1. Beta-receptor antagonists
1.1. Selective β-1
1.1.1. Clinical indications
1.1.1.1. β-1 effect: reduce HR & inotropy
1.1.1.2. Less β-2 effect: less constriction of airway
1.1.2. Drugs
1.1.2.1. Atenolol
1.1.2.1.1. HTN, angina pectoris, MI, arrhythmias
1.1.2.2. Metaprolol
1.1.2.2.1. HTN, angina, MI, arrhythmias
1.2. Non-selective
1.2.1. Clinical indications
1.2.1.1. Blocks β-1: lowers HR
1.2.1.2. Blocks β-2: constricts airway
1.2.1.3. Angina & MI: Reduces HR, contractility & arterial pressure
1.2.1.4. HTN: Reduces HR, contractility, & inhibits release of renin
1.2.1.5. Congestive heart failure: Blocks noradrenaline & promotes bradycardia
1.2.1.6. Cardiac arrhythmias: β-1 blockers reduce heart conduction rates
1.2.2. Drug
1.2.2.1. Propranolol
1.2.3. Precautions
1.2.3.1. Care in bronchoconstrictive diseases
1.2.3.2. Caution in peripheral vascular disease
1.2.3.3. Caution with patients with heart conduction defects or anti-arrhythmic drugs
1.2.3.4. Withdrawal syndromes
1.2.3.5. Caution in patients with DM
1.3. Intrinsic Sympathetic Activity (ISA)
1.3.1. Clinical indications
1.3.1.1. For patients that exhibit excessive bradycardia with sustained β-blocker therapy
1.3.2. Drugs
1.3.2.1. Pindolol
1.3.2.1.1. Non-selective β-blocker with ISA: Asthma or COPD
1.3.2.2. Acebutolol
1.3.2.2.1. Cardioselective β-blocker with ISA
2. Function: blocks stimulation of sympathetic division
3. Alpha-receptor antagonists
3.1. Selective α-1
3.1.1. Prazosin
3.1.1.1. Clinical indications
3.1.1.1.1. HTN
3.1.1.1.2. BPH
3.1.1.2. Adverse effects
3.1.1.2.1. Dizziness, weakness, nausea, palpitation, edema, 'first dose phenomenon', & urinary incontinence
3.1.1.3. Risk factors
3.1.1.3.1. Upright posture
3.1.1.3.2. Volume depletion
3.1.1.3.3. taking BP-lowering drugs
3.1.2. Alfuzosin
3.1.2.1. Clinical indications
3.1.2.1.1. Treatment of functional symptoms with BPH
3.1.3. Terazosin
3.1.3.1. 1 mg - BPH
3.1.3.2. 2 mg - HTN & BPH
3.1.3.3. 5 mg - HTN & BPH
3.2. Selective α-2
3.2.1. Mirtazipine
3.3. Non-selective
3.3.1. Phenoxibenzamine
3.3.1.1. Clinical indications
3.3.1.1.1. Treat HTN in pheochromocytoma
3.3.1.1.2. Efficacy in reducing vasoconstriction caused by adrenaline & noradrenaline
3.3.1.2. Adverse effects
3.3.1.2.1. Nasal congestion
3.3.1.2.2. Postural HTN
3.3.1.2.3. Reflex tachycardia