1 ADRENERGIC ANTAGONITS

2 ADRENERGIC BLOCKERS ALPHA BLOCKERS Alpha 1 Blockers Nonselective Alpha Blockers Doxazosin Phenoxybenzamine Prazosin Phentolamine Terazosin

3 BETA BLOCKERS Non Selective Beta 1 selective Blockers Blockers Propranolol Metoprolol Timolol Atenolol Nadolol Esmolol Acebutolol Betaxolol Labetalol - Both Alpha and Beta BLocker

4 DRUGS AFFECTING NEUROTRANSMITTER UPTAKE OR RELEASE Cocaine Guanethidine Reserpine

5 Phenoxybenzamine Blocks alpha 1 and 2, irreversible blockade MOSTLY Actions - prevents V.C, Epinephrine reversal Therapeutic uses : – Opposing catecholamines --pheochromocytoma – Causes vasodilation

6 SE: Postural hypotension Sexual dysfunction Tachycardia Contraindicated in ↓ coronary perfusion.

7 Phentolamine Alpha 1 and 2 blocker Duration of action less Uses & SE – mostly same as Phenoxybenzamine.

8 Alpha 1 specific blockers Prazosin Terazosin Doxazosin – long acting

9 Actions Dose ---- Uses Side effects ---- CVS Avoid high doses HTN Orthostatic hypotension Nasal stuffiness Fatigue Sexual dysfunction (less)

10 Non selective beta antagonists Propranolol Timolol Nadolol

11 Propranolol CVS – HR ↓, CO ↓ PERIPHERAL VESSELS – NO ALPHA ACTION BRONCHI - ↑ CONTRACTION SODIUM LEVELS - ↑ GLYCOGENOLYSIS -↓ GLUCAGON - ↓ BLOCKS DRUGS – Isoproterenol, & β actions of epinephrine

12 USES HTN ---- decreases CO ANGINA---decreases oxygen demand MI---- protects myocardium GLAUCOMA-- Timolol MIGRAINE HYPERTHYROIDISM– blunts sympathetic stimulation

13 SIDE EFFECTS BRONCHOCONSTRICTION CONTRAINDICATION –ASTHMA, COPD ARRHYTHMIAS – gradual reduction in dose SEXUAL IMPAIREMENT

14 NON SELECTIVE BETA ANTAGONISTS TIMOLOL NADOLOL → very long duration of action Considered more potent than propranolol. Same effects and SE as propranolol.

15 SELECTIVE BETA 1 ANTAGONISTS ATENOLOL METOPROLOL ESMOLOL USES – HTN,ANGINA CAN BE USED IN COPD, DM CASES

16 ANTAGONISTS AND PARTIAL AGONISTS PINDOLOL ACEBUTOLOL USES : HTN with moderate bradycardia

17 ALPHA AND BETA BLOCKER LABETALOL Peripheral vasodilation -- ↓ B.P No vasoconstrictive effect USES : OLD AGE HTN, PIH SE: Orthostatic hypotension and dizziness.

18 NT AFFECTING DRUGS RESERPINE - CYTOPLASM TO STORAGE VESICLE USES -- ↓B.P. ↓ H.R

19 NT AFFECTING DRUGS GUANETHIDINE –BLOCKS RELEASEOF NE IN VESICLE TO MEMBRANE USES—gradual lowering of B.P and H.R. in hypertensives

20 NT AFFECTING DRUGS COCAINE Block Na-K ATPase REUPTAKE DECREASED (NE) USES ----local anesthetic???