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AA Pharm: Alpha Adrenergic Receptor Blockers

AB
selective alpha-adren blockersdoxazosin, prazosin, terazosin
mechanism of selective alpha-adren blockersblock periph alpha 1 recptors-> inhib vc-> secondary vd (both art and ven)
effects of selective alpha-adren blockdec afterload of the heart, dec periph vasc resis, vasodil(2ndary)
which selective alpha-adren blocking med(s) is elim by the liver?prazosin, doxazosin
which selective alpha-adren blocking med(s) is elim by liver and urine?terazosin
side effects of selective a-a blockersorthostatic hypoTN (w/ 1st dose or hi dose), dizzy, drowsy, headache; short-lived 2-4 wks
indications for selective a-a bockersHTN, heart failure, benign prost hyperty
contra for selective a-a blockershypersensitivity
drug intraxns with selective a-a blockersB-blockers, verapamil, NSAIDs
what is "first dose effect" of sel a-a blockers?ortho hypoTN w/ 1st dose or hi dose; give at bedtime
pts at risk for first dose effect of sel a-a blockerspatients w/ Na and H2O depletion
what other med is given to help with first dose effectdiuretics
what condition is sel a-a blocker used as adjunct(not primary)heart failure
mech of non-sel a-a blockersblock alpha 1 & 2 receptors -> dec periph resis & inc CO(2ndary to reflex inc sympathetic outflow)
non-selective alpha receptor blockersphentolamine, phenoxybenzamine
elimination of non-sel a-receptor blockersliver only
med used to dx pheochromocytomaphentolamine
side fx of non-sel a-a blockersortho hypotn, reflex tachy, diarrhea, nasal cong, dizzy, sex dysfxn, miosis
which side fx are caused by phenoxybenzaminesexual dysfunction, miosis
indications for phentolamineHTN emerg assd w/ pheochromocytoma, extravisation of alpha agonist
indications for phentoxybenzamineHTN assd w/ pheochromocytoma or exogenous admin of catecholamines
contra assd w/ phentolaminehypersensitivity, coronary and cerebral arterioscl, MI(unless cocaine)
contra assd w/ phenoxybenzamineshock, coronary and cerebral arterioscl
a-B receptor antagonistslabetalol, carvedilol
mechanism of a-B antagonistsnon-sel beta blocking & alpha blocking
effects of a-B antagonistsdec HR, dec MC, vd
excretion of a-B antagonistshepatic
a-B antagonist indicated for heart failurecarvedilol
side fx of a-B antagonistsbradycar, hypotn, dizzy, fatigue, depressed, sex dys, dyslipid, sleep dys
indications for labetalolHTN, acute aortic dissection, HTN assd pheochromocytoma
indications for carvedilolHTN, adjunct mild heart failure
contra for a-B blockerssame as beta blockers
drug interaxns for carvedilolCIM, rifampin, digoxin, Ca ch blockers, othe meds that dec bp
drug interaxns for labetalolCIM, other meds that dec bp
which IV a-B antagonist has more beta blockinglabetalol


Suzanne M. Clous

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