Adrenergic Receptor Blockers Jp (2)

7/23/2019 Adrenergic Receptor Blockers Jp (2)

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ADRENERGIC RECEPTOR BLOCKERS

α-BLOCKERS:1.Non-selective (1!"# non-

co$%etitive: P&eno')en*+$ine# Di)en+$ine

!. Co$%etitive# non-selective:P&entol+$ine#

D,E# D,Et'

. Co$%etitive# α1-selective:P+*osin#

te+*osin# /o'+*osin# t+$s0losin# +l0*osin

2. α- +n/ 3-)loc4es: L+)etolol# c+ve/ilol

5. α!-selective: 6o&i$)ine ( not 0se/ clinic+ll"



!

ADRENERGIC RECEPTOR BLOCKERS

(cont/"

3-)loc4es:

1. Non-selective (1!" : Po%+nolol#

o'%enolol# %in/olol#sot+lol# n+/olol#ti$olol

!. C+/ioselective (31":Biso%olol# es$olol#

+ce)0tolol# +tenolol# $eto%olol#celi%olol (7 +t 3!"

. α- +n/ 3-)loc4es: L+)etolol# c+ve/ilol#

ne)ivolol# )et+'olol



α-BLOCKERS

8 P&+$+colo9ic+l eects:

8 CS: α1 )loc4+/e : +so/il+t+tion#

/ece+se/ TPR ; +ll in BP8 Dece+se/ oce o c+/i+c cont+ction ;

+ll in BP

8 Post0+l &%otension (<ist /ose eect=" +n/ ele' t+c&c+/i+.

8 DALE>S ASO?OTOR REERSAL



2

α-BLOCKERS (CONTD"

8 Ot&e eects: Sl099is& %0%il# /ece+se/

+/ene9ic s@e+tin9# n+s+l st0iness#

/ece+se/ esist+nce to 0ine o0tlo@ in

$+les ( BP,".

8 P&eno')en*+$ine: Also )loc4s ,1# Ac&

+n/ 5-,T ece%tos.

8 ADR: <ist /ose eect=# ele' t+c&c+/i+#

n+s+l st0iness# +ti90e# se/+tion

n+0se+.



5

α-BLOCKERS (CONTD"

8 P&entol+$ine : ADR: Ds&t&$i+s#

+n9in+ %ectois# &%e+ci/it# /i+&e+.

8P+*osin# te+*osin# /o'+*osin : α

1

-selective )loc4es. Less ele' t+c&c+/i+

%ost0+l &%otension +n/ enin ele+se.

Peee/ in ,TN.

8 T+$s0losin# +ll0*osin :α1A-selective

(0oselective": Peee/ in B,P.



3-)loc4es

8 Po%+nolol :Non-selective 3-)loc4e @it&$e$)+ne st+)ili*in9 +ctivit# no intinsic

s$%+t&o$i$etic +ctivit.

8 P.K.E.:!5 o+l )io+v+il+)ilit. oo/ en&+nces

its +)so%tion.

8 Eects:

8 C..S.:Ne9+tive ino-# c&ono-# /o$o- +n/

)+t&$oto%ic eects.

8 SA +te +n/ A con/0ction /ece+se/

8 Ds&t&$i+s# I,D ( e'ce%t v+i+nt +n9in+"#

,TN.



F

Po%+nolol (cont/"

8 Bloo/ vessels : +soconstiction. No c&+n9e

in BP. C&onic 0se e/0ces %l+s$+ enin +ctivit#

t&0s e/0cin9 BP.

8 Res%i+to t+ct :Bonc&oconstiction (3!-)loc4+/e".CI in +st&$+tics.

8 Ee : IOP /ece+se/ ) e/0cin9 +H0eo0s

&0$o o$+tion :Ti$olol# )et+'olol#lev)0nolol :ee /o%s.

8 C.N.S.: S$%+t&etic tone is e/0ce/ :+ll in BP.

8 Se/+tion# /e%ession# slee% /ist0)+nces.



Po%+nolol (cont/"

8 ?et+)olic eects: S$%to$less

&%o9lce$ic co$+ in /i+)etics. CI in

D?.

8 S4elet+l $0scle te$os +e )loc4e/.



1J

C+/ioselective )et+-)loc4es

8 Biso%olol# Es$olol# Ace)0tolol# Atenolol#

?eto%olol# Celi%olol. Ne)ivolol.

8 Rel+tivel s+e in +st&$+tics +n/

/i+)etics.

8 Atenolol /oes not coss BBB.

8 T&e +e not eective in contollin9se4let+l $0scle te$os.



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Bet+-)loc4es @it& ISA

8 Pin/olol# O'%enolol#Ace)0tolol.

8 Less $oc+/i+l /e%ession +n/

)+/c+/i+# &ence %eee/ in %+tients

@it& lo@ c+/i+c eseve.

8 Less li4el to c+0se e)o0n/ &%etension

on +)0%t @it&/+@+l.



1!

ADR o )et+-)loc4es

1. CS: B+/c+/i+# &e+t )loc4# CC# e)o0n/

,TN on +)0%t cess+tion.

!. RS: Bonc&oconstiction.

. ?et+)olic: S$%to$less &%o9lce$ic co$+in /i+)etics.

2. CNS: Let&+9# slee% /ist0)+nces# +ti90e +n/

/e%ession.5. Ot&es: N+0se+# /i+&e+ +n/ s4in +s&.



1

8 Te+t$ent o )et+-)loc4e ove/ose

1. P+ce $+4e

!. Iso%en+line I in0sion

. Ato%ine I )ol0s

2. Gl0c+9on I )ol0s

CI o non-selective )et+-)loc4es:

8 Ast&$+

8 Bloc4

8 CC

8 D?

8 +i+nt +n9in+



β blockers- drug interactions

• Verapamil, digitalis- SA node and AVconduction are depressed

• Insulin and hypoglycemic drugs

• α agonists- Hypertensive crisis

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SES O BETA-BLOCKERS

1.,TN

!. An9in+ %ectois

.?I

2.C+/i+c /s&t&$i+s

5. +llot>s tetolo9

. ?it+l stenosis @it& t+c&c+/i+

. Dissectin9 +otic +ne0s$

F. ,%eto%&ic c+/io$o%+t&

.S0)+otic stenosis



1

SES O BETA-BLOCKERS (cont/"

1J. P&eoc&o$octo$+ ( @it& +l%&+-)loc4e"

11. T&oto'icosis

1!. ?i9+ine Po%&l+'is: Po%+nolol

1. Gl+0co$+ : Ti$olol# )et+'olol# lev)0nolol

12. An'iet st+tes

15. Alco&ol @it&/+@+l s$%to$s.

1. C,: ?eto%olol# celi%olol# ne)ivolol



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Adrenergic Receptor Blockers Jp (2)

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