Adrenergic and Antiadrenergic Flashcards
Gimme all the alpha and beta functions
alpha 1 - eyes dilation + AH production
- bladder contract!
alpha 2 - saliva; DECREASES AH production
- alphas - vasoconstriction of viscera, skin; shut down GI, contract sphincters
beta 1 - Heart
- AH production too
beta 2 - lungs, vasodilation for muscles;
- Insulin
- RELAX UTERUS
beta 3 - lipolysis, bladder RELAX
Whats phenylephrine
alpha 1 agonist
- decongestant
Whats oxymetazoline
alpha agonist - spray lmao
- both alpha 1 and alpha 2
Whats brimonidine
alpha 2 (eyedrops) - for glaucoma AH production
Ophthalmic brimonidine is used to lower pressure in the eyes in patients who have glaucoma (high pressure in the eyes that may damage nerves and cause vision loss) and ocular hypertension (pressure in the eyes that is higher than normal but not high enough to cause vision loss).
Whats dopamine
lmao
A1 and B1 agonist
Name all the beta agonists
- b2 [4]
- b3
b2 - Salbutamol - SABA Salmeterol - LABA Formoterol - LABA + ICS Fluticasone Indacaterol - LABA for COPD
b3 - Mirabragon
- for overactive bladder
Why LABA and CS given tgt
BA decreases beta receptors
CS increases beta receptors
Whats the biochemistry of beta agonist for bronchodilation
GPCR adenylyl cyclase increase cAMP - inhibit MLCK - MLC not phosphorylated, smooth muscle relaxes
Whats the side effects of beta agonists
Note that dose dependence cross over
- hence B2 to B1
- Tachycardia, Tremors; arrhythmia
Non-specific B agonists
- reflex bradycardia, urinary incontinence, hypertension, arrhythmia
Gimme alpha agonist side effects
Hypertension, Reflex BC;
- Rebound congestion
Premature labour how
Give B2 agonist to relax uterus
Name the indirect adrenergic classes
MAOI - Moclobemide
TCA, SSRI
- TCA - Imipramine, Amitriptyline
- SSRI - fluoxetine, Paroxetine, Sertraline, escitaloprám
Displacements - nasal decongestants w direct alpha agonist function
- ephedrine
- pseudoephedrine
Gimme the blockers
- function
- AE
- Uses
NOTE BETA 2 also for RENIN
alpha blocker
- a1 azosin - Prazosin
- used for hypertension, BPH incontinence
- AE: hypotension, reflex TC, nasal congestant
beta blockers
- beta 1 specific
- atenolol, betaxolol - heart use; eye use respectively
- – recall beta 1 w AH production function
- non beta 1,2 specific blockers
Propranolol, Sotalol (heart), Timolol (eye) - use for antihypertensive, antiarrhythmic
- timolol for eye drops;
AE OF BETA BLOCKER
- asthma cannot; even beta 1 atenolol cos dose dependence selectivity
- heart failure, bronchoconstriction
who cannot receive beta blockers
diabetes
- note b2 for insulin
- b3 for lipolysis
but beta blockers hide symptoms of hypoglycaemia
- tremors, palpitations
2 classes of indirect blockers
- gimme the biochemistry
- recall d-MD, t-MD
a2 agonists
- a2 direct function - hence dry mouth
- autoreceptors at Pre-S ganglion, decreases NA release throughout body
- “central antihypertensives”
- Dexmedetomidine
- — used for sedation
Synthesis block of NA
- L-tyrosine to L-DOPA to Dopamine
- Tyrosine hydroxylase; DOPA DEcarboxylase
give methyldopa for inhibition of L-tyrosine and production of false neurotransmitter
- methyldopa also have direct a2 function lol
Note severe hypotension, shock, cardiac resus
- give NA, A, Dopamine
- beta agonist SE usually TC, arrhythmia; reflex BC
okie
Name all drugs
- alpha agonists, beta agonists
- alpha block, beta block
indirect agonists
indirect blocks
alpha agonists
- alpha 1 Phenylephrine - Nasal
- alpha 2 Brimonidine - Eye drops – DECREASE AH
- note methydopa + ephedrine and pseudoephedrine have direct a2 too
- alpha 1 + 2 - oxymetazoline
beta agonists
- SABA, LABA;
- b3: Mirabegron - OVERACTIVE BLADDER NOT BPH
alpha block
- alpha 1 Prazosin - BPH
beta block
- b1: atenolol, betaxolol (for hypertension // glaucoma)
- NON- SELECTIVE
- propranolol; sotalol, timolol (hear and eye)
indirect agonists
- MAOI moclobemide; TCA, SSRI; Pseudoephedrine and ephedrin
indirect blocks
- Methyl-DOPA and a2 agonist: dexmedetomidine
Gimme drugs for glaucoma
alpha 2 agonists - DECREASES AH
- brimonidine
beta 1 block
- betaxolol; timolol
Muscarinic agonists
- Pilocarpine
Gimme drugs for BPH
- which should be avoided
RELAX BLADDER
- alpha 1 blockers - Prazosins
Beta 3 agonist (can but not common)
- Mirabegron - for overactive;
Muscarinic agonists contracts so no
- bethanechol NO Bethanechol is used to treat INCONTINENCE due to certain causes (e.g., surgery, bladder muscle problems). It works by helping the bladder muscle to squeeze better, thereby improving your ability to urinate.
Note alpha 1 agonist, should be avoided
- Nasal decongestants;
Muscarinic block avoid too
- Diphenhydramine (Gen 1 AH w M block too)
- M BLOCK = RELAX but AH PROSTATE CONTRACT
Decongestants increase the resistance to urine flow through the prostate by causing the smooth muscle in the prostate to squeeze the urethra, and antihistamines weaken the bladder contractions. This lessens the bladder’s ability to expel the urine.
