BETA BLOCKERS Flashcards Preview

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Flashcards in BETA BLOCKERS Deck (27)
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1
Q

2 types of Beta Receptors

A

Beta-1 and beta 2

2
Q

Beta 1 found primarily in the

A

Heart

3
Q

Beta 2 found primarily in the

A

Smooth muscle of the vasculature and bronchi.

4
Q

Beta Blockers MOA

A

coupled to ADENYLATE CYCLASE, When activated, adenyl cyclase converts adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP), a secondary intracellular messenger, that stimulates protein kinase A to phosphorylate membrane calcium channels, leading to an increase in cytoplasmic Ca2+ level

5
Q

Beta BLOCKERS MOA short

A

Activate adenylate cyclase

Increase cAMP

6
Q

Main effects of Beta adrenergic stimulation

A

positive inotropy, chronotropy, dromotropy,

and lusitropic relaxant effect

7
Q

Secondary messenger cAMP is metabolized by phosphodiesterase, phosphodiesterase
inhibitors augment

A

b1 activity, which is manifested by sympathomimetic effects.

8
Q

Because b-adrenergic receptor blocking agents have _________inotropy and chronotropy—_________myocardial oxygen demand and improving______

A

negative ; decreasing ;myocardial perfusion

9
Q

Current recommendations for patients with acute

coronary syndromes are for

A
Beta Blockers agents to be started early
Statins, 
Antiplatelet drugs
ACEis
90% reduction in mortality rates at 6 months following the diagnosis of acute coronary syndrome.
10
Q

Patients with congestive heart failure, even if they are not hypertensive, can benefit from b-blockade; the administration of _______and ________ have been
reported to improve cardiac ejection fraction, reverse abnormal patterns of gene expression toward normal, and decrease mortality rate.

A

carvedilol and of metoprolol

11
Q

What is Intrinsic Sympathomimetic Activity?

A

Beta Blockers with intrinsic sympathomimetic activity cause mild peripheral vasodilation without reducing cardiac output.

12
Q

Beta Blockers with no ISA

A

Beta Blockers without intrinsic sympathomimetic activity lower blood pressure by decreasing cardiac output and inhibiting renin release and central sympathetic outflow.

13
Q

Beta Blockers with Diabetes

A

They may mask hypoglycemic symptoms in patients
with diabetes and increase triglyceride and reduce high-density lipoprotein
levels.

14
Q

Abrupt discontinuation of b-adrenergic receptor blocking agents is associated with

A

rebound hypertension and tachycardia, which can result in

myocardial ischemia or infarction.

15
Q

Absolute Contraindications of Beta Blockers

5S O

A

Severe bradycardia
Sinus node dysfunction or high-grade AV block
Overt ventricular systolic failure
Severe asthma or active bronchospasm
Severe peripheral vascular disease with rest ischemia
Severe depression

16
Q

In patients who have taken an accidental or intentional overdose of b-adrenergic receptor blocking agents, the side effects can be mitigated by which drug?
what dose ______administer IV over _____Then ________

A

glucagon, 100 mg/kg, administered intravenously over 1 min, then 1 to 5 mg/h

17
Q

NonSelective Cardioselective Beta Blockers

ProTiNaSo

A

Propanolol
Timolol
Nadolol
Sotalol

18
Q

CardioSelective Beta Blockers

MetEsAtAce

A

Metoprolol
Atenolol
Acebutalol
Esmolol

19
Q

ISA and additional properties

A

Labetalol
Pinadolol
Acebutalol

20
Q

Also a class III antiarrythmic

A

SOTALOL

21
Q

Of particular importance for anesthesia providers, b-adrenergic receptor blocking agents should be used in patients

A

at high risk for experiencing a coronary event and who are undergoing non-cardiac and vascular operations

22
Q

In men, b-adrenergic receptor blocking agents increase the incidence of

A

impotence.

23
Q

Side effects of Beta Blockers

A
Hypotension
Bradycardia
CNS depressants sypmtoms (fatigue, sedation)
hallucinations
Depression
24
Q

Renally Excreted Beta Blockers (BiAtNaSo)

A

Atenolol
Bisoprolol
Nadolol
Sotalol

25
Q

Hepatic Excreted (MetProCarLa)

A

Metoprolol
Propranolol
Carvedilol
Labetalol

26
Q

Metabolism of Esmolol

A

Blood esterases

6-9 min Half life

27
Q

Indications of Beta Blockers

A
HTN
Dysrhythmias
SVTs
Hypertrophyic Obstructive Cardiomyopathy
Thyroid storm (if LV ok) 
Dissecting aneurysm
MVP,MS