Adrenergic Direct Agonist

Question 1

Cardiovascular system (B1)

Answer 1

-Positive Chronotropic effect
-Positive inotropic effect

Question 2

Vascular Smooth Muscle (alpha 1 and Beta 2)

Answer 2

-Alpha 1: Vasoconstriction
-Beta 2: Vasodilation

Question 3

Respiratory Tract (Beta 2)

Answer 3

Bronchodilation

Question 4

Urinary Tract (Alpha 1 and Beta 3)

Answer 4

-Relaxes Bladder
-Constrict Sphincter

Question 5

GI tract (Alpha 1 and Beta 2)

Answer 5

-Decrease GI motility
-Constrict Sphincter

Question 6

Glands (M3)

Answer 6

Stimulation secretion (sweat glands)

Question 7

Kidney (Beta 1)

Answer 7

Increase Renin secreation

Question 8

Adipocytes (Beta 3)

Answer 8

Increase Lipolysis

Question 9

Which have the strongest response to alpha agonist?

Answer 9

Epinephrine > Norepinephrine&raquo_space; Isoproterenol

Question 10

Which have the strongest response to Beta agonist?

Answer 10

Isoproterenol > Epinephrine > Norepinephrine

Question 11

Alpha 1 (Gq)

Answer 11

-Vascular s. Muscle: Vasoconstriction
-GI and bladder sphincter: Constriction

Question 12

Alpha 2 (Gi)

Answer 12

Suppression of release of Norepinephrine by negative feedback.

Question 13

Which is one of the most potent vasopressor drugs known?

Answer 13

Epinephrine

-Low dose: predominantly B1 and B2
-High dose: prefers a1 than B2

Question 14

What can given to treat necrosis cause by epinephrine at the site of infection?

Answer 14

Phentolamine antagonista competitivo de alpha

Question 15

What drug is a prodrug that administer norepinephrine and to treat orthostatic hypotension?

Answer 15

Droxidopa

Question 16

The effect of dopamine at different concentrations.

Answer 16

-Low dose act on D1 causing vasodilation increasing renal blood flow and urine output.
-Intermediate dose acts on D1 and B1 increasing HR and cardiac contractibility
-High dose acts on alpha 1 increasing blood pressure and risk of arrhythmias.

Question 17

Why is Fenoldopam a preferred treatment to control severe hypertension?

Answer 17

It only acts as an agonist on D1 peripheral receptors.

Question 18

Which drugs were regulated since they are potent CNS stimulants thar are precursors of methamphetamine?

Answer 18

Ephedrine, Phenylpropanolamine, and Pseudoephedrine (relief nasal congestion).

Question 19

Phenylephrine

Answer 19

Alpha 1 selective agonist

Treatment for hypotension, vasoconstriction in regional analgesia and open-angle glaucoma.

Question 20

Metaraminol

Answer 20

Alpha 1 selective agonist

Indirectly increase release of norepinephrine. To treat hypotensive states in surgical procedures.

Question 21

Midodrine

Answer 21

Alpha 1 selective agonist

Prodrug with active metabolite, desglymidodrine. Treat orthostatic hypotension

Midodrine, not droxidopa, increases the risk of supine hypertension.

Question 22

What is the primarily treatment of Alpha 2 selective agonist?

Answer 22

To treat hypertension.

Question 23

Clonidine

Answer 23

Alpha 2 Selective agonist

Lowers blood pressure even applied topically in the eye. However, it increases BP if administered IV. Can be used as a patch for a long period of time.

Question 24

True or False: Clonidine can be used as diagnosis of hypertension or pheochromocytoma.

Answer 24

True

Most common symptoms of pheochromocytoma (PHE). Palpitations, Headaches, Episodic sweating (diaphoresis)

Question 25

True or False: All drugs that activate Alpha 2 receptors can cause Xerostomia, Badycardia, and Sedation.

Answer 25

True

Question 26

Apraclonidine

Answer 26

**Alpha 2 selective agonist** Decrease intraocular pressure

Question 27

Brimonidine

Answer 27

**Alpha 2 selective agonist** Crosses the BBB and can produce hypotension and sedation

Question 28

Guanfacine

Answer 28

**Alpha 2 selective agonist** More selective for alpha 2 than Clonidine. To treat ADHD.

Question 29

What is the first line of treatment to treat hypertension during pregnancy?

Answer 29

**Methyldopa:** a prodrug to alpha methylnorepinephrine

Question 30

Tizanidine

Answer 30

Centrally acting alpha 2 agonist. Relaja músculos.

Question 31

Dexmedetomidine

Answer 31

Centrally acting alpha 2 agonist. Used for sedation and cause no respiratory depression.

Question 32

What are the therapeutic applications of Isoproterenol?

Answer 32

-**asthma** inhibits antigen-induced release of histamine -**Emergency stimulation of the heart**

Question 33

What are the effects of the two stereoisomers of Dobutamine?

Answer 33

- (-) isomer acts as an **alpha 1 agonist and a weak beta 1 agonist (inotropism)** - (+) isomer acts as an **alpha 1 antagonist and a potent beta 1 agonist.**

Question 34

What is the treatment and adverse effect of Beta 2 selective agonist?

Answer 34

To treat asthma and COPD but it can cause tachycardia since can stimulate B1 in the heart.

Question 35

How to diagnose asthma?

Answer 35

Methacoline challenge

Question 36

Metaproterenol

Answer 36

**Short-acting Beta 2 selective agonist** To treat long term COPD, asthma, and acute bronchospasm. Less selective than albuterol or terbutaline, more prone to cause cardiac stimulation.

Question 37

What drug has fewer side effects than albuterol and is an R-enantiomer of Albuterol?

Answer 37

**Levalbuterol** Like Albuterol, is a short-acting beta 2 selective agonist

Question 38

Pirbuterol

Answer 38

**Short acting beta 2 selective agonist** Menos potente que albuterol pero más selectivo a los pulmones

Question 39

What is the difference between Salmeterol and formoterol? (Both are long acting beta 2 selective agonist)

Answer 39

Are agents of choice for nocturnal asthma but Salmeterol last more than 12 hours and take 30 minutes to see the effect and Formeterol last 12 hours but less time to see the effect. Arformeterol is only for treating COPD not asthma.

Question 40

What three drugs are very long acting beta 2 selective agonist?

Answer 40

Indacaterol, Olodaterol, and Vilanterol.

Question 41

What are two Beta 3 selective agonist drugs?

Answer 41

Mirabegron and Vibegron. Evita que vaya al baño.