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Adrenergic-Blocking Drugs (Non- Selective: (Sotalol (Betapace) (Used for…
Adrenergic-Blocking Drugs
Alpha Blockes:
Phentolamine – Regitine
used to treat extravasation of IV site from drugs (that leak out of the vein)
Reduces peripheral vascular resistance and used to treat hypertension
Used in the treatment of pheochromocytoma (an adrenal gland tumor that releases catecholamines)
Tamsulosin (Flomax)
Blocks receptors on bladder and prostate causing relaxation and urinary flow
Cannot use with erectile dysfunction drugs
Alpha Blockers can also be used to
reverse vasoconstriction associated with Raynaud’s Disease and frostbite
First dose phenomenon – severe and sudden drop in blood pressure – can cause patients to fall or pass out
Orthostatic hypotension
Toxicity Treatment: activated charcoal to bind drug and remove from body
Beta Blockers:
Block Sympathetic Nervous System stimulation by competing with norepinephrine and epinephrine at beta-adrenergic receptors
Beta 1 receptors are located primarily in the heart – cardioselective beta blockers
Beta 1 and Beta 2 adrenergic receptors are blocked by non-selective beta blockers
Cardioselective:
Beta 1 blockers reduces:
Myocardial stimulation – reduces heart rate
Slows conduction through the AV node
Prolongs SA node recovery
Decreases myocardial oxygen demand by decreasing myocardial contractility
Metoprolol IV/PO
Used to increase survival in patients after experiencing a myocardial infarction
Atenolol (Tenormin)
Used to prevent future heart attacks in patients who have had one
Used for angina and hypertension
Carvedilol (Coreg)
Used primarily for treatment of heart failure
Helps slow progression of heart failure and decrease hospitalizations
Also beneficial for angina and hypertension
Non- Selective:
Sotalol (Betapace)
Used for difficult dysrhythmias, which can be life threatening – sustained ventricular tachycardia.
Toxicity
: Atropine to manage bradycardia; vasopressors for severe hypotension and/or hemodialysis.
Propranolol (Inderal)
Used in the treatment of Tachydysrhythmias and pheochromocytoma
Contraindicated in patients with bronchial asthma (makes bronchioles constrict and narrows the airway)
CONTRAINDICATIONS
Non-selective beta blockers impede secretion of insulin from the pancreas causing hyperglycemia.
Non-selective beta blockers cause release of free fatty acids from adipose tissue – elevating blood levels of triglycerides and reduced HDLs
Do not abruptly stop these drugs – can cause angina, MI or rebound hypertension