This is chapter six cardio and in this video we’ll be discussing beta adrenergic beta blockers are a pretty common drug class, and they’re especially used for patients who have heart failure and in patients after they have had a heart attack we’ll have four examples of medications today – three of them will be considered beta blockers, and then we’ll also compare that to
An alpha blocker. alpha and beta are different receptors that are seen in the sympathetic nervous system, and beta1 is a receptor that is found in the heart, and we stimulate that we see bronchodilation or improvement of breathing. we would see a decrease in heart rate, and if we block beta2, that would actually be bad and we would see we have three different generations
Of beta blockers. our first generation of beta blocker is propranolol or inderal. first generation just means that it is non-beta selective. it’s good that it hits beta1 in the heart to lower the heart rate, but it’s bad in that it hits beta 2 in the lungs, so then we get bronchoconstriction. we can remember how propranolol works by hitting both beta1 and beta2 by
Remembering the brand name inderal, and the ending says ‘-al’ or ‘all’ the beta receptors. our example of a second-generation beta blocker is metoprolol. and metoprolol is a beta1 selective, otherwise known as a cardioselective beta blocker. unfortunately, when we lower our heart rate, our body compensates by constricting our arterioles which can then lead to a slight
Increase in blood pressure. there’s two salt forms of metoprolol – the lopressor is metoprolol tartrate salt form and that’s long acting, so we can remember that one is the long acting because the brand name ends in xl. our example of a third-generation beta blocker is carvedilol or coreg. also get that bronchoconstriction. it also blocks alpha1, so since it blocks alpha,
It leads to vasodilation which can better control blood pressure. we don’t see the typical stem of ‘-olol’ with carvedilol – we can remember that carvedilol works a little bit differently by remembering the ‘-dil-‘ part of carvedilol, so we can think of that as our last example is just for comparison., it’s an alpha blocker. doxazosin or cardura is our example. to relax
Smooth muscle in the bladder neck and prostatic capsule, so then we can use this for benign prostatic hyperplasia, which can lead to difficulty urinating, especially in older men. doxazosin, since it is a non-selective alpha blocker, can also be used to lower blood pressure as well with its vasodilatory effects. ‘a beta blocker that is an alpha blocker also is?’ and
Then these four answers will remain the same throughout the rest of the video. a) propranolol, b) metoprolol, the correct answer is c) carvedilol because as you recall, it blocks alpha and beta. a) and b) are incorrect, propranolol and metoprolol, because theose both just work on beta. d) doxazosin is incorrect because it has no effect on beta but it does block alpha.
For the remaining three questions, we will change the question to make each answer correct. question three, be used with caution in asthmatics is?’ and the correct answer is a) propranolol. propranolol blocks beta2 receptors in the lungs, so it can lead to bronchoconstriction, which would be bad in asthmatic patients who already have constriction problems in their lungs.
Metoprolol, carvedilol and doxazosin don’t work quite as hard on the beta2 receptors or they don’t quite work there at all, so these can be used just fine in patients who have asthma. that correct answer is b) metoprolol because it is beta selective or cardio selective. because it is selective for beta1 but it also blocks alpha receptors. doxazosin is doxazosin. it is an
Alpha blocker which is indicated for both of those disease states. a) and b), propranolol and metoprolol, are incorrect because they only work on beta receptors, and carvedilol, while it does work on alpha receptors, there is no indication for
Transcribed from video
(CC) Beta Blockers Propranolol vs Metoprolol (CH 6 CARDIO NAPLEX / NCLEX PHARMACOLOGY REVIEW) By Tony PharmD