Adrenergic Agonists Flashcards

1
Q

Epinephrine at low doses activates what receptors?

A

B1 and B2. Causes increased HR ad CO, vasodilation. Increased systolic BP and decreased diastolic BP. Bronchodilation.

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2
Q

Epinephrine at high doses activates what receptors?

A

A1, A2, B1, B2. Net effect increase HR and CO, increase systolic and diastolic BP. Increase MAP and TPR from A1/A2 activation of vasoconstriction.

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3
Q

Epinephrine toxicity?

A

Arrhythmias, cerebral hemorrhage, pulmonary edema, anxiety

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4
Q

Norepinephrine physiological effects

A

Activates A1, A2, B1. Increase in CO due to increased contractility (B1). Increase in MAP (systolic and diastolic) due to A1 activation. Decrease in HR as a baroreceptor reflex response.

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5
Q

Norepinephrine toxicity

A

Ischemia

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6
Q

Norepinephrine indications?

A

Shock

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7
Q

Epinephrine indications?

A

Bronchospasm, anaphylaxis, cardiac arrest

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8
Q

Dopamine physiological effects at low doses?

A

Activate D1 and B1 receptors. Vasodilation in renal and splanchnic circulations (decrease in TPR due to D1 activation). Increase in HR and CO due to B1 activation.

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9
Q

Dopamine physiological effects at high doses?

A

Activates A1, A2, B1 receptors. Overall increase in MAP, TPR, and CO.

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10
Q

Dopamine toxicity at low and high doses?

A

Low dose toxicity: hypotension.

High dose toxicity: ischemia

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11
Q

Dopamine indications?

A

Cardiogenic shock

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12
Q

Isopreterenol physiological effects?

A

Nonselective Beta agonist. Activate B1 receptors to increase HR, CO, systolic BP. Activate B2 to cause vasodilation, decrease in TPR. Bronchodilation caused by B2 activation.

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13
Q

Isoproterenol Toxicity

A

Tachyarrhythmias

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14
Q

Isoproterenol Indications

A

Bradycardia or heart block when TPR is already too high

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15
Q

Isoproterenol Contraindications

A

Angina with arrhythmias

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16
Q

Dobutamine physiological effects

A

Selective B1 agonist. Increase HR and increase CO.

17
Q

Dobutamine indications

A

Short term Rx for cardiogenic shock or CHF

18
Q

Dobutamine toxicity

A

Hypotension (excess Dobutamine will begin to activate B2 receptors. Arrhythmias.

19
Q

Terbutaline and Albuterol Physiological effects

A

Selective B2 agonists. Bronchodilation and uterine relaxation.

20
Q

Terbutaline and Albuterol Indications

A

Bronchospasm and COPD

21
Q

Terbutaline and Albuterol Toxicity

A

Muscle tremor
Tachycardia (B1)
Tolerance

22
Q

Phenylephrine Physiological effects

A

Selective A1 agonist. Vasoconstriction (A1). Decrease in HR (baroreceptor reflex). Pupillary dilation (A1 activation- mydriatic agent). Decrease bronchiole and sinus secretions.

23
Q

Phenylephrine Toxicity

A

Hypertension

24
Q

Phenylephrine Indications

A

Hypotension during anasthesia
Supraventricular tachycardia
Mydriatic agent in ophthalmology
Nasal congestion

25
Q

Clonidine Physiological Effects

A

Selective A2 agonist. Causes acute vasoconstriction (increase in BP), then long term decrease in BP due to negative feedback on presynaptic neurons in the CNS.

26
Q

Clonidine Toxicity

A

Dry mouth.

Hypertensive crisis if withdrawing from medication –> get excess sympathetic activation after A2 inhibition in the CNS.

27
Q

Clonidine Indications

A

Hypertension due to sympathetic activation

28
Q

What are the indirect acting sympathomimetics? Basically, how do they function physiologically?

A
Amphetamine
Methamphetamine
Methylphenidate
Ephedrine
Pseudoephedrine
Tyramine

Either increase release of endogenous catecholamines or decrease reuptake of endogenous catecholamines.

29
Q

Physiological effects of indirect acting sympathomimetics?

A

Increased TPR and MAP (A1, A2)
Positive inotropic and chronotropic effects (B1)
CNS Stimulant
Anorexia

30
Q

Toxicity of indirect acting sympathomimetics

A

Tachycardia, anxiety

31
Q

Indications of indirect acting sympathomimetics

A

ADD, narcolepsy, nasal congestion

32
Q

Contraindications of indirect acting sympathomimetics

A

Prior history of drug abuse
Patient has taken a monoamine oxidase inhibitor in the last two weeks.
Hypertension

33
Q

Basic function amphetamine

A

Reverse monoamine reuptake transporter.

34
Q

Basic functions Methylphenidate (Ritalin)

A

Dopamine reuptake inhibitor

Increase attention

35
Q

Basic functions Ephedrine

A

stimulate release of catecholamines and some direct effect in activating adrenergic receptors