Adrenergic Drugs Flashcards
Epinephrine
alpha1,2, beta1,2 agonist
- increases HR, increases BP
- vasoconstriction decreases spread of blood anesthetics and blood loss in surgeries
- administered IM or SC< not oral (degraded in stomach by COMT and liver by MAO)
- IV only in emergencies. can cause arrhythmia (inc HR) or cerebral hemmorages (inc BP)
Norepinephrine
alpha1,2, Beta1 agonist
-increases BP, decreases HR (baroreceptor reflex)
ephedrine
alpha1,2,beta1,2 agonist
- increases HF, decreases TPR
- induces NE release (to act as an indirect agonist)
phenylephrine
alpha1 agonist; used for nasal decongestion
clonidine
alpha2 agonist: decreases BP
- calms sympathetic outflow
- treats HTN
bromidine
alpha2 agonist: treats glaucoma (decreased aq humor production, decreases intraocular pressure)
isoproterenol
beta1,2 agonist
- decrease BP, increases HR
- broken down by COMT
MAST (Metaproterenol, Albuterol, Salmeterol, Terutaline
Beta2 agonist (bronchodilatory effects)
- treats asthma, COPD, premature labor (decreased contractions)
- no real heart effects
Metaproterenol
B2 agonist
Albuterol
B2 agonist
Salmeterol
B2 agonist
Terutaline
B2 agonist
tyramine
indirect adrenergic agonist (uses NET to get into presynaptic nerve in place of NE. gets into vesicles and forces NE out. DBH durns tyramine into octopamine, which acts as a false transmitter
- exhibits tachyphylaxis
- metabolized by MAO
- tyramine from wine and cheese + MAOI –> hypertensive crisis from huge NE release
amphetamine:
increases NE secretion by uptake into vesicles, exhibits tachyphylaxis
metaraminol
alpha1,2 agonist
- releases NE, can be a false transmitter
- reduces local blood loss and spread of anesthetics during surgery like Epi
cocaine and methylphenidate
block NET, NE stays in terminal longer
phenoxybenzamine
irreversible alpha1,2 antagonist
- treats pheochromocytoma
- SFX: reflex tachycardia due to decreased TPR, orthostatic hypotension due to lack of vasoconstriction)
- coadminister with Epi: Epi reversal: Epi only acts at Beta receptors, decrease BP
phentolamine
competitive (reversible) alpha1,2 blocker
- releases histamine
- SFX: reflex tachycardia due to decreased TPR, orthostatic hypotension due to lack of vasoconstriction)
Prazosin
alpha1blocker
- decrease BP, no change in HR
- SFX: orthostatic hypotension
- treats HTN
Yohimbine:
reversible alpha2 blocker
-opposite of clonidine: increase BP, increases HR
1st generation of Beta blockers
non-selective, lipid soluble, short half life, metabolized by liver, cause bronchoconstriction by B2 inhibition (bad for COPD, asthma)
- decreases HR, HF, BP
- treats: HTN, CHF, arrhythmia, chest pain
propranolol
1st generation Beta blocker:
non-selective, lipid soluble, short half life, metabolized by liver, cause bronchoconstriction by B2 inhibition (bad for COPD, asthma)
-decreases HR, HF, BP
-treats: HTN, CHF, arrhythmia, chest pain
Timolol
1st generation Beta blocker
-short acting
non-selective, lipid soluble, short half life, metabolized by liver, cause bronchoconstriction by B2 inhibition (bad for COPD, asthma)
-decreases HR, HF, BP
-treats: HTN, CHF, arrhythmia, chest pain
Pindolol
1st generation Beta blocker
-partial agonist
non-selective, lipid soluble, short half life, metabolized by liver, cause bronchoconstriction by B2 inhibition (bad for COPD, asthma)
-decreases HR, HF, BP
-treats: HTN, CHF, arrhythmia, chest pain
2nd generation of beta blockers
beta1 antagonists; better for asthmatics
- decreases HR, HF, BP
- treats: HTN, CHF, arrhythmia, chest pain
atenolol
long acting beta1 antagonist
- decreases HR, HF, BP
- treats: HTN, CHF, arrhythmia, chest pain
acebutalol
beta1 antagonist
- partial agonist
- decreases HR, HF, BP
- treats: HTN, CHF, arrhythmia, chest pain
metoprolol
beta1 antagonist; better for asthmatics
- decreases HR, HF, BP
- treats: HTN, CHF, arrhythmia, chest pain
carvediol
alpha1 and beta1 antagonist
-vasodilates, treats HTN, CHF, arrhythmia, chest pain, etc
celiprolol
beta1 antagonist, partial beta2 agonist
- beta blocker effects
- beta 2 agonist –> vasodilation
nebivolol
beta1 antagonist, releases NO from endothelial cells to cause vasodilation
metyrosine
indirect adrenergic antagonist: inhibits tyrosine hydroxylase (RLS)
- blocks epi/NE synth
- treats pheochromocytoma
methylodpa
indirect adrenergic antagonist: competes with dopa for dopa decarboxylase (DDC)
- blocks NE synth, forming methyl NE (a false neurotransmitter and alpha 2 agonist- good for HTN!)
- sympatholytic
reserpine
indirect adrenergic antagonist: prevents uptaken NE from being put into vesicles (VMAT-2) , so it is instead degraded by MAO.
- sympatholytic
- depletes NE stores in 24 hr, takes 1-2 weeks to replenish
