Adrenergic Agonists and Adrenergic Blockers

Question 1

NERVOUS SYSTEM

Answer 1

Central- brain and spinal cord

Peripheral- outside the brain and spinal cord

Autonomic (visceral) involuntary,
acts on smooth muscles and organs

Somatic (voluntary)
innervates skeletal muscles

Question 2

AUTONOMIC NERVOUS SYSTEM

Answer 2

Sympathetic
Adrenergic 
Neurotransmitter:
Norepinephrine
Epinephrine
Dopamine
Fight & Flight

Parasympathetic
Cholinergic
Neurotransmitter
Acetylcholine
Rest & Digest

Question 3

Sympathetic/Adrenergic Response

notes

Answer 3

Missing (GU) bladder and uterus, skin, hypercoagulability
Stimulation of sympathetic nervous system or use of adrenergic drugs can cause (Sympathetic responses):
Mydriasis, bronchodilation
↑ heart rate; peripheral vasoconstriction (HTN)
relaxation of GI tract, bladder, and uterus (no BM, voiding, or babies while running from the bear)
decrease secretions in the lungs, saliva, GI tract
shunting of blood from GI, GU, & skin
Glycogenolysis and peripheral insulin resistance 🡺 hyperglycemia (in diabetics)

Question 4

Sympathetic/Adrenergic Response

Answer 4

eyes: pupils dilate
heart: increased hr

kidneys:
release of epinephrine by adrenal gland
SHUNTING

increase coagulability
increase BP

bladder rectum: no BM of voiding or babies while running from the bear

ovaries:
no babies

GI: slowdown of digestive process

lungs: relaxation of bronchial tree
pancreas: mobilization of glucose
skin: hair stands up

fight and flight

Question 5

Negative Feedback vs. Drugs

NEGATIVE FEEDBACK

Answer 5

(natural process)
Fight or flight stimuli =>
release of catecholamines

Activities adrenergic receptors
α1, β1, β2

High level of catecholamines activating

α2 => stops adrenergic system

Rest and digest stimuli =>

release of acetylcholine

Activates muscarinic receptors

Question 6

Negative Feedback vs. Drugs

DRUGS

Answer 6

Adrenergic agonist
BEAR
Adrenergic antagonist 
CHICKEN 
Cholinergic (See next set of slide)
CHICKEN 
Anticholinergic (See next set of slide) 
BEAR

Question 7

BEAR

Answer 7

Bear 
adrenergic 
adrenergic agonist
sympathomimetic 
anticholinergic

Question 8

CHICKEN

Answer 8

Sleepy Chicken 
adrenergic antagonist
adrenergic blockers
sympatholytic 
cholinergic

Question 9

Adrenergic Receptors

ALPHA 1

Answer 9

BLOOD VESSELS
EYE
BLADDER
PROSTATE

peripheral vasoconstriction–> increased BP

mydriasis

bladder sphincter/ prostate contraction and
detrusor muscle relaxation => urinary retention

Increased BP not necessarily HTN
Urinary retention (bladder) v fluid retention (kidneys)

Question 10

Adrenergic Receptors

ALPHA 2

Answer 10

inhibits norepinephrine release

promotes vasodilation–> decreased BP

miosis

Question 11

Adrenergic Receptors

BETA 1

Answer 11

HEART
BLOOD VESSELS

increased force of contraction and HR –> increased:
HR
CO

Question 12

Adrenergic Receptors

BETA 2

Answer 12

LUNG

bronchodilation

Question 13

Classification of Adrenergic Agonists(Sympathomimetics)

Answer 13

SELECTIVE

NONSELECTIVE

Question 14

SELECTIVE

Answer 14

works on specific receptor 
alpha 1
alpha 2 
beta 1 
beta 2 

albuterol = selective beta 2 agonist

open airways and helps asthma and copd

at higher doses becomes nonselective and stimulating beta-1 causing tachycardia

Question 15

NONSELECTIVE

Answer 15

effects different receptors at the same time, activates alpha-1, beta 1&2

increases BP
increases HR
open airway

Epinephrine IM:
for allergic reaction

Epinephrine IV:
for cardiac arrest
severe hypotension (shock_

Question 16

epinephrine

Answer 16

α1, β1,β2

Vasoconstriction, ↑ HR, bronchodilation

Shock
cardiac arrest

ephedrine (Ephedrine) IV is used to treat low BP post anesthesia

Question 17

guanfacine

Answer 17

guanfacine (Tenex) alpha2 agonist for ADHD vs. guaifenesin (Mucinex) cough suppressant

Question 18

epinephrine

selective or nonselective

Answer 18

Nonselective

Question 19

epinephrine

INDICATION

Answer 19

IM/SubQ: 
Allergic reactions (anaphylaxis)

IV: 
Cardiogenic shock (Cardiac arrest)

Aerosol: 
Airway obstruction (bronchospasm)

Question 20

epinephrine

SIDE EFFECTS

Answer 20

High risk for extravasation

antidote: phentolamine mesylate

Question 21

epinephrine

SIDE EFFECTS

Answer 21

Hypertension
Pulmonary edema, Dyspnea

Tachycardia
Dysrhythmias/ Palpitations

worsening prostate disease (BPH)
Urinary retention

If it crosses BBB (large dose)
Tremors, restlessness, dizziness, fall

Mydriasis
worsening glaucoma, photophobia

Hypercoagulability
DVT, PE, CVA, MI

Lower GI motility/secretions
poor absorption, N/V, constipation, xerostomia, hypoactive bowel sounds

Blood shunting
Acute kidney injury, ischemic bowel, cold skin

Glycogenolysis
Hyperglycemia particularly in DM

DVT: deep vein thrombosis (blood clots in venous system that may circulate to the lungs (PE)
PE: pulmonary embolism (blood clots in the lungs
CVA: cerebrovascular accident (stroke)
MI: myocardial infarction (reduced or stopped coronary circulation = heart attack)
RF: renal failure (abnormal labs: high BUN, creatinine, low GFR, oliguria, uremia)
Xerostomia: dry mouth

Question 22

Adrenergic BlockersAdrenergic Antagonists(Sympatholytic)

Adrenergic Blockers at Receptorseffects & side-effects
effects & side-effects

Answer 22

Alpha 1 blocker

Beta 1 blocker

Question 23

Alpha 1 blocker

Answer 23

decreased BP

orthastatic hypotension

reflex tachycardia

relax bladder neck and prostate

miosis

priaprism

low ejaculation and anorgasmia

Contractility: force of contraction
HR: heart rate
Priapism: extended time of erection resulting in tissue death

Question 24

Beta 1 blocker

Answer 24

decreases contractility - negative intrope

decreases pulse rate or HR - negative chronotrope

inotrope: conductivity of electrical signal (action potential)
chronotrope: HR