Adrenergic Bronchodilators Quiz 2 Flashcards
How are catecholamines inactivated?
By heat, light or air (known as beta blockade)
What are side effects of catecholamines?
Tachycardia, hypertension, nausea, headache, dizziness, skeletal muscle tremor
What are naturally occurring catecholamines?
Epinephrine, dopamine, norepinephrine
What are man made catecholamines?
Isoproterenol and isoetharine
What are isomers?
Mirror images
What are ultra short acting agents?
They lack B2 specificity, have lots of cardiac effects, very short acting and short duration and are metabolized by COMT
What is epinephrine?
A potent catecholamine bronchodilator that stimulates both alpha and beta receptors. It is available as a synthetic racemic mixture and is used to treat people with status asthmaticus or who have cardiac issyes
When is epinephrine-adrenaline primatene mist used?
It is used for emergency situations both alpha and beta, and can be administered by inhalation or injection
What is the isomer of epinephrine?
Racemic epinephrine
What is racemic epinephrine-vapoenfrin micronefrin, asthmanefrin?
A strong alpha adrenergic vasoconstricter used to decrease airway swelling
What is isoetharine-bronkosol bronkometer?
One of the first B2 specific adrenergic bronchodilators that has a short duration but a rapid onset. It has minimal B1 stimulation and may turn pink
What are CATS?
They are short ultra short acting agents that are rapidly inactivated by COMT and unsuitable for oral administration (epinephrine, racemic epinephrine, isoetharine)
CATS are inactivated by
The gut and liver, but also by heat, air and sunlight
What is another name for short acting agents?
SHORTS or rescue drugs
What are some examples of SHORTS?
Metaproterenol, albuterol, pirbuterol, levalbuterol
What does the keyhole theory of B2 specificity state?
The larger the catecholamine side chain, the more B2 specific
What are some short acting-resorcinol agents?
Metaproterenol (nebulizer) and terbutaline (used for premature labor in oral or injectable form)
What are the benefits of short acting-saligenin agents?
B2 preference, effective by mouth, peak in 30-60 mins, duration up to 6 hours
What is the stereoisomer of short-acting albuterol?
Racemic mixture
What is short acting-pirbuterol?
A noncatecholamine adrenergic agent that is available as a breath-actuated MDI. Onset 5-8 mins, peak 30 mins and duration 5 hours. Less potent, by weight, than albuterol
Short acting _______ is the single (R) isomer form of racemic albuterol and contains no (S) isomer
Levalbuterol
______ contains both (R) and (S)
Albuterol
What long acting B adrenergic agent is approved for COPD?
Arformoterol
Assessment of drug
Monitor flow rates (should have a 20% increase), assess ABGs, note effect on blood glucose and potassium, and watch reaction to freon or sulfites
Maintenance therapy of _____ is not controlled by inhaled corticosteroids
Asthma
What needs a daily bronchodilator?
COPD
A1 receptor stimulation and an agonist?
Vasoconstriction effect; epinephrine
B1 receptor stimulation
Increased HR and contractile force
B2 receptor stimulation
Relaxation of bronchial smooth muscle
