Adrenergic Flashcards
Norepinephrine (Levophed)
Class: Non-selective agonist
Mechanism: Agonist: α1, α2, β1
Therapeutics: Hypotension
Side Effects: Hypertension; arrythmias; headache
Epinephrine
Class: Non-selective agonist
Mechanism: Agonist: α1, (α2), β1, β2
Therapeutics: Anaphylactic shock; combined with local anesthetics; glaucoma
Side Effects: Palpitation; arrhythmias; headache; tremor
Amphetamine
Class: Indirect acting
Mechanism: Increases release of NE
Therapeutics: ADHD, narcolepsy, recreation
Side Effects: Hypertension, insomnia, anxiety, arrhythmias
Isoproterenol (Isuprel)
Class: Non-selective β agonist
Mechanism: Agonist: β1, β2
Therapeutics: Bronchodilator/asthma; shock; heart block
Side Effects: Palpitation; tachyarrhythmia; headache
Dobutamine
Class: β1-selective β agonist
Mechanism: Agonist: β1
Therapeutics: Cardiac decompensation; shock; heart block
Side Effects: Tachyarrythmias; hypertension
Albuterol (Proventil)
Class: β2-selective β agonist
Mechanism: Brochodilation
Therapeutics: Prevent or reverse exercise-induced bronchospasm; mild asthma; COPD
Side Effects: Can mask progressively severe inflammation
Terbutaline (Brethine)
Class: β2-selective β agonist
Mechanism: Brochodilation
Therapeutics: Prevent or reverse exercise-induced bronchospasm; mild asthma; COPD; early labor
Side Effects: Can mask progressively severe inflammation
Phenylephrine (Neo-Synephrine)
Class: α1-selective α agonist
Mechanism: Vasoconstriction
Therapeutics: Nasal congestion; postural Hypotension
Side Effects: Hypertension; reflex bradycardia
Clonidine (Catapres)
Class: α2-selective α agonist
Mechanism: Decrease sympathetic outflow from CNS
Therapeutics: Hypertension; shock; withdrawal from drug dependence
Side Effects: Sedation
α-methyldopa (Aldomet)
Class: α2-selective α agonist
Mechanism: Decreases synthesis of NE (by going through entire pathway instead of dopa); end-product (a-methylnorepinephrine) activates a2 inhibitors
Therapeutics: Hypertension, shock, withdrawal from drug dependence
Side Effects: Sedation
Fenoldopam (Corlopam)
Class: Selective dopamine agonist
Mechanism: Vasodilation
Therapeutics: Increase blood flow at renal, mesenteric, and cerebral arteries
Dopamine
Class: Mixed acting (direct/indirect)
Mechanism: Agonist: D1, α1, β1
Therapeutics: Shock, renal failure, hypotension
Side Effects: Vasoconstriction (@ high doses)
Phentolamine (Regitine)
Class: Non-selective α-antagonist
Mechanism: Antagonist: α1, α2
Therapeutics: Pheochromocytoma, Raynaud’s, frostbite
Side Effects: Postural hypotension; inhibit ejaculation
Phenoxybenzamine (Dibenzyline)
Class: Non-selective α-antagonist
Mechanism: Antagonist: α1, α2; non-competitive blocker (covalent bond to receptor)
Therapeutics: Pheochromocytoma, Raynaud’s, frostbite
Side Effects: Postural hypotension; inhibit ejaculation
Prazosin (Minipress)
Class: α1-selective antagonist
Mechanism: Vasodilation
Therapeutics: Primary HTN, BPH
Side Effects: Postural hypotension (usually 1st dose)
Terazosin (Hytrin)
Class: α1-selective antagonist
Mechanism: Vasodilation
Therapeutics: Primary HTN, BPH
Side Effects: Postural hypotension (usually 1st dose)
Propranolol (Inderal)
Class: Non-selective β-antagonist (1st generation)
Mechanism: Antagonist: β1, β2
Therapeutics: Angina, Hypertension, Arrythmias
Side Effects: Bradycardia, Bronchoconstriction, Sexual Dysfunction
Timolol (Betimol)
Class: Non-selective β-antagonist (1st generation)
Mechanism: Antagonist: β1, β2
Therapeutics: Angina, Hypertension, Arrythmias, Glaucoma
Side Effects: Bradycardia, Bronchoconstriction, Sexual Dysfunction
Metoprolol (Lopressor)
Class: β1-selective antagonist (2nd generation)
Mechanism: Decrease heart rate, contractility, CO
Therapeutics: HTN, Angina, Arrythmias, CHF
Side Effects: Bradycardia, Sexual Dysfunction
Atenolol (Tenormin)
Class: β1-selective antagonist (2nd generation)
Mechanism: Decrease heart rate, contractility, CO
Therapeutics: HTN, Angina, Arrythmias, CHF
Side Effects: Bradycardia, Sexual Dysfunction
Bisoprolol (Zebeta)
Class: β1-selective antagonist (2nd generation)
Mechanism: Decrease heart rate, contractility, CO
Therapeutics: HTN, Angina, Arrythmias, CHF
Side Effects: Bradycardia, Sexual Dysfunction
Carvedilol (Coreg)
Class: Non-selective β-antagonist (3rd generation “A”)
Mechanism: Antagonist: β1, β2
Therapeutics: CHF, HTN
Side Effects: Bradycardia, Fatigue
Labetalol (Trandate)
Class: Non-selective β-antagonist (3rd generation “A”)
Mechanism: Antagonist: β1, β2
Therapeutics: CHF, HTN
Side Effects: Bradycardia, Fatigue
Betaxolol (Kerlone)
Class: β1-selective antagonist (3rd generation “B”)
Mechanism: Decrease heart rate, CO
Therapeutics: CHF, HTN
Side Effects: Bradycardia
Tyramine
Class: Indirect acting
Mechanism: Increases cytoplasmic NE release
Misc: Tyramine is involved with an exchange transporter: tyramine goes in, NE comes out
Guanethidine (Ismelin)
Mechanism: False neurotransmitter (vesicles become full of guanethidine rather than NE)
Therapeutics: Antihypertensive
Side Effects: Many and serious
Reserpine
Mechanism: Release of empty vesicles (NE is not taken into vesicles b/c it binds uptake transporter and stops it)
Therapeutics: Older antihypertensive
Side Effects: Many and serious (depression and suicide are major ones)
α-me-tyrosine (Metirosine)
Mechanism: Inhibit tyrosine hydroxylase (decreases NE synthesis)
Therapeutics: Pheochromocytoma
Side Effects: Many and serious
Ephedrine (Pretz-D)
Therapeutics: Nasal decongestion, anorexic
