A.12

Question 1

Indirect sympathomimetic

Answer 1

Ephedrine,
Phenylephrine,
Clonidine,
Rilmenidine,
Methyldopa,
Oxymetazoline,
Methylphenidate

Question 2

Ephedrine

Answer 2

MOA: Indirect sympathomimetic+weak β2 agonist; Effect: Enhance monoamine release;
IND: Nasal decongestant, treatment of Hypotension associated w/ anesthesia (especially spinal anesthesia!); Extra: Plant-derived alkaloid

Question 3

Phenylephrine

Answer 3

MOA: α1-agonist;
ROA: oral, parentral
Effect: Vasoconstriction (↑BP);
DOA: 50-60min;
IND: Hypotension treatment, Nasal decongestant, Mydriasis, Common cold/flu medications combined w/NSAIDs/paracetamol;
SEs: Hypertension, reflex bradycardia, stroke, MI

Question 4

Oxymetazoline

Answer 4

MOA: non selective α agonist (works on α1,2);
Effect: Vasoconstriction (local use);
IND: Nasal decongestant (local use);
SEs: mild side effects

Question 5

Clonidine

Answer 5

MOA: α2-agonist;
ROA: p.o or T.D patch;
Effect: Presynaptic α2 leads to decrease in NE release→BP↓;
IND: HTN, ADHD, Tourette’s syndrome;
SEs: Sedation, dry mouth, bradycardia, severe rebound hypertension;
Extra: Imidazole derivative

Question 6

Rilmenidine

Answer 6

MOA: α2-agonist;
ROA: p.o;
Effect: vasodilation;
IND: HTN;
SEs: milder than clonidine;
Extra: Imidazole derivative, clonidine-like structure

Question 7

Methyldopa

Answer 7

MOA: α2-agonist;
ROA: p.o or i.v;
Effect: Inhibit NE release via presynaptic α2-receptor (cannot activate adrenergic Rs→safe in pregnancy); IND: HTN in pregnancy;
SEs: drug-induced-lupus, sedation, nausea;
Extra: Pro-drug→transported into the brain and converted to methyl-NE

Question 8

Methylphenydate

Answer 8

MOA: Inhibits reuptake of DA and NE (by DAT and NET); ROA: p.o;
IND: ADHD, Narcolepsy;
SEs: Insomnia, nausea, headache, decreased appetite; Extra: Amphetamine derivative

Question 9

I2 antagonis

Answer 9

Idazoxan