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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
Ephedrine (3 uses)
Nasal decongestion Urinary incontinence Hypotension
26
Cocaine (mechanism)
Reuptake inhibitor of catecholamines & general agonist
27
Cocaine (never use with)
b-blockers if cocaine intoxication is suspected -> unopposed a1 activation -> extreme HTN
28
Cocaine (use)
Local anesthetic
29
Difference between effects of NE and isoproterenol on HR
NE has a effects whereas isoproterol doesn't | So NE causes reflex bradycardia (a1-mediated), isoproterenol causes increased HR (b1-mediated)
30
Difference between effects of NE and isoproterenol on BP
NE has a effects whereas isoproterol doesn't | So NE causes increase in BP (a1-mediated), isoproterenol causes decrease in BP (b2-mediated)
31
Clonidine (mechanism)
a2-agonist (sympatholytic)
32
Clonidine (3 uses)
HTN urgency (doesn't decrease renal BF) ADHD Severe pain Off-label for ethanol/opioid withdrawal
33
Clonidine (side effects)
Rebound HTN if stopped immediately CNS & resp depression Pro sympa stuff (bradycardia, hypotension, small pupil)
34
Methyldopa (mechanism)
a2-agonist (analog of L-dopa that gets converted in brain to methyl-NE)
35
Methyldopa (use)
HTN in pregnancy (safe to use in pregnancy)
36
Methyldopa (side effects)
Hemolytic anemia (direct Coombs +) SLE-like syndrome Hepatotoxicity
37
Phenoxybenzamine (mechanism)
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
Phenoxybenzamine (use)
Pre-op pheochromocytoma resection (prevents catecholamines crisis)
39
Phenoxybenzamine (side effects)
Orthostatic hypotension, reflex tachycardia
40
Phentolamine (mechanism)
Nonselective competitive a-blocker (reversible)
41
Phentolamine (3 uses)
``` MAOI crisis (pts on MAOi who eat tyramine-containing foods) Cocaine overdose Pheochromocytoma ```
42
Phentolamine (side effects)
Orthostatic hypotension, reflex tachycardia
43
Prazosin and other "-osin" (mechanism)
a1-blocker
44
Prazosin and other "-osin" (use)
Urinary sx of BPH (esp tamsulosin) Prozosin also used for PTSD All used for HTN except tamsulosin
45
Prazosin and other "-osin" (side effects)
1st-dose orthostatic hypotension | dizziness, headache
46
Mirtazapine (mechanism)
Atypical antidepressant a2-blocker -> increases release of NE and 5-HT Potent 5-HT2 and 5-HT3 ANTAgonist
47
Mirtazapine (use)
Depression
48
Mirtazapine (side effects)
Sedation (desirable in depressed pts w/ insomnia tho), Increases appetite and weight gain, increases serum cholesterol Dry mouth
49
Yohimbine (mechanism)
a2-blocker
50
Yohimbine (historic use)
erectile dysfx (replaced by PDE inhibitors now)
51
B1-blockers
A-M (first half of alphabet, ending in "-olol") | acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol
52
Nonselective b-blockers
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
Nonselective a & b blockers
Things with modified suffix carvedilol, lavetalol Also get decreased SVR from a blockade
54
Nebivolol (mechanism)
``` Blocks b1 (cardiac) Stimulates b3 (activates NO synthase in vasculature) ```
55
Timolol (use)
Glaucoma (reduces aq humor secretion)
56
Metoprolol (use)
SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval)
57
Esmolol (use)
``` SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval) Acute HTN emergency (ultra short acting) ```
58
B blockers (antidote)
Glucagon
59
B blockers (side effect)
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
Partial B agonists
Pindolol | Acebutolol
61
Partial B agonists (contraindication)
Angina
62
Metoprolol (side effect)
Dyslipidemia
63
Propanolol (side effect)
Exacerbate vasospasm in Prinzmetal angina
64
Pseudoephedrine (mechanism)
a agonist
65
Pseudoephedrine (3 uses)
``` Reduces secretions (hyperemia, edema, nasal congestion) Open obstructed eustachian tubes Illicitly used to make methamphetamine ```
66
Pseudoephedrine (2 side effects)
HTN | CNS stimulation/anxiety
67
Carteolol (mechanism and use)
``` B blocker -> decreases aq humor synthesis For glaucoma (no pupillary/vision changes) ```
68
Brimonidine (mechanism)
a2 agonist -> decreases aq humor synthesis
69
Brimonidine (use)
Glaucoma
70
Brimonidine (side effects)
Eyes stuff: blurry vision, hyperemia, foreign body sensation/pruritus, allergic rxn
71
Betaxolol (mechanism and use)
``` B blocker -> decreases aq humor synthesis For glaucoma (no pupillary/vision changes) ```
72
Propanolol (3 uses)
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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