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What is Clonidine?
What does it do?
Should it be taken orally?
An Alpha 2 agonist
Activation of Alpha 2 receptors in the brain, cause inhibition of sympathetic system.
- Supression of Release of NE by Presynaptic Alpha 2 receptors
- Yes-- has excellent Oral Bioavailability
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What are some adverse effects of Clonidine?
What do you use it for?
Sedation, Bradycardia, sexual dysfunction and rebound hypertension.
- 1.Adjuvant in anesthesia
- 2.Glaucoma
- 3. Hypertension (unpolular for this)
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What is Alpha Methyl Dopa?
What is its mechanism?
What is it used for?
It is a Alpha 2 agonist
Gets converted to alpha-methylnorepinephrine. Activation of these at the brainstem--> inhibit SNS output and Lower BP
Drug of choice in Hypertension with Pregnancy.
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List the Beta 2 agonists: (FRATS)
Which are short and which are long acting?
- Terbutaline
- Ritodrine---> used for uterine relaxant
- Albuterol--- Short acting--> Bronchial Asthma
- Formoterol--- Long acting--> Bronchial Asthma
- Salmeterol--- Long acting--> Bronchial Asthma
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What are the clinical applications of Cocaine?
Cause Vasoconstiction and local anesthesia
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What are the clinical applications of Catecholamines and Epinephrine
Anaphylaxis, gluacoma, asthma, and vasoconstriction
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What are the clinical applications of Norepinephrine?
Cause vasoconstriction in hypotension
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What are the clinical applications of Isoproterenol
Asthma, atrioventricular block
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What are the clinical applications of Dopamine?
Shock, and heart failure
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What are the clinical applications of Dobutamine?
Shock and heart failure
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What are the clinical applications of Ephedrine
Asthma, urinary incontenence, and cause vasoconstriction in hypotension
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What are the general effects of alpha blockade?
- -Hypotension (no vasoconstriction)
- -Reflex tachycardia (due to low BP)
- -Failure of Ejaculation (no SNS)
- -Postural Hypotension (low BP when standing up)
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What are the Irreversible, alpha blockers?
What do you use this for?
Phenoxybenzamine
Pheochromocytoma
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What is Pheochromocytoma?
What are the Main symptoms?
A pheochromocytoma or phaeochromocytoma (PCC) is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth [1] and secretes excessive amounts of catecholamines, usually adrenaline (epinephrine) if in the adrenal gland and not extra-adrenal, and noradrenaline (norepinephrine)
Pallor, Pressure, Pain, Palpation
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What are the Reversible, Nonselective Alpha blockers?
Phentolamine
Tolazoline
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What are the Reversible, selective Alpha blockers?
Prazosin
Terazosin
Doxazosin
Tamsulosins
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What are the Alpha 2 selective Alpha blockers?
Yohimbine
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What is Prazosin?
When is it used?
What are some side effects?
Slective Alpha 1 blocker
- Used in Hypertension and Benign prostate Hypertrophy
- ______________________
- Postural hypotension
- Sexual dysfunction (cannot ejaculate)
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What are some uses of Alpha Blockers?
What are some adverse effects?
- Pheochromocytoma
- Hypertension
- CCRF
- Benign hypertrophy of the Prostate
- Migraine
- ____________________
- Postural Hypotension
- Impotence
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When do you use BETA BLOCKERS?
- -Ischemic heart disease (just not Prinzmetals angina)
- -Therapy for Stable and unstable angina
- -Preferered therapies of Hypertension
- -Major anti-arrhythmic drugs
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What are the non-selective, No intrinsic activity Beta Blockers?
- Propranolol
- Timolol
- Nadolol
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What are the Non-Selective, Intrinsic activity Beta Blockers?
Pindolol
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What are the Non-selective, Alpha blocking action, Beta blockers?
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What are the Selective Beta-1 blockers?
- Betaxolol
- Esmolol
- Atenolol
- Metoprolol
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What is Acebutolol?
It is a Beta-1 selective blocker WITH intrisic Sympathetic activity (ISA)
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What are Propranolol's Effects in the:
Heart
AV conduction
Respiritory tract
Eyes
CNS
Skeletal muscle
- Heart--- Negative Inotropic,chronotropic, dromotropic action
- AV conduction--- decreased
- Respiritory tract--- bronchial constriction
- Eyes---decreases AqHumor production
- CNS--- Sedation, Lethargy, depression, Sleep probs
- Skeletal muscle--- Antagonizes the epinephrine induced tumors.
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What is Inotropic,chronotropic, dromotropic action
- Inotropic-- contraction of the heart
- chronotropic-- Heart rate
- dromotropic -- effects the Conduction to the AV node
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What are some precautions of Beta Blockers? Think of the ABCD's and H
- Be careful when the patient has:
- AV block
- Bradycardia
- COPD and Bronchial Asthma
- Diabetes Mellius
- Hyperlipidemia
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