Adrenergic Agonists

BLOCKERS

Alpha 1 adrenergic blockers

Prazosin (Minipress) Selective blockade of alpha 1 adrenergic receptors Causes dilation of arterioles and veins

Relaxation of smooth muscles in the bladder neck

and prostatic capsule Approved only for treatment of hypertension Can benefit men with BPH

Prazosin
Administered orally

Adverse effects: Orthostatic hypotension Reflex tachycardia Inhibition of ejaculation First dose effect

Other alpha 1 blockers

Terazosin Doxazosin Tamsulosin

Phentolamine

Beta blockers
Used to treat: Angina pectoris Hypertension Cardiac dysrhythmias Myocardial infarction Heart failure

Other Uses of Beta Blockers

Hyperthyroidism Migraine Stage fright Pheochromocytoma Glaucoma

Adverse Effects of Beta 1 Blockers

Bradycardia Reduced cardiac output Precipitation of heart failure AV heart block Rebound cardiac excitation

Adverse Effects of Beta 2 Blockers

Bronchoconstriction Inhibition of

glycogenolysis

Beta 1 Blockers
Non-selective Propranolol (Inderal) Blocks both beta 1 and beta 2 receptors

Adverse Effects of Beta 1 Blockers

Bradycardia Av heart block Heart failure

Rebound cardiac excitation

Bronchoconstriction Inhibition of glycogenolysis Depression and insomnia

Precautions, Warnings, Contraindications

Severe allergy Diabetes Cardiac disorders

Respiratory disorders
Psychiatric disorders

Drug Interactions

Calcium channel blockers Insulin

Metoprolol (Lopressor, Toprol XL)

Beta 1 blocker (cardioselective Blocks Beta 1 activation

Can block beta 2 activation if taken in large doses

Case Study

Jessie James is an 45-yearold who is being treated for hypertension. Several types of medications have been tried without success. His physician has decided to prescribe propranolol, 40 mg twice daily.

Mr. James wants to

know what side effects might he experience from the propanolol. What will you tell him?

 Jessie James is an 45-

year-old who is being treated for hypertension. Several types of medications have been tried without success. His physician has decided to prescribe propranolol, 40 mg twice daily.

Why should clients be

discouraged from abruptly stopping propranolol. Why is this so?

 Jessie James is an 45-

year-old who is being treated for hypertension. Several types of medications have been tried without success. His physician has decided to prescribe propranolol, 40 mg twice daily.

You learn that Mr.

James also has diabetes mellitus. What special consideration must be made when he is taking propranolol?

 Jessie James is an 45-

year-old who is being treated for hypertension. Several types of medications have been tried without success. His physician has decided to prescribe propranolol, 40 mg twice daily.

You also learn that he

has a history of asthma. Metoprolol may be a better selection of beta blocker for him because..

 Jessie James is an 45-

year-old who is being treated for hypertension. Several types of medications have been tried without success. His physician has decided to prescribe propranolol, 40 mg twice daily.

The physician has

considered the use of proazosin (Minipress) . Why might this drug be considered for Mr. James?