Adrenergic Agonist - Drug

Question 1

What are the Adrenergic receptors

Answer 1

Alpha (A1, A2)

Beta (B1, B2, B3)

Question 2

Location of A1 receptors

Answer 2

Vascular smooth muscle
UB sphincter 
Intestinal Smooth muscle 
Liver : glycogenolysis and cholesterol synthesis 
Radial iris muscle
Prostate smooth muscle

Question 3

Location of A2

Answer 3

Presynaptic Adrenergic nerve terminal 
Lipocytes
Platelets - increase in platelet agreegation
Beta cells of pancreas 
Vascular smooth muscle

Decrease in aqueous humor production

Question 4

Location of B1

Answer 4

Heart
Juxtagromerular cells

Increase in Lipolysis

Question 5

Location of B2

Answer 5

GIT
Bronchial smooth muscle
Uterus smooth muscle 
Pancreatic beta cells 
Liver 
Skeletal muscle

Increase in aqueous humor production
Increase in potassium uptake

Question 6

B3?

Answer 6

Lipolysis in adipose tissue
Bladder mid area of detruso muscle

Skeletal muscle: thermogenesis

Question 7

Order of potency if Adrenergic receptors and their agonist for Beta receptors

Answer 7

Isoproterenol > Epinephrine > NE

Question 8

Order of potency of Adrenergic receptors and their agonist for Alpha receptors

Answer 8

Epinephrine > NE > Isoproterenol

Question 9

Dopamine receptors

Answer 9

D1, B1 (alpha1 at high doses), D2

D1: relaxes renal smooth muscle

Question 10

Dobutamine receptors

Answer 10

D1, B1 alpha1

Mainly beta 1 receptor

Question 11

Epinephrine receptors

Answer 11

A1, A2, B1, B2

Question 12

NE receptors

Answer 12

A1, A2, B1

Question 13

Isoproterenol receptors

Answer 13

B1, B2

Question 14

How are adrenergic agonist classified

Answer 14

Direct ( cathecolamines and selective Agonists)

Indirect and mixed

Question 15

What are the directly acting cathecolamines

Answer 15

NE
E
Dopamine
Dobutamine
Isoproterenol

Question 16

What are the selective agonists

Answer 16

Alpha1, alpha2 and beta2 agonists

Question 17

Use of epinephrine

Answer 17

• Anaphylactic shock DOC
• Asthma
• open angle glaucoma: constriction of ciliary body blood vessels
• Increase duration of local Anesthesia

Question 18

S/e of epinephrine

Answer 18

Arrhythmia
Pulmonary edema
Hemorrhage
CNS disturbance

Question 19

Use of NE

Answer 19

Septic Shock
Hypotension
Never for asthma
Causes reflex bradycardia

Question 20

Use of Isoproterenol

Answer 20

Emergency tx of heart block and severe bradycardia
Bronchial asthma
Electrophysiologic evaluation of tachyarrhythmia

Question 21

S/e of Isoproterenol

Answer 21

Tachycardia
Arrhythmia
Palpitations
Coronary insufficiency due to no alpha effect

Question 22

Drug of choice for cardiogenic and hypovolumic shock

Answer 22

Dopamine

Question 23

Use of Dobutamine

Answer 23

Diagnostic cardiac Stress test
Short term management of heart failure with cardiogenic shock

It has a short half life so should be given with normal saline/glucose

Question 24

Examples of alpha 1 agonists

Answer 24

Phenylephrine
Methoxamine

And other zolines

Question 25

Main use of alpha 1 agonist

Answer 25

NASAL congestion

The zolines are mostly used as topical nasal decongestant

Question 26

Examples of alpha 2 agonists

Answer 26

Methyldopa
Clonidine
Tizanidine
Guanfacine

Question 27

Methyldopa?

Answer 27

Treat HTN in pregnant woman and in renal dysfunction pts

S/E -hemolytic anemia

• hepatitis
• drug induced lupus
• hyperprolactinemia

Question 28

Clonidine?

Answer 28

Uses

• Essential HTN (HTN urgency)
• ADHD
• Tourette syndrome
• withdrawal symptoms from opiates and benzodiazepines

Question 29

Examples of beta 2 selective agonist

Answer 29

Albuterol: fast acting asthma/Copd 
Sulbutamol
Salmeterol: long duration asthma/Copd 
Formoterol: 
Metaproterenol
Terbutaline + ritudrine : uterine relaxation and bronchospasm in asthma

Question 30

Use of B2 selective agonist

Answer 30

Asthma

Question 31

Examples of in direct acting adrenergic agonists

Answer 31

Amphetamime

Tyramine

Question 32

Doc for ADHD

Answer 32

Amphethamine - methylphenidate

Question 33

Use of in direct acting adrenergic agonists

Answer 33

ADHD
Narcrolepcy
Obesity
Depression

Question 34

Use and example of mixed acting drugs

Answer 34

Ephedrine or pseudoephedrine

Used as a nasal decongestant and causes bronchodilation
Urinary incontinence
Hypotension

Question 35

Cocaine

Answer 35

An indirect sympathomimetics

Used to confirm Horner syndrome as it causes mydriasis in intact SNS

Cocaine intoxication + beta blocker =coronary vasospasm

Question 36

Dopamine application

Answer 36

For unstable bradycardia and shock

Increase hr and bp (at high dose)

Question 37

Fendolpam ?

Use and s/e

Answer 37

Adrenergic agonist

Use: hypertensive crises, vasodilator, post-op HTN,

S/e - natriuresis, hypotension, tachycardia, headache, flushing

Question 38

Fenoldopam receptors

Answer 38

D1

Increase HR and CO
Decrease BP via vasodilation

Question 39

Use of Phenylephrine

Answer 39

Nasal decongestant
Mydriasis: ocular procedures
Ischemic priapism
Vasoconstrictor: hypotension

Question 40

Tizanidine

Answer 40

A selective A2 agonist

Use- relief of spasticity
S/e- hypotension, weakness , Xerostomia

Question 41

Midodrine

Answer 41

A direct sympathomimetic that acts on A1 receptor

Question 42

Midodrine use and s/e

Answer 42

Use- autonomic insufficiency
Postural hypotension

S/e - exacerbate supine hypertension

Question 43

Amphetamine use

Answer 43

ADHD
Obesity
Narcolepsy

Question 44

S/e of Clonidine

Answer 44

CNS Depression 
Bradycardia 
Hypotension 
Respiratory depression 
Miosis
Rebound HTN with abrupt cessation