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Pharm I > Adrenergic > Flashcards

Adrenergic Flashcards

1
Q

Epinepherine

A

MOA: Adrenergic agonis; direct
Therapeutic class: Pressor, cardiac stimulant, bronchodilator, local anesthetic adjunct, anaphylaxis
Indications: anaphalyxis, adjuvant to local anesthetics, cardiac arrest
D: a1, B1, B2 stimulant; vaso/venoconstriction, tachycardia, contractility, bronchodilation, mast cell stabilization
K: IV-immediate, IM-variable, SC- 5-15min; inhaled 1-5m; ophthalmic; metabolized by COMT
T: vasoconstriction, HTN, hemorrhagic stroke, angina, arrhythmias
Interactions: excessive hypertension w/ propranolol
Considerations: BP, HR, rhythm, infusion site for extravisation

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2
Q

Norepinepherine

A

MOA: direct adrenergic agonist
Therapeutic class: pressor, vasoconstrictor
Indications: acute hypotension and shock
P’dynamics: a1 & B1 adrenergic receptors –> vasoconstriction, venoconstriction, ^ HR;
P’kinetics: Half life =1-2min
Tox: excesive vasoconstriction –> infarct ischemia
Interactions: MAOI; HTN w/propranalol
Considerations: BP, HR, infusion site for extravisation

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3
Q

Dopamine

A

MOA: DA[low], Beta 1[med] & alpha 1[high] agonist
Therapeutic Class: Pressor
Indications: CHF, Shock, renal/mesenteric underperfusion
Considerations: IV for short duration

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4
Q

Isoproterenol

A 
MOA: Beta 1&2 agonist
Therapeutic Class: Pressor, 
P'dynamics: increase contractility, HR, card conduction, also vasodilation (Beta 2)
Tox: tachyarrhythmias
Considerations: IV
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5
Q

Phenylepherine

A

MOA: alpha 1 agonist» alpha2; vaso/venoconstriction of vascular SM
Indications: nasal decongestant; mydriatic; IV pressor
P’dynamics: vasoconstricts turbinates
considerations: less potent vasoconstrictor than NE; not COMT; withdrawal increases nasal congestion

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6
Q

Clonidine

A

MOA: alpha 2 agonist action on CNS; down regulates SNS
Indications: HTN, migraine
Tox: sedation & dry mouth; OD or IV –> HTN
Interactions:
considerations: Oral/Patch

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7
Q

dobutamine

A

MOA: Beta 1 agonist; almost no alpha effect
Indications: cariogenic shock; contractility > HR increase
P’dynamics: ^ contractility>HR; dilates renal/mesenteric BVs
Tox: tachycardia, HTN, ectopy
considerations: IV infusion

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8
Q

albuterol

A

MOA: Beta-2 agonist&raquo_space;beta-1
Indications: prompt acting rescue inhaler; COPD, asthma; inhibits premature labor
P’dynamics: relaxes SM in bronchioles
Tox: anxiety, tachycardia, tremor

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9
Q

ephederine

A

MOA: Indirect adrenergic; stimulates NE+DA release; some direct agonism
Indications: decongestant, surgical HTN
P’dynamics: potent CNS stimulant
Tox: HTN, insomnia
considerations: plant alkaloid; prolonged duration,

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10
Q

pseudoephederine

A

MOA: Indirect adrenergic; stimulates NE+DA release; some direct alpha/beta agonism
Indications: decongestant, bronchiole dilation

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11
Q

amphetamine

A

MOA: Indirect adrenergic, stimulates NE, DA, 5-HT release
Indications: Obesity, ADHD, narcolepsy
Tox: hyperactivity, tachycardia, insomnia, restlessness, tremor
considerations: synthetic similar to ephedrine

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12
Q

tyramine

A

MOA: Indirect adrenergic, stimulates NE, DA release
Indications: Obesity, narcolepsy, ADHD
P’kinetics: MAO metabolism
Interactions: MAOI (phenylzine) –> hypertensive crisis + headache; food drug interaction
considerations: naturally occurring byproduct of tyramine metabolism; present aged/fermented foods

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13
Q

cocaine

A

MOA: Indirect adrenergic agonist; NE/DA/Epi reuptake blocker; stimulates NE/Epi/DA release from neurons; local anesthetic (Na channel blocker); CNS stimulant
Indications: ENT surgery, drug of abuse
P’dynamics: CNS stimulation more intense/shorter than amphetamine
Tox: tachycardia, hypertension, angina, myocardial ischemia/infarct, anxiety
considerations: purified natural alkaloid

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14
Q

phentolamine / regitine

A

MOA: non-selective, competitive Alpha-antagonist
Indications: antihypertensive for pheochromocytoma; Dx of pheochromocytoma; NorEpi extravasation
P’dynamics: blocks a1, a2 pre/post synaptic receptors; decreases pre/afterload
P’kinetics: IV only, half-life 20mins
Tox: hypotension w/ syncope; orthostatic hypotension; decreased libido
Interactions: additive w/ antihypertensives; hypotension w/ diuretics.
considerations:

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15
Q

phenoxybenzamine

A

MOA: Irreversible Alpha-Antagonist
Indications: peripheral vasospasm

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16
Q

prazosin

A

MOA: Alpha-1 Antagonist;
Indications: HTN, BPH
P’dynamics: inhibits NE mediated vaso/venoconstriction
P’kinetics: PO + transdermal F~60%; hepatic metabolism; onset 2h; duration 12-24h
Tox: orthostatic hypotension, esp w/ diuretics; syncope
Interactions: additive w/ most antihypertensives; esp diuretics
considerations: BP, weight edema; start gradually at bed time; R/O carcinoma for males w/ BPH

17
Q

tamulosin

A

MOA: Alpha-1 Antagonist; preferential to prostate
Indications: BPH; ureter spasm w/ kidney stones
P’dynamics: blocks alpha1 receptors in prostate; relaxes SM in prostate and bladder neck
P’kinetics: PO F~>90%; CYP450 metabolism, half-life 6h; duration 16h
Tox: hypotension w/ syncope; allergy; reduced libido
Interactions: additive w/ most antihypertensives
considerations: R/O carcinoma B4 use; Øcrush/chew

18
Q

propranalol

A

MOA: non-specific Beta Antagonist
Indications: HTN; arrhythmias, 1* + 2* MI prevention, angina
P’dynamics: direct binding of beta receptors; reduce CO and RAAS activation
P’kinetics: PO + IV; Hepatic clearance; variable F;
Tox: hypotension, bradycardia, heart block, worsen CHF, bronchospasm
Interactions: additive w. antihypertensives; AV block additive w/ CEBs
considerations: useful in HTN w/ exertional angina/MI/Afib; abrupt withdrawl; HTN w/ NE

19
Q

timolol

A

MOA: Beta antagonist
Indications: Open angle glaucoma, hypertension, MI prevention
P’dynamics:non selective beta blockade
P’kinetics: PO&IV; Hepatic clearance
Tox: hypotension, bradycardia, heart block, worsen CHF, bronchospasm
considerations: useful in HTN w/ exertional angina/MI/Afib; abrupt withdrawl

20
Q

pindolol

A

MOA: Beta antagonist
Indications: Hypertension, angina, arrhythmia
P’dynamics:non selective beta blockade
P’kinetics: PO&IV; Hepatic clearance
Tox: hypotension, bradycardia, heart block, worsen CHF, bronchospasm
Interactions:
considerations: useful in HTN w/ exertional angina/MI/Afib; abrupt withdrawl

21
Q

atenolol

A

MOA: preferential Beta-1 Antagonist
Indications: hypertension, s/p MI, arrhythmias, 1, 2 prevention of MI, Angina
P’dynamics: Beta 1 blockade; RAAS blockade
P’kinetics: PO&IV; F variable, Renal excretion; duration 12-24h
Tox: caution w/ abrupt withdrawal; heart block, worse CHF, bronchospasm
Interactions: additive w/ antihypertensives; additive AV block w/ CEBs
considerations: useful in HTN w/ exertional angina/MI/Afib; abrupt withdrawl

22
Q

metroprolol

A

MOA: preferential Beta-1 Antagonist
Indications: hypertension, s/p MI, arrhythmias, 1, 2 prevention of MI, Angina
P’dynamics: Beta 1 blockade; RAAS blockade
P’kinetics: PO&IV; F variable, Renal excretion; duration 12-24h
Tox: caution w/ abrupt withdrawal
Interactions: additive w/ antihypertensives; additive AV block w/ CEBs
considerations: useful in HTN w/ exertional angina/MI/Afib; abrupt withdrawl

23
Q

labetalol

A

MOA: mixed alpha/Beta antagonist
Indications: HTN; stable CHF; HTN crisis
P’dynamics: blocks NE access to alpha-1 and Beta receptors–> multiple modes of action
P’kinetics: excellent absorption; high first pass effect F~25%; Hepatic metabolism 2D6
Tox: avoid w/ bradycardia, heart block, CHF, asthma, shock; caution w/ cardiomyopathy, pheochromocytoma; Pregnancy-D
Interactions: additive w/ most anti-HTN
considerations: reduce dose w/ liver impairment;

24
Q

carvedilol

A

MOA: mixed alpha/Beta antagonist
Indications: HTN; stable CHF; HTN crisis
P’dynamics: blocks NE access to alpha-1 and Beta receptors
P’kinetics: excellent absorption high first pass effect F~25%; Hepatic metabolism 2D6
Tox: avoid w/ bradycardia, heart block, CHF, asthma, shock; caution w/ cardiomyopathy, pheochromocytoma; Pregnancy-D
Interactions: additive w/ most anti-HTN
considerations: reduce dose w/ liver impairment;

Pharm I (8 decks)

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