Adrenergic Agonists & Antagonists Flashcards

1
Q

Name the three direct-acting adrenergic agonists

A

Endogenous catecholamines
B-adrenergic agonists
A-adrenergic agonists

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2
Q

What are the three endogenous catecholamines?

A

Epinephrine
Norepinephrine
Dopamine

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3
Q

At low concentrations of epinephrine, which receptors are activated?

A

Beta 1 & 2

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4
Q

At high concentrations of epinephrine, which receptors are activated?

A

More alpha 1 & some beta 1

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5
Q

Which concentration of epinephrine can cause a baroreceptor reflex to occur?

A

High concentration

*Low does not increase MAP with B2 & B1 activation

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6
Q

What are the uses for epinephrine?

A

Cardiac arrest
Anaphylactic shock
Acute asthmatic attack

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7
Q

Which receptors does norepinephrine act on?

A

A1, A2, B1

*NOT B2

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8
Q

Can norepinephrine cause a baroreceptor reflex kick in?

A

Yes- no B2 action with norepinephrine

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9
Q

What are the uses for norepinephrine?

A

Treat shock

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10
Q

What are the control systems of the baroreceptor reflex?

A

Changes in vasculature lead to reading by baroreceptors on carotid sinus, this leads to change in heart contraction by sympathetic centers and change in heart rate by vagal centers

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11
Q

Which non-selective adrenergic agonist acts on Beta1 & Beta2 receptors and is used to stimulate the heart in patients with brachycardia or heart block?

A

Isoproterenol

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12
Q

Which selective adrenergic agonist acts on B1 and produces less increase in HR and less decrease in PVR than isopreternol?

A

Dobutamine

*also increases O2 consumption for stress test

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13
Q

Which selective adrenergic agonist acts on B2 receptors and is used in asthma attacks?

A

Albuterol

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14
Q

Which selective adrenergic agonist acts on A1 receptors and is used as a nasal decongestant or to produce mydriasis?

A

Phenylephrine

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15
Q

Which selective & partial adrenergic agonist acts on A2 receptors and inhibits the release of NE, reducing sympathetic outflow?

A

Clonidine

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16
Q

What are the two classes of indirect-acting adrenergic agonists?

A

Releasing agents & uptake inhibitors

17
Q

Which releasing agent causes NE release, acts on A1 and B1 receptors and is used for ADHD and narcolepsy?

A

Amphetamine

18
Q

Which releasing agent also causes NE release and is oxidized by MAO?

A

Tyramine

*if patient is taking MAO inhibitor (antidepressant), tyramine can cause vasopressor episodes

19
Q

Which uptake inhibitor blocks monoamine reuptake resulting in potentiation and prolonging of central and peripheral actions?

A

Cocaine

20
Q

What are the two mixed-acting adrenergic agonists that act by causing release of NE?

A

Ephedrine and pseudoephedrine

21
Q

Which mixed-acting agonist is a poor substrate for COMT & MAO, having long duration, penetrates CNS, and is used as a pressor agent for spinal anesthesia?

A

Ephedrine

22
Q

Which mixed-acting agonist is one of four ephedrine enantiomers and is commonly used in decongestant mixtures (sudafed)?

A

Pseudoephedrine

23
Q

Name the two types of alpha & beta antagonists

A

Non-selective alpha or beta antagonists

A1 or B1 selective antagonists

24
Q

Name the two types of non-selective alpha antagonists

A

Phenoxybenzamine

Phentolamine

25
Q

Which non-selective alpha antagonist acts irreversibly on A1 & A2 receptors, has been found unsuccessful for hypertension cases, and is used prior to tumor removals for pheochromocytoma?

A

Phenoxybenzamine

26
Q

Which non-selective alpha antagonist acts reversibly on A1 & A2 receptors, can be used to control hypertension in pheochromocytoma pre-ops & surgical removals, and can be used as an antidote for hypertension due to stimulate drug overdoses?

A

Phentolamine

27
Q

Which selective alpha antagonist is specific for A1 receptors, is used for hypertension (not a DOC), and for symptom relief of benign prostatic hyperplasia?

A

Prazosin

28
Q

Which non-selective beta antagonist acts on B1 & B2 receptors and cause respiratory crisis in COPD or asthma patients?

A

Propranolol

29
Q

Which beta selective antagonist acts on B1 receptors and is used in diabetic hypertension patients?

A

Atenolol

30
Q

Which partial beta antagonist competes with NE and is preferred in patients with diminished cardiac reserve or brachycardia?

A

Pindolol

31
Q

What are adverse effects of beta blockers?

A

Bronchoconstriction (avoid with asthmatic patients)
Hypoglycemia (avoid in patients with insulin-dependent diabetes due to B2 inhibition of gluconeogenesis —> B1 blocker preferred)
CNS - sedation, dizziness, fatigue etc.