Adrenegic Agonists Flashcards

0
Q

Side effects of ALPHA 1 agonists

A

Vasoconstriction
Decongestion
Mydriasis

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1
Q

Site for adrenergic ALPHA 1 receptors

A

Vascular smooth muscle (constriction)

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2
Q

Receptors for ALPHA 2 agonists

A

Central sympathetic vase motor center

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3
Q

Clinical significance of ALPHA 2 agonists

A

Anti hypertensive

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4
Q

Receptors for BETA adrenergic agonists

A

Heart, lower respiratory smooth muscle, bladder wall, uterus, skeletal muscle vasculature

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5
Q

Clinical significance of BETA receptor agonists

A

Cardiac stimulation
Bronchodilation
Decrease uterine contractions

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6
Q

Key properties of catecholamines

A

Potent
Rapidly inactivated by COMT/MAO
Polar

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7
Q

Methoxamine receptor selectivity

A

Alpha 1

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8
Q

Indications for methoxamine

A

Maintain/restore/support BP
Reverse hypotension linked to shock
Evoke bradycardia to combat tachycardia (paroxysmal SV)

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9
Q

Pharmacokinetics of Methoxamine

A

Long duration of action

More CNS penetration

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10
Q

Adverse reactions to alpha 1 adrenergic receptors

A

Hypertensive headache, anxiety
Nausea & vomiting
Pulmonary edema
Cerebral hemorrhage

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11
Q

Phenylephrine receptor selectivity

A

Alpha 1> Alpha 2 adrenergic agonist

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12
Q

Indications for phenylephrine

A

Relieve nasal congestion
Evoke Mydriasis (avoiding cycloplegia)
Evoke reflex bradycardia

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13
Q

Phenylephrine pharmacokinetics

A

Non chatecholamine
Long duration of action
More CNS penetration

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14
Q

Why is phenylephrine preferred over anti-muscarinic agents as a myadritic?

A

Lack of cycloplegic effect = less of a chance of triggering latent or worsening glaucoma

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15
Q

Clonidine receptor selectivity

A

ALPHA 2 adrenergic agonist

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16
Q

Indications of Clonidine

A

Lower blood pressure in patients with HTN

Temper withdrawal from opiates/diazepenes

Treat diarrhea in diabetics

Diminish hot flashes

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17
Q

Albuterol receptor selectivity

A

B2 adrenergic agonist

18
Q

Indications for albuterol/Salmeterol/Terbutaline

A

Acute treatment of bronchospasm (wheezing, breathing difficulties) seen in asthma/COPD

19
Q

Salmeterol receptor selectivity

A

B2 adrenergic agonist

20
Q

What is the off label use for Terbutaline?

A

Delay/reduce premature labor

21
Q

Dobutamine receptor selectivity

A

B1>B2>a1 adrenergic agonist

22
Q

Indications for Dobutamine

A

Short term inotropic support in CHF/surgical procedures

Measure cardiac response to stimulated stress/exercise

Evaluate efficacy of medications for angina

Eval risk for Coronary heart disease

Identify arrhythmias

23
Q

Isoproterenol receptor selectivity

A

Non selective B adrenergic agonist

24
Q

Indications for Isoproterenol

A

Tx of AV block or cardiac arrest

To alleviate acute attack of asthma

25
Q

Norepinephrine receptor selectivity

A

a>B adrenergic receptor agonist

26
Q

Indications for NE

A

Increase vascular resistance/BP in acute hypotensive shock BUT NE will decrease blood flow to kidney and PVR is quite high in patients with shock

27
Q

Treatment goals of shock

A

Optimize tissue perfusion
Treatment of underlying cause
Volume replacement

Controversial: Dopamine, NE

28
Q

Dopamine receptor selectivity profiles

A

Low doses: b1

High dose a1

29
Q

Epinephrine receptor selectivity

A

B=A Adrenergic

30
Q

Indications for epinephrine

A

Advanced cardiac life support
Relief of bronchospasm
Anaphylaxis
Prolong duration of local anesthetic

31
Q

What are the differences in low/high doses of epinephrine ?

A

Low: b1,2> a1(almost no change)

High: b1-b2-a1. (Increase PVR)

32
Q

Ephedrine receptor selectivity

A

B-A Adrenergic agonist, indirect Adrenergic agonist

33
Q

Indications for ephedrine

A

Relieve nasal congestion
Relief bronchospasm
Asthma, press or during spinal anesthesia, heart block etc

34
Q

Amphetamine receptor selectivity

A

Indirect acting Adrenergic agonist

35
Q

Indications for amphetamine

A

ADHD
narcolepsy
Depression
Weight loss

36
Q

Tyramine receptor selectivity

A

Indirect acting Adrenergic agonist

37
Q

Cocaine selectivity

A

MOA transporter inhibitors

38
Q

Indication for cocaine

A

Epistaxis

39
Q

MOA of cocaine

A

Block uptake of NE into Adrenergic nerve terminals

40
Q

Adverse effects for Adrenergic agonists

A

Pressor agents: hemorrhage, pulmonary edema, headache

Cardiac stimulants: angina, MI, tachycardia, myocardial damage

CNS: fear, anxiety, tension, headache, tremor, paranoia

41
Q

Substance in wine/cheese that can precipitate a hypertensive crisis when someone is taking a MAOI

A

Tyramine

42
Q

Which drug class is commonly used to treat asthma

A

B2 Adrenergic receptor agonists