Adrenergic Agents

Question 1

Direct sympathomimetics

Answer 1

Epinephrine
Norepinephrine
Dopamine

Question 2

Indirect sympathomimetics

Answer 2

Ephedrine

Cocaine

Question 3

Adrenergic Agonists

Answer 3

Phenylephrine
Isoproterenol
Clonidine
Albuterol

Question 4

Adrenergic Antagonists

Answer 4

Methyldopa
Phenoxybenzamine
Prazosin
Propranolol
Metoprolol

Question 5

Alpha 1 receptor mechanism of action

Answer 5

PLC activated –> increased IP3 –> and DAG –> increased intracellular Ca2+

Question 6

Alpha 1 receptor locations

Answer 6

vascular smooth muscle, prostate, heart, and pupillary dilator muscle (leads to pupil dilation)

Question 7

Alpha 2 receptor MOA

Answer 7

AC inhibited –> decreased cAMP

Question 8

Beta 1 receptor MOA

Answer 8

AC activated –> increased cAMP

Question 9

Beta 2 receptor MOA

Answer 9

AC activated –> increased cAMP

Question 10

D1 MOA

Answer 10

AC activated –> increased cAMP

Question 11

D2 MOA

Answer 11

AC inhibited –> decreased cAMP

Question 12

Alpha 2 receptor locations

Answer 12

Nerve terminals of adrenergic and cholinergic neurons;

Platelets

Question 13

Alpha 2 receptor action in nerve terminals of adrenergic and cholinergic neurons

Answer 13

inhibit release of neurotransmitters

Question 14

Alpha 2 receptor action in platelets

Answer 14

increase aggregation

Question 15

Beta 1 action

Answer 15

increases rate and contractility of the heart

Question 16

Beta 2 locations

Answer 16

smooth muscle of respiratory vascular and uterine tissue;

Liver

Question 17

Beta 2 actions

Answer 17

Promotes relaxation, leading to bronchodilation, vasodilation, and uterine relaxation;
increases glycogenolysis

Question 18

D1 receptor location

Answer 18

smooth muscle of splanchnic and renal vessels

Question 19

D1 receptor action

Answer 19

vasodilation of renal blood vessels

Question 20

D2 receptor location

Answer 20

Nerve terminals of CNS neurons

Question 21

D2 action

Answer 21

regulates neurotransmitter release

Question 22

Preferred substrate of alpha 1 & 2 receptors

Answer 22

Epi > NE&raquo_space; Isoproterenol

Question 23

Preferred substrate of beta 1 & 2 receptors

Answer 23

Isoproterenol > Epi > NE

Question 24

Preferred substrate of D1 & D2 receptors

Answer 24

Dopamine

Question 25

Acts as an alpha agonist when the drug is given at high doses and as a beta agonist if the drug is given at low doses

Answer 25

Epinephrine

Question 26

Epinephrine is used to treat

Answer 26

``` Cardiac arrest Severe hypotension Bronchospasm in asthma Anaphylaxis Wide-angle glaucoma as an opthalmic solution ```

Question 27

Epinephrine side effects

Answer 27

HTN, Arrhythmias, MI, pulmonary edema headache, anxiety

Question 28

When acting as an alpha 1 agonist, epinephrine causes

Answer 28

vasoconstriction, thereby leading to increased systolic and diastolic blood pressure.

Question 29

When acting as beta 1 agonist, epinephrine

Answer 29

increases heart rate and contractility --> increased CO and systolic BP.

Question 30

When acting as a beta 2 agonist, epinephrine

Answer 30

relaxes vascular and respiratory smooth muscle --> bronchodilation & mild decrease in diastolic BP

Question 31

Potent alpha 1, alpha 1, and beta 1 receptor agonist

Answer 31

Norepinephrine

Question 32

Net effect of NE administration

Answer 32

increased systolic & diastolic BP, increased contractility, no change in heart rate

Question 33

Clinical use of NE

Answer 33

Used as a pressor in the emergency treatment of severe hypotension and shock

Question 34

Side effects of NE

Answer 34

Angina; MI; arrhythmias; decrease in renal blood flow

Question 35

Increases CO without decreasing blood flow to vital organs, such as the kidneys

Answer 35

Dopamine (used as a pressor in the emergency treatment of severe hypotension and shock)

Question 36

Acts as an agonist at alpha 1 receptors at high doses and as an agonist at beta and D1 receptors at lower doses

Answer 36

Dopamine

Question 37

Dopamine effects

Answer 37

Vasoconstriction --> increased BP (alpha) Increases HR & contractility --> inc. CO (beta1) Promotes renal perfusion (D1)

Question 38

Dopamine side effects

Answer 38

Cardiac arrhythmias; angina; HTN nausea

Question 39

Beta1 receptor agonist that increases CO in decompensated CHF or cardiogenic shock

Answer 39

Dobutamine

Question 40

Dobutamine side effects

Answer 40

Tachyarrhythmias | Peripheral vasodilation

Question 41

Stimulates the release of NE and Epi from neurons, directly stimulates alpha and beta receptors --> increased BP & CO, bronchodilation, CNS stimulation (insomnia, decreased appetite, improved athletic performance)

Answer 41

Ephedrine

Question 42

Used as a nasal decongestant and in the treatment of stress incontinence in women

Answer 42

Ephedrine, pseudoephedrine

Question 43

SE of ephedrine

Answer 43

HTN, tremor, anxiety, arrhythmia

Question 44

Drug that enters the CNS and stimulates the release of NE, epi, and dopamine from neurons --> arousal state (insomnia, decreased appetite)p

Answer 44

Amphetamine

Question 45

Amphetamine overdose

Answer 45

Psychosis, arrhythmia, seizure, death

Question 46

Derivative of amphetamine that is used to treat narcolepsy and ADHD in kids

Answer 46

Methylphenidate

Question 47

Blocks the Na+/K+ ATPase that is responsible for the reuptake of NE, serotonin, and dopamine into synaptic terminals, potentiating their effects; also blocks voltage-gated Na+ channels

Answer 47

Cocaine (can also be used as a local anesthetic for ENT surgery)

Question 48

SE of cocaine

Answer 48

HTN; drug of abuse; cardiac ischemia; arrhythmias

Question 49

Inhibits the neuron's ability to store NE, dopamine, and serotonin --> depletion of these neurotransmitters throughout body --> serious psych depression + parkinsonism (previously used to treat HTN)

Answer 49

Reserpine

Question 50

Inhibits NE release from sympathetic neurons; previously used to treat HTN but has bad side effects (orthostatic hypotension --> shock)

Answer 50

Guanethidine

Question 51

Alpha1-agonist --> systemic vasoconstriction and pupil dilation. Topical application to nasal mucosa decreases mucosal secretions.

Answer 51

Phenylephrine

Question 52

Phenylephrine clinical uses

Answer 52

severe hypotension and shock, nasal congestion produce mydriasis for retinal examination

Question 53

Side effects of phenylephrine

Answer 53

cardiac arrhythmias (reflex bradycardia); headache

Question 54

Alpha 1 agonist that is used to treat hepatorenal syndrome and orthostatic hypotension due to ANS dysfunction; SE include supine HTN

Answer 54

Midodrine

Question 55

Alpha 2 agonist that acts primarily the vasomotor centers of the medulla --> reduced NE release --> decreased central adrenergic activity --> decrease in vasoconstriction, CO, and HR; does not decrease RBF

Answer 55

Clonidine

Question 56

Clinical use of clonidine

Answer 56

Hypertension, esp hypertension with comorbid renal disease

Question 57

Side effects of clonidine

Answer 57

Rebound HTN; bradycardia; sedation