adrenergic drug Flashcards
a1
radial muscle of iris
b1
heart, kidney
a2
smooth muscle, presynaptic
b2
bronchial smooth muscle, uterine wall
Epinephrin
- agonist on all receptor
- direct acting
- prolong anaesth.
- cardiac arrest
- anaphylactic
- shock
NE
- agonist on a1, a2, b1 receptor
- hypotensive pt
isoproterenol
- agonist on B1, B2
- pt w heart block
dobutamine
- agonist on B1
- acute MI pt
salbutamol, terbutaline, salmeterol, formoterol
- agonist B2
- bronchiole dilate
- uterine relaxant
ritodrine, isoxsuprine
- agonist B2
- uterine relaxant
Phenylephrine, methoxamine
- agonist a1
- nasal decongest
- mydriatic
oxymetazoline
- direct agonist a1, a2
- nasal decongest
cocaine
- indirect acting
- block reuptake of NE
- mechanism: block NaCl dependent NE transporter -> no transporter reuptake NE -> NE accumulate -> enhanced sympathetic actvt & longer duration of action
ephedrine
-mixed acting agonist
- act on a1,a2,b1,b2 + increase NE release
- thru IV
- treat hypotension due to spinal anesthesia
Dopamine
- mixed acting agonist
- receptor a1,a2,b1,d1 + increase NE
- cardiogenic shock
mephentermine
- a1 + Increase NE
- hypotensive state
adverse effect NE/EPI
tolong raja pergi hantar roti telur
- tachycardia
- restlessnes
- palpitation
- headache
- raise in BP
- tremors
phenoxybenzamine
- irreversible, non selective, a-blockers
- a1
- reduce: vasoconstriction, peripheral resistance, BP
- increase: NE, HR
- not used as maintenance therapy for hypotension
- site of administration: orally, slow IV
used for pheochromocytoma (benign tumor and adrenal gland)
prazosin, terazosin, doxazosin, tamsulosin, alfuzosin
- selective, a1 blockers
- 1st dose may produce aggregates orthostatic hypotension (postural/syncopal)
- need to be given during bed time
- side effects: nasal stiffness, tachycardia, impaired ejaculation, impotent
terazosin, doxazosin, alfuzosin
TDA
for hypertension
propranolol, timolol
- 1st gene, non selective, b blockers
- avoid in pt w COPD, asthma
- long duration: reduce aqueous humor in eye
atenolol, acebutolol, bisoprolol, esmolol, metoprolol
- 2nd gene, selective, B blockers
- for pt w chronic heart failure
- hypertensive pt w impaired pulmonary action
labetalol, carvedilol
- 3rd gene (w vasodilatory effect), non selective B blockers
- for hypertensive emergencies
- side effect: postural hypotension, hepatotoxicity (block B1, b2, a)
betaxolol, celiprolol, nebivolol
3rd gene (w vasodilatory effect), selective B blockers B1
- control hypertension + congestive cardiac failure
