Anti-adrenergic drugs

alpha blockers (a1,a2)

PHENOXYBENZAMINE (a1 greater/ equal a2)

ALKALOIDS (from plants) (a1>>)

indirect-acting antiadernertic
(ihibit cate syn)

METYROSINE

a/b blocekrs

labetalol b1=b2>a1

b blockers

propranolol
pindolol
timolol
sotalol

b1

metoprolol, acebutrolol, bisoprolol (good for stable heart failure)
atenolol
esmolol

a1

prazosin
tamsulosin

two mechanisms
irreversible
reversible

irrs- PHENOXYBENZAMINE , covalent

revers - everything else

a1 antag

prazosin/tamsulosin
HELPS WITH PROSTATE
arterial/venous vasodilation
EPI effect is REVERESED
ADRENERGIC SWEATING STOPPED
FALL IN BP!

oral bio 60-90%
distrubites all tissues (brain too)

a1 - antag effects

Baroreceptors blocked when u stand up

Cardio - first dose hypotension (syncope), myocardial/cerebral ischemia

perif EDeMA, w/ chronic treatment

uninary freq/inconticance up
sexual disfunction, inhibit ejact

a1-antag uses

Pheochomocytoma (then u gotta use b blockers)

use in prostatic hypertrophy (rlx bladder)

raynaur'ds disease (cold finger tips)

chronic hypertension/emergency

nonselctive a antag
(phenoxybenzamine)

vaso dilation (perifer)
increase of HR (enchance NE release, reflex)

EPi reversed

HD - inhibtit cat reuptake (phenoxybenazmine)

could last up to 7 days
oral bio 30%, all tissues
24 hrs 1/2 life

b antag

local anestheic (Na+) channels
affects are PRONOUNCED when symp tone is high/SMALL when tone is low

ALL VASODILATION BLOCKED

b antag

CVS - lower cardiac output

vessels - TPR inrease intially (reflex), normalizaed later

resp - broncoconst nml...bad with ppl with ASTHMA)

ocular - decreased rate of aq humor

metabolism - decreased renin

timolol

lower intra occ press

sotalol

pronounced K+ blocking actvity

a-b antag

labetol/carevediol

labetol - anesthetic activy
cav - none

decreased of TPR

b antag

lipid SOLUBILTY!

prop,meto, labetoal
low bioavail/big first pass/cross BBB

b-antag adverse affects

CVS - perip vasc spams
heart failure, withrdrwal affects

resp...= increase resistance
sexual dysfunction (with chroinc treatments)

contraindiactions

vascospaic angina - block b2, cause a1 vasoconstction

USES of b blockers

hypertension
arrhythimias
exertional angina

open/closed in glaucoma

indirect acting

Metyrosinse - inhibit tyrosine hydroxylase (up to 70%)