SYMPHATOLYTICS/ADRENERGIC ANTAGONIST

addition – alpha 2 blocker Rauwolscine

CLINICAL USE OF NON-SELECTIVE ALPHA BLOCKERS

NON SELECTIVE ALPHA BLOCKERS

1.) Phenoxybenzamine –

A.)management of pre-surgical pheochromocyoma

)Pheochromcytoma – enlargement of adrenal medulla which reults in increase secretion of adrenaline.

C.)Can also be used for carcinoid tumor due to its anti-serotonerhic effects

D.)Mastocytosis

2.) Phentolamine - vasodilation

A.) Are used to prevent or stop tissue damage due to overusage of alpha-1 agnosist drugs

B.) Treat rebound hypertension usually due to clondine

C.) Erectile dysfunction – when blood vessels in the penis relaxes, more blood can enter the vessels which results in
erection.

Phentolamine is locally injected to the penis shaft

ADVERSE EFFECT OF PHENTOLAMINE: Hypotension

General moa of Olols – antagonistic effects of beta-1 receptors

Classification of Beta blockers

1.) Selectivity
2.) Miscellaneous actions

Major contrainidcation of NSTP drugs

Contrainidicated with bronchial

asthmatic.

Miscellaneous actions of Beta-blockers

1. Intrinsic Symphatomimetic activity

2. Membrane stabilizing actions
3. Alpha-blockade

1. ISA – Intrincsic Symphatomimetic activity - drugs that block Beta-1 and activates B2

EXAMPLE: Acebutolol, Pindolol

2. Alpha-blocking activity – beta blockers that can also block alpha-1 receptors causing vasodilation

EXAMPLE: Labetolol, Carvedilol

3. Membrane stabilizing actions (also have local anesthetics) – Should never be instilled to the eyes

EXAMPLE: Propanolol, Acebutolol, Labetolol, Metoprolol

SPECIAL BETA BLOCKER

Nebivolol – most cardioselective betablocker by enhancing the level of nitric oxide in the body

Nitric oxide- is an endogenous vasodilator

CLINICAL USES OF NON-SELECTIVE BETA BLOCKERS

3 GENERAL USAGE OF NON-SELECTIVE BETA BLOCKERS

1. Arrhytmias – also term as class II drugs

2. Acute panic syndrome – treatment of tachycardia
3. Migraine headache
 COMMON SIDE EFFECTS / ADVERSE FFECTS OF DIRECT ACTING ADRENERGIC DRUGS

Best time to take alpha –blockers: Bedtime

COMON ADVERSE EFFECT OF ADRENERGIC NEURONAL DRUGS (PERIPHERALLY ACTING)