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Adrenoreceptor Blockers

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Santa Monica

Alright so today we’re going to be talking about your adrenal receptor blockers which include your beta blockers and your alpha blockers so this is just a quick overview of some of those drugs that are coming we use in cardiovascular research as well as medicine your beta blockers in general operate by having a negative chronotropic effect that is they decreased

Heart rate as well as a negative inotropic effect that is they decrease contractility they can also decrease the vasomotor tone via reduction of your angiotensin 2 what are the important things to know about beta blockers is there side effects important side effects include hyperkalemia sexual dysfunction particularly in men nightmares and the fact that acute

Withdrawal of these drugs can increase sympathetic activity it’s also very important to note that you should not use these beta blockers and decompensated chf or in patients with bradycardia particularly six sign of syndrome we’re just going to go over a few of the most common beta blockers particularly those you will see in practice so propanolol is a very

Common beta blocker with trade names of inderal commend lil innopran the mechanism of action affirmed panel wall is of course that it’s a beta blocker but in particular it tends to be a non-selective data blocker that is its acting on both beta 1 and beta 2 receptors it also tends to inhibit running secretion so it can have effects on things like angiotensin and

Aldosterone as well therapeutic uses for propanolol include things like arrhythmias acute mi situations hyperthyroidism open-angle glaucoma and a variety of other situations where you might have hypertension side effects of propranolol include bradycardia cardiac failure hypertension bronchospasm that’s due to the on the beta 2 receptor fatigue and an increase in

Plasma lipids as well as the other side effects we talked about in general for beta blockers metoprolol and atenolol are two beta blockers that are selectively beta adrenergic antagonists so they are tend to be more selective than some of the other beta blockers their therapeutic uses are similar to propanolol however you know they may be more beneficial in patients

Who have asthma or diabetes or peripheral vascular disease and that is in patients who you don’t want the beta 2 receptor or the you know the beta 2 receptor to be affected side effects of beta-blockers include the same things that we’ve talked about it’s important to note that metoprolol is metabolized through the liver whereas a tunnel although it goes through

The kidney asthma well otherwise known as bready block is another selective beta 1 blocker it is very rapidly metabolized so it goes through the system very quickly typically you’re going to use esmolol in emergent situations like hypertensive emergency or also in management of perioperative hypertension in addition to this previous beta blocker side effects we

Talked about esmolol also has a risk of hypertension some nausea as well as dizziness now there are other beta blockers that also have some alpha blocking activity as well these include labetalol carvedilol and the middle wall so these beta blockers again act both on the beta receptors they’re non selective but they also can have effects on alpha blockers causing

Values of dilating effects therapeutic uses for these types of beta-blockers include eo chromis automa hypertensive emergencies chf and preeclampsia important side effects are similar to those that we’ve already talked about but it’s important to note that in the middle of all of these actually has the fewest side effects so if you want to use a drug that kind

Of has this beta blocking activity as well as some of the alpha and tagging istic affects my bibble elped should be your choice moving on to alpha blockers these tend to be yours o sins things like pride prazosin terazosin and doxazosin they are selective alpha 1 antagonists causing relaxation of the vessels and otherwise causing more compliance of the vessels

Generally we’re not going to be using these for mono therapy for hypertension you know you might use these in a hypertensive patient with bph because it can be beneficial for bph individuals as well the important things to know about alpha blockers like these are the side effects so salt and water retention can happen so you might want to administer these with a

Diuretic you also might seem i’ll dizziness headache sexual dysfunction as well as edema in addition to your alpha 1 blockers you can also have alpha-2 agonist remember alpha 2 receptor is a presynaptic receptor and so when you stimulate this receptor through an agonist you’re actually going to get a reduction in the peripheral vascular resistance that is the base

Of dilation in in the periphery as well as the kidney there is no direct action on the heart with your alpha to agnes methyldopa is obviously one of these types of alpha to agnes that you’re commonly going to see therapeutic uses for methyldopa include hypertension especially during pregnancy you’re typically not going to use it as a monotherapy you might use it as

An add-on therapy if you know your aces your arms your diet aren’t working in hypertension but primarily you’re going to be using methyldopa and alpha-2 agonist for pregnancy related hypertension the side effects of methyldopa include sedation nightmares depression vertigo and hemolytic anemia clonidine or katha pres is another alpha 2 receptor agonist so again

It can cause vasodilation some of the therapeutic uses for chronodyne include hypertension migraines anxiety panic attacks in some cases it can be used for cancer pain important thing to know about clonidine is that side effects note that it can cause sedation dry mouth constipation as well as rectal dysfunction perhaps the most important thing though to know about

Clonidine is that you need to discontinue it slowly to in voy voy a hypertensive crisis never just abruptly stop clonidine you always want to discontinue it slowly so thank you for listening and i hope you tune in next time

Transcribed from video
Adrenoreceptor Blockers By Uri Ben-Zur MD