Adrenergic and Antiadrenergic

Question 1

Gimme all the alpha and beta functions

Answer 1

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

Question 2

Whats phenylephrine

Answer 2

alpha 1 agonist

- decongestant

Question 3

Whats oxymetazoline

Answer 3

alpha agonist - spray lmao

- both alpha 1 and alpha 2

Question 4

Whats brimonidine

Answer 4

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).

Question 5

Whats dopamine

Answer 5

lmao

A1 and B1 agonist

Question 6

Name all the beta agonists

• b2 [4]
• b3

Answer 6

b2 - 
Salbutamol - SABA
Salmeterol - LABA
Formoterol - LABA + ICS Fluticasone
Indacaterol - LABA for COPD

b3 - Mirabragon
- for overactive bladder

Question 7

Why LABA and CS given tgt

Answer 7

BA decreases beta receptors

CS increases beta receptors

Question 8

Whats the biochemistry of beta agonist for bronchodilation

Answer 8

GPCR
adenylyl cyclase
increase cAMP
- inhibit MLCK
- MLC not phosphorylated, smooth muscle relaxes

Question 9

Whats the side effects of beta agonists

Answer 9

Note that dose dependence cross over

• hence B2 to B1
• • Tachycardia, Tremors; arrhythmia

Non-specific B agonists
- reflex bradycardia, urinary incontinence, hypertension, arrhythmia

Question 10

Gimme alpha agonist side effects

Answer 10

Hypertension, Reflex BC;

- Rebound congestion

Question 11

Premature labour how

Answer 11

Give B2 agonist to relax uterus

Question 12

Name the indirect adrenergic classes

Answer 12

MAOI - Moclobemide
TCA, SSRI
- TCA - Imipramine, Amitriptyline
- SSRI - fluoxetine, Paroxetine, Sertraline, escitaloprám

Displacements - nasal decongestants w direct alpha agonist function

• ephedrine
• pseudoephedrine

Question 13

Gimme the blockers

• function
• AE
• Uses

NOTE BETA 2 also for RENIN

Answer 13

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

Question 14

who cannot receive beta blockers

Answer 14

diabetes

• note b2 for insulin
• b3 for lipolysis

but beta blockers hide symptoms of hypoglycaemia
- tremors, palpitations

Question 15

2 classes of indirect blockers

• gimme the biochemistry
• recall d-MD, t-MD

Answer 15

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

Question 16

Note severe hypotension, shock, cardiac resus

• give NA, A, Dopamine
• beta agonist SE usually TC, arrhythmia; reflex BC

Answer 16

okie

Question 17

Name all drugs

• alpha agonists, beta agonists
• alpha block, beta block

indirect agonists
indirect blocks

Answer 17

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

Question 18

Gimme drugs for glaucoma

Answer 18

alpha 2 agonists - DECREASES AH
- brimonidine

beta 1 block
- betaxolol; timolol

Muscarinic agonists
- Pilocarpine

Question 19

Gimme drugs for BPH

• which should be avoided

Answer 19

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.