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Pharmacology > Adrenergic Agents > Flashcards

Adrenergic Agents Flashcards

1
Q

Epinephrine (mechanism)

A

Stimulates a1, a2, b1, b2 (b > a)

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2
Q

Norepinephrine (mechanism)

A

Stimulates a1 > a2 > b1

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3
Q

Epinephrine (4 uses)

A

Anaphylaxis
Open angle glaucoma
Asthma
For severe hypotension

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4
Q

Norepinephrine (use)

A

For severe hypotension (but decreases renal perfusion)

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5
Q

Isoproterenol (mechanism)

A

Nonselective b-agonist

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6
Q

Isoproterenol (use)

A

For evaluation of tachyarrhythmias (specifically in hemodynamically stable TdP to increase sinus rate and shorten QT interval)

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7
Q

Isoproterenol (side effects)

A

Can precipitate tachyarrhythmias and worsen ischemia (increases risk of MI)

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8
Q

Dopamine (mechanism)

A

Stimulates D1 = D2 > b > a

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9
Q

Dopamine (3 uses concerning heart)

A

Unstable bradycardia
CHF
Cardiogenic shock

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10
Q

Dopamine (side effect)

A

Arrhythmias

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11
Q

Dobutamine (mechanism)

A

b1 agonist -> increases HR, contractility, conduction velocity, myocardial O2 consumption
Also decreases peripheral vascular resistance by having a little bit of b2 effect too

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12
Q

Dobutamine (2 uses)

A

CHF (inotropic > chronotropic)

Cardiac stress testing

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13
Q

Dobutamine (side effect)

A

Arrhythmias (b/c it increases cardiac conduction velocity)

Angina (b/c it increases myocardial O2 consumption by increasing HR and having positive inotropic effect)

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14
Q

Phenylephrine (mechanism)

A

Stimulates a1 > a2

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15
Q

Phenylephrine (4 uses)

A

Hypotension (vasopressor)
Mydriatic
Reduces secretion (so decongestant for rhinitis, hyperemia, edema)
Open obstructed eustachian tubes

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16
Q

Albuterol (mechanism)

A

Stimulates b2 > b1

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17
Q

Albuterol (use)

A

Acute asthma

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18
Q

“-terol” (mechanism)

A

Salmeterol and formoterol

Stimulates b2 > b1

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19
Q

“-terol” (2 uses)

A

Salmeterol and formoterol
Long-term asthma
Long-term COPD control

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20
Q

Terbutaline (mechanism)

A

Stimulates b2 > b1

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21
Q

Terbutaline (use)

A

Reduces premature uterine contractions

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22
Q

Amphetamine (mechanism)

A

Increases NE by being agonist, reuptake inhibitor, and causing release of stored NE

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23
Q

Amphetamine (3 uses)

A

ADHD
Obesity
Narcolepsy

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24
Q

Ephedrine (mechanism)

A

Increases NE by being agonist and causing release of stored NE

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25
Q

Ephedrine (3 uses)

A

Nasal decongestion
Urinary incontinence
Hypotension

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26
Q

Cocaine (mechanism)

A

Reuptake inhibitor of catecholamines & general agonist

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27
Q

Cocaine (never use with)

A

b-blockers if cocaine intoxication is suspected -> unopposed a1 activation -> extreme HTN

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28
Q

Cocaine (use)

A

Local anesthetic

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29
Q

Difference between effects of NE and isoproterenol on HR

A

NE has a effects whereas isoproterol doesn’t

So NE causes reflex bradycardia (a1-mediated), isoproterenol causes increased HR (b1-mediated)

30
Q

Difference between effects of NE and isoproterenol on BP

A

NE has a effects whereas isoproterol doesn’t

So NE causes increase in BP (a1-mediated), isoproterenol causes decrease in BP (b2-mediated)

31
Q

Clonidine (mechanism)

A

a2-agonist (sympatholytic)

32
Q

Clonidine (3 uses)

A

HTN urgency (doesn’t decrease renal BF)
ADHD
Severe pain
Off-label for ethanol/opioid withdrawal

33
Q

Clonidine (side effects)

A

Rebound HTN if stopped immediately
CNS & resp depression
Pro sympa stuff (bradycardia, hypotension, small pupil)

34
Q

Methyldopa (mechanism)

A

a2-agonist (analog of L-dopa that gets converted in brain to methyl-NE)

35
Q

Methyldopa (use)

A

HTN in pregnancy (safe to use in pregnancy)

36
Q

Methyldopa (side effects)

A

Hemolytic anemia (direct Coombs +)
SLE-like syndrome
Hepatotoxicity

37
Q

Phenoxybenzamine (mechanism)

A

Nonselective a-blocker (irreversible) -> dose-response curve shifted right and down (rather than just shifted right like the other REVERSIBLE a blocker) -> can look like noncompetitive binding

38
Q

Phenoxybenzamine (use)

A

Pre-op pheochromocytoma resection (prevents catecholamines crisis)

39
Q

Phenoxybenzamine (side effects)

A

Orthostatic hypotension, reflex tachycardia

40
Q

Phentolamine (mechanism)

A

Nonselective competitive a-blocker (reversible)

41
Q

Phentolamine (3 uses)

A 
MAOI crisis (pts on MAOi who eat tyramine-containing foods)
Cocaine overdose
Pheochromocytoma
42
Q

Phentolamine (side effects)

A

Orthostatic hypotension, reflex tachycardia

43
Q

Prazosin and other “-osin” (mechanism)

A

a1-blocker

44
Q

Prazosin and other “-osin” (use)

A

Urinary sx of BPH (esp tamsulosin)
Prozosin also used for PTSD
All used for HTN except tamsulosin

45
Q

Prazosin and other “-osin” (side effects)

A

1st-dose orthostatic hypotension

dizziness, headache

46
Q

Mirtazapine (mechanism)

A

Atypical antidepressant
a2-blocker -> increases release of NE and 5-HT
Potent 5-HT2 and 5-HT3 ANTAgonist

47
Q

Mirtazapine (use)

A

Depression

48
Q

Mirtazapine (side effects)

A

Sedation (desirable in depressed pts w/ insomnia tho),
Increases appetite and weight gain, increases serum cholesterol
Dry mouth

49
Q

Yohimbine (mechanism)

A

a2-blocker

50
Q

Yohimbine (historic use)

A

erectile dysfx (replaced by PDE inhibitors now)

51
Q

B1-blockers

A

A-M (first half of alphabet, ending in “-olol”)

acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol

52
Q

Nonselective b-blockers

A

N-Z (second half of alphabet, ending in “-olol”)
nadolol, pindolol (partial agonist), propanolol, timolol
More side effects from b2 blockade (bronchoconstriction in lungs)

53
Q

Nonselective a & b blockers

A

Things with modified suffix
carvedilol, lavetalol
Also get decreased SVR from a blockade

54
Q

Nebivolol (mechanism)

A 
Blocks b1 (cardiac)
Stimulates b3 (activates NO synthase in vasculature)
55
Q

Timolol (use)

A

Glaucoma (reduces aq humor secretion)

56
Q

Metoprolol (use)

A

SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval)

57
Q

Esmolol (use)

A 
SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval)
Acute HTN emergency (ultra short acting)
58
Q

B blockers (antidote)

59
Q

B blockers (side effect)

A

Blunted response to hypoglycemia (dangerous in diabetics bc mask sx of hypoglycemia) -> selective B1 blockers preferable in DM over nonselective
Don’t use in suspected cocaine users (unopposed a-adrenergic activity)
Hyperkalemia w/ nonselective b blockers (interferes w/ B2 mediated intracellular K+ uptake)

60
Q

Partial B agonists

A

Pindolol

Acebutolol

61
Q

Partial B agonists (contraindication)

62
Q

Metoprolol (side effect)

A

Dyslipidemia

63
Q

Propanolol (side effect)

A

Exacerbate vasospasm in Prinzmetal angina

64
Q

Pseudoephedrine (mechanism)

65
Q

Pseudoephedrine (3 uses)

A 
Reduces secretions (hyperemia, edema, nasal congestion)
Open obstructed eustachian tubes
Illicitly used to make methamphetamine
66
Q

Pseudoephedrine (2 side effects)

A

HTN

CNS stimulation/anxiety

67
Q

Carteolol (mechanism and use)

A 
B blocker -> decreases aq humor synthesis
For glaucoma (no pupillary/vision changes)
68
Q

Brimonidine (mechanism)

A

a2 agonist -> decreases aq humor synthesis

69
Q

Brimonidine (use)

70
Q

Brimonidine (side effects)

A

Eyes stuff: blurry vision, hyperemia, foreign body sensation/pruritus, allergic rxn

71
Q

Betaxolol (mechanism and use)

A 
B blocker -> decreases aq humor synthesis
For glaucoma (no pupillary/vision changes)
72
Q

Propanolol (3 uses)

A

Essential/familial tremors
Migraine prophylaxis
Reduction of portal venous pressure (to prevent variceal bleed)
Other more obvious things

Pharmacology (12 decks)

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