Adrenergic Agonists Flashcards
Identify the Adrenergic Agonist
- Direct alpha 1 agonist (“pure-a”)
- peripheral vasoconstriction
- Reflex Bradycardia
- Increased coronary blood flow
Phenlephrine (Neo-Synephrine)
Identify the Adrenergic Agonist
- Direct adrenergic agonist
- B1->inc HR, contractility
- B2-> bronchodilation
- A1-> dec. splenic/renal blood flow & inc. coronary/cerebral perfusion pressure
Epi
Identify the Adrenergic Agonist
- a non-catecholamine sympathomimetic
- Indirect > Direct
- Causes NE release -> rapid tachyphylaxis
- Mild direct Beta action -> inc HR
Ephedrine
Identify the Adrenergic Agonist
- Direct alpha 1 stimulation
- Intense arterial and venous vasoconstriction
- end-organ ischemia/necrosis
- Pulmonary vasoconstriction
NE
Identify the Adrenergic Agonist
-Dose related agonist to all adrenergic receptors
DA > B > A
-Good for pedi - causes tachy
Dopamine
Identify the Adrenergic Agonist
- Highly potent B1 and B2 agonist
- Incr HR & contractility
- Bronchodilator
- Decrease in SVR due to peripheral vasodilation, but overall effect is inc SBP and dec DBP
Isoproterenol
Identify the Adrenergic Agonist
- Selective B1 agonist -> inc CO due to contractility = INOTROPE
- Coronary vasodilation
- Weak B2 activity -> slight Inc HR
Dobutamine
Identify the Adrenergic Agonist
- Selective Phosphodiesterase (PDE) Inhibitor
- INODILATOR
- Effective pulmonary vasodilator
- Signif effect on SVR -> HYPOTENSION
Milrinone (Primacor)
Identify the Adrenergic Agonist
- Selective DA1 - receptor agonist
- Inc renal blood flow -> diuresis
- Dec PVR -> reflex tachycardia
Fenoldopam
Identify the Adrenergic Agonist
- Selective A2 agonist (A2:A1 =220:1) used to treat hypertension
- Not commonly used in IV
- Sedative
- Adjunct for analgesia: add to LAs or opioids for RA
- Withdrawal syndrome: hypertensive crisis
Clonidine
Identify the Adrenergic Agonist
- more highly selective A2 agonist than Clonidine
- (A2:A1 = 1620:1)
- used primarily for sedation
- used to treat hypertension
Dexmedetomidine ( Precidex)
- Non-adrenergic sympathomimetic
- Activation of smooth muscle V1 receptors
- Exogenous version of ADH
- Effective vasoconstrictor (binds to vascular smooth muscle)
- May preserve mesenteric perfusion better than NE
- Extravasation -> tissue necrosis
Vasopressin
Identify the Adrenergic Agonist
- Non-adrenergic sympathomimetic
- Activation of smooth muscle V1 receptors
- Exogenous version of ADH
- Effective vasoconstrictor (binds to vascular smooth muscle)
- May preserve mesenteric perfusion better than NE
- Extravasation -> tissue necrosis
Vasopressin
Which adrenergic agonist has effects similar to epi?
Ephedrine
Which adrenergic agonist is the drug of choice in OB because it is thought to preserve uterine blood flow better than direct A1 agonsists?
Ephedrine
How does the duration of action of ephedrine compare to that of epi?
ephedrine last 10x longer than epi
Does ephedrine cause greater arterial or venous vasoconstriction?
Venoconstriction > arteriolar constriction
Redistribution of blood centrally, improved venous return (preload)
___ is used to treat anaphylaxis and ventricular fibrillation.
Epi
T or F. Ephedrine may have anti-emetic properties.
true
___ is used in TX of diabetes insipidus.
Vasopressin
diabetes insipidus = lack of ADH secretion
Risks associated with the use of Epi include ___, ___ and ____.
Risks: cerebral hemorrhage, coronary ischemia, ventricular dysrhythmia
Withdrawal of ____ could lead to hypertensive crisis.
a
___ can be used to support BP in septic shock, cardiac arrest, post-CPB vasoplegia, and interaction between ACE-I and general anesthesia.
Vasopressin
a
a
In addition to its sedative effects, side effects of clonidine include ___, ___, and ___.
bradycardia, hypotension, dry mouth
___ is effective for treating post-op shivering.
Clonidine
T or F. Milrinone is an effective pulmonary vasodilator.
True
____ is used to Inc HR in presence of Heart block - maintains HR until pacemaker can be placed
Isoproterenol (Isuprel)
Identify the adrenergic agonist
May increase cardiac O2 requirements as well as decrease myocardial perfusion - Also, coronary artery dilation may lead to coronary steal
Isoproterenol (Isuprel)
___ is not a good 1st-line treatment for cardiogenic shock but can be used to treat refractory hypotension (shock, sepsis)
NE
T or F. NE should only be given thru central access - not a PIV b/c extravasation->tissue necrosis.
True
What are the “Low,” “Med” and “High” dose ranges of Dopamine and which receptor is associated with each?
Low Dose <2 mcg/kg/min = DA receptor
Med Dose 2-10 mcg/kg/min = B1 receptor
High Dose 10-20 mcg/kg/min = A1 receptor
