Adrenergic Agonists And Antagonists Flashcards by Joel Glotfelty

What are the three endogenous catecholamines?

-Affect both alpha and beta receptors

Epinephrine, Norepinephrine, and Dopamine

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Epinephrine has a higher affinity for

Beta receptors

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The adrenergic receptor activation is dose-dependent for

Epinephrine

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What are the cardiac effects of Epinephrine?

Positive inotrope and chronotrope

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Causes a slight reduction in SVR which widens the pulse pressure

Epinephrine

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A higher dose of epinephrine results in more

Alpha effect

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The number one drug of choice for anaphylaxis (IV)

Epinephrine

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Used to treat asthma (Rx bronchospasm) and open angle glaucoma

Epinephrine

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Causes palpitations, HTN, tremor, and anxiety

Epinephrine toxicity

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Epinephrine is contraindicated in patients on non-selective beta blockers and those with

Hyperthyroidism

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Also has a dose dependent response, but has essentially no B2 activity

Norepinephrine

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Has a negligible direct effect on the heart at low dose

Norepinephrine

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Causes an INCREASE in both arterial and venous tone

Norepinephrine

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Norepinephrine also results in an increase in

Systolic BP (SBP) and Diastolic BP (DBP)

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The number one drug of choice for hypotension in sepsis and also for cardiogenic shock

Norepinephrine

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Should be regarded as the first line vasopressin in the treatment of septic shock

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Activation of DA1 receptors in the kidney induces

Dieresis

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Activation of Beta-1 receptors ion the heart produces an increase in

Contractile force

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Clinically, is used for treating hypotension, low cardiac output, and unstable bradycardia

Dopamine

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Dopamine toxicity causes

Arrhythmia, wide QRS, and angina

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A non-selective alpha agonist

Norepinephrine

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An alpha-1 selective agonist

Phenylephrine

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And alpha-2 selective agonist

Clonidine

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A non-selective Beta agonist

Isoproterenol

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A beta-1 selective agonist

Dobutamine

A beta-2 selective agonist

Albuterol

Causes increased arterial/venous tone which results in increased BP

Phenylephrine

Causes decreased venous capacitance and a reflex decrease in HR

Phenylephrine

The number 2 drop of choice for hypotension if we can’t use NE

Phenylephrine

Has the central action of decreasing SNS outflow

Clonidine

Decreases HR and arterial/venous tone

Clonidine

Used to treat hypertension and ADHD and can be sued as an anxiolytic

Clonidine

Has the beta-1 effects of increasing HR, contractility, and conduction velocity

Isoproterenol

Has the beta-2 effects of decreasing peripheral vascular resistance (afterload)

Isoproterenol

Syncope due to slow or absent pulse

Stokes-Adams attack

Used to treat Stokes-Adams attack

Isoproterenol

Beta 1 selective adrenergic agonists -Causes increased contractility

Dobutamine

It’s increased contractility effect is greater than its chronotropic effect

Dobutamine

The number one drug of choice for cardiogenic shock with maintained BP

Dobutamine

Add to NE in septic shock with low CO -Used for cardiac stress test

Dobutamine

Used to treat urinary incontinence and hypotension

Ephedrine

What is the irreversible NON-selective alpha-blocker

Phenoxybenzamine

What is the reversible NON-SELECTIVE alpha blocker?

Phentolamine

Lower peripheral vascular resistance (alpha-1 block), decrease BP, and can cause orthostatic hypotension

Alpha antagonists

The ONLY irreversible non-selective alpha blocker

Phenoxybenzamine

Blocks NE reuptake at presynaptic terminals -Alpha-1 effect is greater than alpha-2 effect

Phenoxybenzamine

Phenoxybenzamine blocks catecholamine-mediated

Vasoconstriction

Phenoxybenzamine is used to treat

Pheochromocytoma

Blocks peripheral resistance and it’s alpha-2 effects cause cardiac stimulation

Phentolamine

Used for the treatment of pheochromoytoma and in NE extravasion

Phentolamine

Used to treat a patient on MAO inhibitor w/ tyramine ingestion

Phentolamine

What is the selective alpha-2 blocker?

Yohimbine

Prazosin, terazosin, doxazosin, and tamulosin are the 4

Alpha-1 selective alpha blockers

Highly selective alpha-1 effects on relaxing arterial and venous smooth muscle

Prazosin

Used to treat hypertension and benign prostatic hyperplasia

Prazosin

Is considered “uroselective” as it blockers the alpha receptors in the prostate. Thus it is more selective for BPH

Tamulosin

Works in CNS to increase SNS outflow to periphery - Used for erectile dysfunction - Contraindicated in CV disease

Yohimbine

Limited bioavailability when taken orally -Large volume of distribution

Beta-blockers

Are negative chronotropes and negative inotropes

Beta-blockers

Cause a slowed AV conduction with increased PR interval

Beta blockers

Used to treat Coronary Artery Disease (CAD)

Beta-blockers

Used to lower high blood pressure by suppressing renin release -Only effective if you have high BP

Beta-blockers

Blockage of beta-2 receptors in the periphery can cause an increase in

Peripheral Vascular Resistance

Can cause bronchoconstriction, even w/ beta-1 selective drugs

Beta blockers

Contraindicated w/ severe obstructive disease

Beta-blockers

Block lipolysis, leading to increased VLDL and decreased HDL -Causes impaired glucose tolerance

Beta-blockers

In the eye, beta-blockers reduce

Intraocular pressure

Used to treat a myocardial infarction -Given in acute STEMI

Propranolol

Used in symptomatic heart failure where we see reduced ejection fraction

Metoprolol

Also used to treat hyperthyroidism, glaucoma, and migraine

Beta-blockers

Can precipitate acute MI in patients with CAD -can cause ventricular tachyarrythmia

Beta-blockers

Can cause CHF exacerbation in patients with acute decompensated HF

Beta-blocker

The presence of an AV conduction defect can lead to a serious bradyarrhythmia when taking a

Beta Blocker

Causes bronchoconstriction, a worsens glycemic control in type 2 DM

Beta blockers

Prototypical beta blocker -highly lipophilic

Propranolol

Has partial agonist activity and is an intrinsic sympathomimetic

Pindolol

Beta blocker with a VERY long duration of action

Nadolol

A non-selective 3rd generation Beta-blocker that has cocaine-like activity

Labetolol

alpha-1 receptor blockade leads to

Vasodilation

Also contributes to a fall in BP, in part by blocking reflex sympathetic stimulation of the heart

Beta-1 blockade

A non-selective 3rd generation beta-blocker with antioxidant and anti-inflammatory properties

Carvedilol

Beta-1(cardio)-selective antagonists are preferred in patients with asthma, COPD, and DM. Four examples are

Metoprolol, atenolol, acebutolol, and esmomlol

A ULTRA short-acting parenteral beta-1 blocker

Esmolol

A beta-1 selective third generation beta blocker

Nebivolol

Most highly selective beta-1 agent -LONG activity

Nebivolol

Has vasodilatory effects via NO release

Nebivolol

The first line antipode to beta blocker toxicity is

Glucagon