Adrenergic Agents

Question 1

Non-selective adrenergic agonists

Answer 1

Phenylephrine, epinephrine, norepinephrine, pseudoephedrine, midodrine

Question 2

Phenylephrine

Answer 2

Topical nasal decongestant, vasoconstrictor
Can be used IV for hypotension
Eye drops to dilate pupils
Topical for hemorrhoids

Question 3

Non-selective alpha-1 adrenergic antagonists (Quinazoline alpha-1)

Answer 3

Prazosin, terazosin, doxazosin, afluzosin, used for BPH, can be used for high BP
Side effects of dizziness, fainting, orthostatic hypotension

Prazosin off-labed for nightmares due to PTSD

Question 4

BPH

Answer 4

Benign Prostatic Hypertrophy
Low urine flow due to enlarged prostate
Occurs in 50% of men over 50-60, 90% over 80

Question 5

Tamsulosin (Flomax)

Answer 5

Increases urinary flow rate, selective for alpha-1a (present in prostate)
Used for BPH and kidney stones

Question 6

Phenoxybenzamine

Answer 6

IRREVERSIBLE binding inhibitor, used for pheochromocytoma (tumors of adrenal medulla), causes tachycardia

Question 7

Clonidine (Catapres)

Answer 7

Alpha-2 receptors, inhibits adenyl cyclase to decrease cAMP,
Reduces HTN, manages Tourette tics, anesthesia, treatment of dependence
Buccal form for oral mucositis with chemo
Typically used as a patch
Drowsiness, sedation, dry mouth, hypotension
TAPER when D/C since major rebound hypertension occurs

Question 8

3 types of beta receptors

Answer 8

Beta 1 - cardiac and vascular smooth muscle
Beta 2 - lung, kidney
Beta 3 - Adipose tissue, skeletal muscle, gall bladder, urinary bladder

Question 9

Effects of Beta-1 Blockers

Answer 9

Lower BP
Lower HR
Inhibit renin release from kidney (less angiotensin II formed)
NOT 1st line for HTN

Question 10

Propranolol (Inderal) and other non-selective beta blockers

Answer 10

Non-selective, highly lipophilic
For HTN, arrhythmias, MI, prevention of migraines, anxiety/panic attacks, essential tremor birthmarks

Side effects: orthostatic hypotension, bradycardia, fatigue, parasthesia, hyperglycemia

Question 11

Timolol

Answer 11

Ophthalmic agent for glaucoma

Question 12

Beta-1 selective antagonists

Answer 12

Atenolol, bisoprolol, metoprolol (6th top most prescribed drug)

Question 13

Esmolol

Answer 13

IV prodrug, 9 min t1/2, short term control of ventricular rate (decrease cardiac output), antiarrhythmic

Question 14

Non-selective with ISA (slows down resting HR by 4-8 bpm)

Answer 14

Acebutolol, pindolol, penbutolol

Question 15

Carvedilol (Coreg)

Answer 15

Non-selective, acts as an antioxidant (good for MI patients), for HF or HFrEF

Question 16

Nebivolol (Bysotolic)

Answer 16

Vasodilatory properties
Beta-3 agonist to stimulate NO synthase for vasodilation

Question 17

Sotalol

Answer 17

For afib, and ventricular arrhythmias, can cause QTc prolongation