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1. Beta-receptor antagonists

1.1. Selective β-1

1.1.1. Clinical indications β-1 effect: reduce HR & inotropy Less β-2 effect: less constriction of airway

1.1.2. Drugs Atenolol HTN, angina pectoris, MI, arrhythmias Metaprolol HTN, angina, MI, arrhythmias

1.2. Non-selective

1.2.1. Clinical indications Blocks β-1: lowers HR Blocks β-2: constricts airway Angina & MI: Reduces HR, contractility & arterial pressure HTN: Reduces HR, contractility, & inhibits release of renin Congestive heart failure: Blocks noradrenaline & promotes bradycardia Cardiac arrhythmias: β-1 blockers reduce heart conduction rates

1.2.2. Drug Propranolol

1.2.3. Precautions Care in bronchoconstrictive diseases Caution in peripheral vascular disease Caution with patients with heart conduction defects or anti-arrhythmic drugs Withdrawal syndromes Caution in patients with DM

1.3. Intrinsic Sympathetic Activity (ISA)

1.3.1. Clinical indications For patients that exhibit excessive bradycardia with sustained β-blocker therapy

1.3.2. Drugs Pindolol Non-selective β-blocker with ISA: Asthma or COPD Acebutolol 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 Clinical indications HTN BPH Adverse effects Dizziness, weakness, nausea, palpitation, edema, 'first dose phenomenon', & urinary incontinence Risk factors Upright posture Volume depletion taking BP-lowering drugs

3.1.2. Alfuzosin Clinical indications Treatment of functional symptoms with BPH

3.1.3. Terazosin 1 mg - BPH 2 mg - HTN & BPH 5 mg - HTN & BPH

3.2. Selective α-2

3.2.1. Mirtazipine

3.3. Non-selective

3.3.1. Phenoxibenzamine Clinical indications Treat HTN in pheochromocytoma Efficacy in reducing vasoconstriction caused by adrenaline & noradrenaline Adverse effects Nasal congestion Postural HTN Reflex tachycardia