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Pharm Spring 2023 > Adrenergic Agonists/ Antagonists > Flashcards

Adrenergic Agonists/ Antagonists Flashcards

1
Q

What is the major function of alpha 1

A

Vasoconstriction

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2
Q

What is the major function of alpha 2

A

Decreased release of NE from sympathetic neurons

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3
Q

What is the major function of beta 1

A
  1. Increase heart rate
  2. Increase heart contractility
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4
Q

What is the major function of beta 2

A

Bronchodilation (lungs)

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5
Q

What does epinephrine effect?

A

Potent stimulant of alpha and beta adrenergic receptors

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6
Q

What are the effects on epinephrine on blood pressure

A

Rapid spike in BP
1. Direct myocardial stimulation (positive inotropic effect)
2. Increase in HR (positive chronograph effect)
3. Vasoconstriction in vascular beds (alpha 1)

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7
Q

What are the effects of epinephrine on the myocardium

A
  1. Drastically increases myocardial oxygen demand
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8
Q

What are the effects of epinephrine on respiratory tract

A
  1. Very potent bronchodilator (beta 2)
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9
Q

What are the metabolic effects of epinephrine

A

Stimulation of beta 2 receptors increases glycogenolysis

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10
Q

What is the alpha 1 activity of norepinephrine

A

Vasoconstriction in vascular beds

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11
Q

What is the beta 1 activity of norepinephrine

A
  1. Direct myocardial stimulation
  2. Increase in HR
    *less potent than epinephrine
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12
Q

What is the beta 2 activity of norepinephrine

A
  1. Very potent bronchodilator
    *slightly less potent than epinephrine
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13
Q

What are the therapeutic uses of epinephrine and norepinephrine

A
  1. Hypersensitivity reactions (epinephrine)
  2. Cardiac arrest and post cardiac arrest
  3. Vasopressor therapy in critical care pharmacotherapy
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14
Q

What are the therapeutic effects beta 1 agonists

A

Chronotropic and inotropic effects in acute decompensated heart failure

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15
Q

What are the therapeutic uses for beta 2 agonist

A

Bronchodilation in treatment of asthma

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16
Q

What is the therapeutic use of dobutamine

A

Used to increase cardiac output in acute decompensated heart failure or cardiogenic shock
*increase HR and contractility

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17
Q

Why is the inhalation adminsitatiron of beta 2 agonist better?

A

Bc it decreases systemic absorption which can also lead to less side effects

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18
Q

What are the short acting beta 2 agonists

A
  1. Albuterol
  2. Levalbuterol
19
Q

What are albuterol and levalbuterol used for?

A

Common agents used in acute treatment of asthma

20
Q

What are the long acting beta 2 agonists (LABA)

A
  1. Salmeterol
    *selectivity for beta 2 receptors is 50 fold greater than that of albuterol
  2. Formoterol
21
Q

What are the ADRS of beta 2 agonists (all types)

A
  1. Tremor
  2. Restlessness
  3. Tachycardia
  4. Hypokalemia
22
Q

What are the therapeutic uses of alpha 1 agonists

A
  1. Treatment of hypotension and / or shock to increase systemic vascular resistance
  2. Nasal decongestant
23
Q

What are the therapeutic uses of alpha 2 agonists

A
  1. Treatment of systemic hypertension
  2. Decrease intra-ocular pressure
  3. Central nervous system sedative
  4. Muscle relaxant
24
Q

What is phenylephrine used for?

A
  1. Add on therapy as a vasopressor in treatment of shock
  2. Also used as a nasal decongestant
25
Q

What is midodrine used for

A

Prodrug
1. Used in the treatment of orhtostatic hypotension

26
Q

What is the use of Clonidine (alpha 2 agonists)

A
  1. Causes decreased release of norepinephrine from sympathetic nerves resulting in a decreased ability to constrict blood vessels
    *anti hypertension medication PO
27
Q

What med is more selective for alpha 2 receptor than Clonidine

A

Guanfacine

28
Q

What is Tizanidine used for (alpha 2 agonist)

A

Muscle relaxant

29
Q

What is the MOA of amphetamine (adderall)

A

Increase release of catecholamines from sympathetic nerve terminals

30
Q

What are the effects on the cardiovascular system while taking aphetamine (adderall)

A
  1. Raises both systolic and diastolic blood pressure
  2. HR is often reflexes slowed
31
Q

What are the effects of amphetamine (adderall) on the smooth muscle

A
  1. Increase contraction of sphincter on urinary bladder
  2. Can cause relaxation of the gut or stimulation of the gut
32
Q

What are other therapeutic uses of sympathomimetic drugs

A
  1. Shock
  2. Hypotension
  3. Hypertension
  4. CHF
  5. Nasal de congestion
  6. Asthma
33
Q

What is the main effect of alpha 1 antagonists

A
  1. Inhibits vasconstriction
  2. Decreased peripheral resistance = lower blood pressure
  3. Reflex tachycardia and natural fluid preservation
  4. Alleviate symptoms of benign prostatic hyperplasia
34
Q

What is prazosin used for (alpha 1 antagonists)

A
  1. Hypertension treatment
35
Q

What is terazosin used for (alpha 1 antagonists)

A
  1. In treatment of hypertension and or BPH
    *can only be taken once daily
36
Q

What is doxazosin used for (alpha 1 antagonist)

A
  1. Treatment of hypertension and BPH
37
Q

What is tamsulosin (flomax) used for (alpha 1 antagonists)

A
  1. Treatment of BPH with little effect on blood pressure
  2. Favors selection of alpha 1 receptors in the prostate
38
Q

What is a common ADR of Alpha 1 antagonists

A
  1. First dose effect
    *postural hypotension and syncope
  2. Reflex tachycardia
38
Q

What are some conditions that beta antagonists aid in? (Beta Blockers)

A
  1. HTN
  2. Ischemic heart disease (coronary artery disease)
  3. Congestive heart failure
  4. Arrhythmias
39
Q

What are the selective beta 1 blockers AABBEMN

A
  1. Acebutolol
  2. Atenolol
  3. Bisoprolol
  4. Betaxolol
  5. Esmolol
  6. Meataprolol
  7. Nebivolol
40
Q

Which non selective beta blockers have alpha 1 antagonistic effects

A
  1. Carteolol
  2. Carvedilol
  3. Labetalol
    *used in treatment for HTN
41
Q

What are the ARDS of beta blockers

A
  1. May exacerbate heart failure in compensated heart failure or acute myocardial infarction
  2. Bradycardia
  3. Abrupt discontinuation can increase risk of sudden death
  4. Difficulty breathing
42
Q

What beta blockers should you have caution with using other agents that slow conduction through the AV node

A
  1. Verapmail
  2. Digoxin
43
Q

What are the therapeutic uses of beta blockers

A
  1. HTN (not first line)
  2. Angina
  3. Chronic heart failure
  4. Dissecting aortic aneurysm / aortic dissection

Pharm Spring 2023 (27 decks)

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