha-beta blockers?

Respiratory conditions with a bronchospastic component (D) Signup and view all the answers

Which of the following statements about the use of alpha-beta blockers in heart failure is correct?

Carvedilol has been shown to be effective in the management of NYHA class II and III heart failure. (C) Signup and view all the answers

Which of the following statements about the use of alpha-beta blockers during pregnancy and breastfeeding is correct?

Labetalol is excreted in breast milk, but the amount of carvedilol excreted is unknown. (A) Signup and view all the answers

Which of the following statements about the pharmacokinetics of carvedilol and labetalol is correct?

Both drugs undergo rapid hepatic first-pass metabolism. (A) Signup and view all the answers

Which statement about giving labetalol to nursing mothers is correct?

Caution should be exercised, considering the benefits versus risks. (C) Signup and view all the answers

What is the potential risk associated with the use of labetalol during pregnancy?

It may increase the risk of small for gestational age (SGA) infants. (A) Signup and view all the answers

What does ACOG recommend regarding the use of labetalol during pregnancy to treat chronic hypertension?

ACOG finds the use of labetalol during pregnancy to treat chronic HTN safe. (C) Signup and view all the answers

What is the recommendation for mild hypertension (less than 150/100 mm Hg) during pregnancy in the absence of comorbidities?

It is reasonable to decrease the dosage or suspend treatment. (C) Signup and view all the answers

How do plasma levels of carvedilol compare between older adults and young adults?

Plasma levels are higher in older adults. (B) Signup and view all the answers

What is the recommendation for monitoring older patients taking carvedilol?

It is advisable to monitor older patients more closely for adverse reactions. (A) Signup and view all the answers

What does the text say about the safety and efficacy of carvedilol and labetalol in children younger than 18 years of age?

Safety and efficacy have not been established for either drug. (C) Signup and view all the answers

What is mentioned in the text regarding a double-blind study on carvedilol in children with chronic heart failure?

The study showed no significant effect on clinical outcomes. (D) Signup and view all the answers

What is the risk for orthostatic hypotension with carvedilol and labetalol compared to beta blockers?

The risk is higher than with beta blockers. (B) Signup and view all the answers

Which of the following is NOT mentioned as an adverse reaction to epinephrine in the text?

Nausea (A) Signup and view all the answers

What is the recommended method to taper the dose of Alpha-Beta Blockers when withdrawing the medication?

Taper the dose by one-half every 4 days (B) Signup and view all the answers

Why should carvedilol and labetalol be used with caution in older adults?

Due to the risk of orthostatic hypotension (A) Signup and view all the answers

What should be done if a patient on an Alpha-Beta Blocker misses a dose?

Take the missed dose up to 8 hours before the next dose for labetalol, 4 hours for carvedilol (D) Signup and view all the answers

What adverse reactions are commonly associated with Alpha-Beta Blockers?

Hypotensive reactions and bradycardia (A) Signup and view all the answers

Why should patients avoid driving while taking Alpha-Beta Blockers?

Due to the potential dizziness and drowsiness caused by the medication (A) Signup and view all the answers

What should patients do if they experience wheezing or difficulty breathing while on Alpha-Beta Blockers?

Notify their healthcare provider immediately (B) Signup and view all the answers

Why should patients consult with their healthcare provider before taking any OTC drugs while on Alpha-Beta Blockers?

To avoid drug interactions causing hypertension and excessive bradycardia (A) Signup and view all the answers