4) Adrenergic Receptor Agonists - Antagonists Flashcards
What is the class for Norepinephrine (Levophed)
Non-selective agonist
What is the mechanism for Norepinephrine (Levophed)
Agonist: alpha 1, alpha 2, beta 1
What are the therapeutics for Norepinephrine (Levophed)
Acute Hypotension
What are the important side effects for Norepinephrine (Levophed)
Hypertension; arrythmias; headache
What is the class for Epinephrine
Non-selective agonist
What is the mechanism for Epinephrine
Agonist: alpha 1, (alpha 2), beta 1, beta 2
What are the therapeutics for Epinephrine
Anaphylactic shock; combined with local anesthetics; glaucoma
What are the important side effects for Epinephrine
Palpitation; arrhythmias; headache
What is the class for Amphetamine
Indirect acting
What is the mechanism for Amphetamine
Increases release of NE
What are the therapeutics for Amphetamine
ADHD, narcolepsy, recreation
What are the important side effects for Amphetamine
Hypertension, insomnia, anxiety, arrhythmias
What is the class for Isoproterenol (Isuprel)
Non-selective beta agonist
What is the mechanism for Isoproterenol (Isuprel)
Agonist: beta 1, beta 2
What are the therapeutics for Isoproterenol (Isuprel)
shock; heart block
What are the important side effects for Isoproterenol (Isuprel)
Palpitation; tachyarrhythmia; headache
What is the class for Dobutamine
beta 1-selective beta agonist
What is the mechanism for Dobutamine
Agonist: beta 1
What are the therapeutics for Dobutamine
Cardiac decompensation; shock; heart block
What are the important side effects for Dobutamine
Tachyarrythmias; hypertension
What is the class for Albuterol (Proventil)
beta 2-selective beta agonist
What is the mechanism for Albuterol (Proventil)
Agonist: beta 2
What are the therapeutics for Albuterol (Proventil)
Prevent or reverse exercise-induced bronchospasm; mild asthma; COPD
What are the important side effects for Albuterol (Proventil)
Can mask progressively severe inflammation
What are the other side effects for Albuterol (Proventil)
Tachycardia, muscle tremor
What are the miscellaneous for Albuterol (Proventil)
10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose –> side effects); can be used night symptoms, but not ideal
What is the class for Terbutaline (Brethine)
beta 2-selective beta agonist
What is the mechanism for Terbutaline (Brethine)
Agonist: beta 2
What are the therapeutics for Terbutaline (Brethine)
Prevent or reverse exercise-induced bronchospasm; mild asthma; COPD; early labor
What are the important side effects for Terbutaline (Brethine)
Can mask progressively severe inflammation
What are the other side effects for Terbutaline (Brethine)
Tachycardia, muscle tremor
What are the miscellaneous for Terbutaline (Brethine)
10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose –> side effects); can be used night symptoms, but not ideal
What is the class for Phenylephrine (Neo-Synephrine)
alpha 1-selective alpha agonist
What is the mechanism for Phenylephrine (Neo-Synephrine)
Agonist: alpha 1
What are the therapeutics for Phenylephrine (Neo-Synephrine)
Nasal congestion; postural Hypotension
What are the important side effects for Phenylephrine (Neo-Synephrine)
Hypertension; reflex bradycardia
What is the class for Clonidine (Catapres)
alpha 2-selective alpha agonist
What is the mechanism for Clonidine (Catapres)
Agonist: CNS alpha 2
What are the therapeutics for Clonidine (Catapres)
Hypertension; shock; withdrawal from drug dependence
What are the important side effects for Clonidine (Catapres)
Sedation
What is the class for alpha-methyldopa (Aldomet)
alpha 2-selective alpha agonist
What is the mechanism for ?-methyldopa (Aldomet)
Metabolite (a-methylnorepinephrine) activates CNS a2 receptors
What are the therapeutics for ?-methyldopa (Aldomet)
Hypertension
What are the important side effects for ?-methyldopa (Aldomet)
Sedation
What are the miscellaneous for ?-methyldopa (Aldomet)
Prodrug; crosses BBB
What is the class for Fenoldopam (Corlopam)
Selective dopamine agonist
What is the mechanism for Fenoldopam (Corlopam)
Agonist: D1 only
What are the therapeutics for Fenoldopam (Corlopam)
Increase blood flow at renal, mesenteric, and cerebral arteries
What are the miscellaneous for Fenoldopam (Corlopam)
~10 minute half-life
What is the class for Dopamine
Mixed acting (direct/indirect)
What is the mechanism for Dopamine
Agonist: D1, alpha 1, beta 1
What are the therapeutics for Dopamine
Shock, renal failure, hypotension
What are the important side effects for Dopamine
Vasoconstriction (@ high doses)
What are the miscellaneous for Dopamine
Low dose = Direct @ D1 Receptors
Medium dose = Direct @ Beta 1, some Indirect
High dose = Direct @ Alpha 1, some Indirect
What is the class for Phentolamine (Regitine)
Non-selective alpha-antagonist
What is the mechanism for Phentolamine (Regitine)
Antagonist: alpha 1, alpha 2
What are the therapeutics for Phentolamine (Regitine)
Pheochromocytoma, Raynaud’s, frostbite
What are the important side effects for Phentolamine (Regitine)
Postural hypotension; inhibit ejaculation
What is the class for Phenoxybenzamine (Dibenzyline)
Non-selective alpha-antagonist
What is the mechanism for Phenoxybenzamine (Dibenzyline)
Antagonist: alpha 1, alpha 2; non-competitive blocker (covalent bond to receptor)
What are the therapeutics for Phenoxybenzamine (Dibenzyline)
Pheochromocytoma, Raynaud’s, frostbite
What are the important side effects for Phenoxybenzamine (Dibenzyline)
Postural hypotension; inhibit ejaculation
What is the class for Prazosin (Minipress)
alpha 1-selective antagonist
What is the mechanism for Prazosin (Minipress)
Antagonist: alpha 1
What are the therapeutics for Prazosin (Minipress)
Primary HTN, BPH
What are the important side effects for Prazosin (Minipress)
Postural hypotension (usually 1st dose)
What is the class for Terazosin (Hytrin)
alpha 1-selective antagonist
What is the mechanism for Terazosin (Hytrin)
Antagonist: alpha 1
What are the therapeutics for Terazosin (Hytrin)
Primary HTN, BPH
What are the important side effects for Terazosin (Hytrin)
Postural hypotension (usually 1st dose)
What is the class for Propranolol (Inderal)
Non-selective beta-antagonist (1st generation)
What is the mechanism for Propranolol (Inderal)
Antagonist: beta 1, beta 2
What are the therapeutics for Propranolol (Inderal)
Angina, Hypertension, Arrythmias
What are the important side effects for Propranolol (Inderal)
Bradycardia, Bronchoconstriction, Sexual Dysfunction
What are the miscellaneous for Propranolol (Inderal)
Workhorse by which all the rest are judged
What is the class for Timolol (Betimol)
Non-selective beta-antagonist (1st generation)
What is the mechanism for Timolol (Betimol)
Antagonist: beta 1, beta 2
What are the therapeutics for Timolol (Betimol)
Glaucoma
What are the important side effects for Timolol (Betimol)
Bradycardia, Bronchoconstriction, Sexual Dysfunction
What is the class for Metoprolol (Lopressor)
beta 1-selective antagonist (2nd generation)
What is the mechanism for Metoprolol (Lopressor)
Antagonist: beta 1
What are the therapeutics for Metoprolol (Lopressor)
HTN, Angina, Arrythmias, CHF
What are the important side effects for Metoprolol (Lopressor)
Bradycardia, Sexual Dysfunction
What is the class for Atenolol (Tenormin)
beta 1-selective antagonist (2nd generation)
What is the mechanism for Atenolol (Tenormin)
Antagonist: beta 1
What are the therapeutics for Atenolol (Tenormin)
HTN, Angina, Arrythmias, CHF
What are the important side effects for Atenolol (Tenormin)
Bradycardia, Sexual Dysfunction
What is the class for Bisoprolol (Zebeta)
beta 1-selective antagonist (2nd generation)
What is the mechanism for Bisoprolol (Zebeta)
Antagonist: beta 1
What are the therapeutics for Bisoprolol (Zebeta)
HTN, Angina, Arrythmias, CHF
What are the important side effects for Bisoprolol (Zebeta)
Bradycardia, Sexual Dysfunction
What is the class for Carvedilol (Coreg)
Non-selective beta-antagonist (3rd generation “A”)
What is the mechanism for Carvedilol (Coreg)
Antagonist: beta 1, beta 2
What are the therapeutics for Carvedilol (Coreg)
CHF, HTN
What are the important side effects for Carvedilol (Coreg)
Bradycardia, Fatigue
What is the class for Labetalol (Trandate)
Non-selective beta-antagonist (3rd generation “A”)
What is the mechanism for Labetalol (Trandate)
Antagonist: beta 1, beta 2
What are the therapeutics for Labetalol (Trandate)
CHF, HTN
What are the important side effects for Labetalol (Trandate)
Bradycardia, Fatigue
What is the class for Betaxolol (Kerlone)
beta 1-selective antagonist (3rd generation “B”)
What is the mechanism for Betaxolol (Kerlone)
Antagonist: beta 1
What are the therapeutics for Betaxolol (Kerlone)
CHF, HTN
What are the important side effects for Betaxolol (Kerlone)
Bradycardia
What is the class for Tyramine
Indirect acting agonist
What is the mechanism for Tyramine
Increases cytoplasmic NE release
What are the miscellaneous for Tyramine
Tyramine is involved with an exchange transporter: tyramine goes in, NE comes out
What is the mechanism for Cocaine
Prevents NE reuptake
What are the therapeutics for Cocaine
Local anesthetic, vasoconstrictor
What are the important side effects for Cocaine
Insomnia, anxiety, arrhythmias
What is the class for Guanethidine (Ismelin)
Nerve ending blocker
What is the mechanism for Guanethidine (Ismelin)
False neurotransmitter (vesicles become full of guanethidine rather than NE)
What are the therapeutics for Guanethidine (Ismelin)
Antihypertensive
What are the important side effects for Guanethidine (Ismelin)
Many and serious
What are the miscellaneous for Guanethidine (Ismelin)
Don’t really use this in US; doesn’t cross BBB
What is the class for Reserpine
Nerve ending blocker
What is the mechanism for Reserpine
Release of empty vesicles (NE is not taken into vesicles b/c it binds uptake transporter and stops it)
What are the therapeutics for Reserpine
Older antihypertensive
What are the important side effects for Reserpine
Many and serious (depression and suicide are major ones)
What are the miscellaneous for Reserpine
Cheap! (used abroad, not here)
What is the class for ?-me-tyrosine (Metirosine)
Nerve ending blocker
What is the mechanism for ?-me-tyrosine (Metirosine)
Inhibit tyrosine hydroxylase (decreases NE synthesis)
What are the therapeutics for ?-me-tyrosine (Metirosine)
Pheochromocytoma
What are the important side effects for ?-me-tyrosine (Metirosine)
Many and serious
What are the miscellaneous for ?-me-tyrosine (Metirosine)
Still used for this
What is the class for Ephedrine (Pretz-D)
Mixed, direct (beta 2)/indirect agonist
What are the therapeutics for Ephedrine (Pretz-D)
Nasal decongestion, anorexic