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Term 3: Pharmacology > Adrenergic Drugs > Flashcards

Adrenergic Drugs Flashcards

1
Q

What neurotransmitters are catecholamines?

A
  • Dopamine
  • Norepinephrine
  • Epinephrine
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2
Q

What are drugs that are directly acting adrenergic drugs?

A

-they are drugs/neurotransmitters that produce responses by interacting with the adrenoreceptors on target cells (alpha or beta)

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3
Q

What are drugs that indirectly acting adrenergic drugs?

A

-Drugs that cause the release of norepinephrine

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4
Q

What kind of receptors are adrenergic receptors?

A

-G protein coupled receptors

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5
Q

What adrenergic receptors does Isoproterenol work on?

A

-B 1, 2, & 3

**only Beta receptors

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6
Q

Does dopamine act on adrenergic receptors?

A
  • Yes, only at high concentrations
  • B1 first, then a1
  • not B2
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7
Q

What happens as the group on the amine of a catecholamine gets larger?

A

That catecholamine has a higher affinity for beta receptors and a lower affinity for alpha receptors

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8
Q

Local anesthetics contain epinephrine.
What receptors are the target?
Why include epinephrine?

A

-alpha 1 receptors

to achieve local vasoconstriction, which keeps the anesthetic locally for a longer duration

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9
Q

What vascular receptors does epinephrine activate at low vs high doses?

A

Low dose:
-B2 receptors = vasodilation

High dose:
-a1 receptors = vasoconstriction

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10
Q

What is the effect of Isoproterenol on mean arterial pressure? Why?

A

-decrease slightly

  • Because it will stimulate B receptors in heart which will strongly increase cardiac force and rate = slightly increased systolic pressure
  • however, lots of vasodilation, causing diastolic pressure to drop a lot, so MAP will drop a bit
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11
Q

A patient upon arrival at Ben Taub emergency room with very high blood pressure 220 / 160. He was treated with clonidine.
Clonidine is an emergency anti-hypertensive.

What is the effect of clonidine (alpha-2 agonist) on release of norepinephrine from
adrenergic nerve terminals?

A. Increase

B. Decrease

A

B. Decrease

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12
Q

Describe adrenergic presynaptic autoreceptors.

A
  • Mostly a2

- NE release will stimulate post synaptic cell, but also activate a2 autoreceptor, thus decreasing vesicular release

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13
Q

What receptors does norepinephrine work on?

A

B1 & alphas

**NOT B2

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14
Q

What receptors does epinephrine work on?

A

All alpha and beta receptors

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15
Q

List Isoproterenol, Norepinephrine, and epinephrine in order of increasing size of their amine group.

A

Norepinephrine –> Epinephrine –> Isoproterenol

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16
Q

What is the effect of epinephrine on the immune system?

A. Up regulates immune system
B. Down regulates immune system

A

B. Down regulates immune system

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17
Q

Cardiovascular effects of dopamine are due to:

A

1) agonist at dopamine receptors
2) releasing more NE from nerve terminals
3) agonist at B1 and a1 receptors (at higher conc.)

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18
Q

What is the cardiovascular effect of low dose dopamine?

A

Vasodilation in renal, mesenteric, coronary, and cerebral vascular beds

**only acting on D1 receptors

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19
Q

What are the uses of high doses of dopamine?

A
  • preserve renal blood flow
  • protect vital organs
  • treat cardiogenic shock
  • Increased force of heart contraction

**acts on D1, B1, and a1 receptors

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20
Q

Why is it good that moderate doses of dopamine will increase heart contractility much more than heart rate?

A

-oxygen demand on the heart does not increase significantly

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21
Q

Where is epinephrine made?

A

Adrenal medulla

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22
Q

Which receptor does Phenylephrine act on? Is it an agonist or antagonist?

A

a1 agonist

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23
Q

Which receptor does Clonidine act on? Is it an agonist or antagonist?

A

a2 agonist

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24
Q

Which receptor does Dobutamine act on? Is it an agonist or antagonist?

A

B1 agonist

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25
Q

Which receptor does albuterol act on? Is it an agonist or antagonist?

A

B2 agonist

*fast acting

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26
Q

Which receptor does salmeterol act on? Is it an agonist or antagonist?

A

B2 agonist

*long acting

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27
Q

Which receptor does Ritodrine act on? Is it an agonist or antagonist?

A

B2 agonist

28
Q

You have a trauma patient and your goal is to improve blood flow to kidneys with out increasing work load on the heart.

Best drug (via IV drip) will be:

A.  Albuterol (b2 agonist)
B.  Low dose Dopamine (Intropin)
C.  Epinephrine (Adrenalin)
D.  Dobutamine (b1 agonist)
E.  Norepinephrine (Levophed)
A

B. Low dose Dopamine (Intropin)

29
Q

When is Phenylephrine used?

A
  • during surgery to raise BP
  • Nasal decongestant

(a1 agonist)

30
Q

When is clonidine used?

A
  • reduces sympathetic outflow from CNS
  • emergency antihypertensive, used in emergency only

(a2 agonist)

31
Q

What is a-methyldopa used for?

A
  • anti-hypertensive in pregnant women
  • prodrug

(a2 agonist)

32
Q

What is priapism and what is its treatment?

A
  • medical condition in which the erect penis does not return to its flaccid state
  • inject cavernosum with Phenylephrine (a1 agonist)
33
Q

When is Dobutamine used?

A

-cardiogenic and septic shock to increase cardiac output

B1 specific agonist

34
Q

When is Ritodrine used?

A

-relaxes uterus, prevents premature deliveries

B2 selective agonist

35
Q

Which one of the following drugs is used for
Cardiac stress test?

A.  Dobutamine
B.   Low dose dopamine
C.   Clonidine
D.   Phenylephrine
E.  Methamphetamine
A

A. Dobutamine

36
Q

What is Ephedrine used for? And what is its MoA?

A
  • nasal decongestant
  • raise blood pressure during surgery

-a and B indirect agonist

37
Q

Priapism is erections lasting for hours.
Pharmacological treatment is:

A.  Albuterol
B.  Clonidine
C.  Dobutamine
D.  Phenylephrine
E.  Amphetamine
A

D. Phenylephrine

38
Q

A. Which of the following is a bronchodilator?
B. Which one is a choice antihypertensive in pregnant women?
C. Which of the following raises BP by vasoconstriction?

A.  Dobutamine
B.  Clonidine
C.  Phenylephrine
D.  Salmeterol
E.  Alpha-methyldopa
A

A= D. Salmeterol

39
Q

What receptors does dopamine act on at low, moderate, and high doses?

A

Low: D1

Moderate: D1 & B1

High: D1, B1, & a1

40
Q

Which receptor does Formoterol act on? Is it an agonist or antagonist?

A

B2 agonist

*long acting

41
Q

What is epinephrine’s effect on Mast cells? What receptor?

A
  • inhibits degranulation (think anaphylaxis)

- B2 agonist

42
Q

What is the first line treatment for Parkinson’s disease?

A.  SSRIs
B.  L-Dopa
C.  Dopamine blockers
D.  Serotonin blockers
E.  Acetylcholinesterase inhibitors
F.  Methylphenidate (Ritalin)
A

B. L-Dopa

43
Q

Why don’t we use selective B2 blockers?

A

-you will suffocate your patient

44
Q

What is a Sympathomimetic?

A

-a drug that mimics nor/epinephrine

45
Q

What type of side effects do SSRIs have?

A

-Adrenergic sid1e effects

46
Q

What are B1 blockers used to treat?

A
  • Hypertension
  • CHF
  • Post-MI
  • Angina pain
  • Glaucoma
  • migraine, hyperthyroidism, performance anxiety
47
Q

What is the suffix of all beta blockers?

A

-olol

48
Q

Why don’t we stop B blocker use abruptly?

A
  • the # of B receptors will have been upregulated

- stopping immediately can cause arrhythmias

49
Q

What is Labetalol?

A
  • Used to treat Hypertension

- Mixed alpha 1 and Beta blocker

50
Q

What is Carvedilol?

A
  • Used to treat Hypertension

- Mixed alpha 1 and Beta blocker

51
Q

Why is a thiazide sometimes used in conjunction with a B blocker?

A
  • to downregulate the RAAAs system

- Decrease plasma volume

52
Q

What are cardio-selective B blockers?

A
  • selective to B1
  • less bronchoconstriction
  • More expensive
53
Q

How can a partial B agonist treat hypertension?

A
  • competing with full agonist epinephrine for B receptors

- wont activated as much as epinephrine, so net effect is decreased cardiac output

54
Q

Out of the following receptors, which receptors predominate (abundant) on smooth muscle around veins?

A.  Beta 2
B.  Alpha 1
C.  Alpha 2
D.  Beta 1
E.  Beta 3
A

B. Alpha 1

55
Q

What are alpha (1) blockers used to treat?

A
  • antihypertensive
  • treat BPH

**Alpha 2 blockers have little clinical use

56
Q 
Vascular tone (peripheral vascular resistance)
is maintained by activation of :
A.  Beta-1 receptors
B.  Nicotinic receptors
C.  Beta-2 receptors
D.  Alpha-1 receptors
E.  Alpha-2 receptors
A

D. Alpha-1 receptors

57
Q

What is Tamsulosin?

A

=Flomax

  • Alpha 1 blocker
  • treats BPH
58
Q

What is Phenoxybenzamine?

A

-irreversible alpha 1 blocker

-used to treat pheochromocytoma
(epinephrine secreting adrenal medulla tumor)

-antihypertensive used during surgery to remove tumor

59
Q

What is Yohimbine

A
  • Alpha 2 blocker
  • Might treat erectile dysfunction? probs not, must be locally injected.
  • Adverse effect: increase HR and BP
60
Q

What is Terazosin?

A
  • Alpha 1 bocker

- Treats hypertension

61
Q

What do parasympathetic presynaptic alpha 2 receptors do?

A

-inhibit release of NT

62
Q

What are the most significant adverse effects of alpha 1 blockers?

A
  • postural/orthostatic hypotension

- reflex tachycardia

63
Q

Why are combined a and B blockers useful? (labetalol, carvedilol)

A

a1 blocker dilates blood vessels; results in reflex tachycardia;
b1-blocker prevents increase in heart rate.
Drugs with multiple activities are some times very useful.

Bottom line: Decrease PVR and Blood Pressure, No change in Heart Rate & Cardiac Output

64
Q

A patient was given a bolus dose of terazosin (Hytrin).

Question A. Terazosin belongs to what class of drug?

A.  Alpha-1 agonist
B.  Alpha-1 blocker
C.  Beta blocker
D.  Alpha-2 blocker
E.  Beta-1 agonist
A

B. Alpha-1 blocker

***ZOSIN

65
Q

A patient on spinal anesthesia goes into severe hypotension.
The drug of choice to correct this hypotension is:

A.  Propranolol
B.  Isoproterenol
C.  Phenylephrine
D.  Clonidine
E.  Albuterol
A

C. Phenylephrine

66
Q

What is the drug of choice to treat BPH (Benign Prostatic Hypertrophy) resulting in urinary retention?

A.  Tamsulosin
B.  Phenylephrine
C.  Nitroglycerin
D.  Bethanechol
E.  Propranolol
F.  Terazosin
A

A. Tamsulosin

67
Q

What causes schizophrenia?

A

-high dopamine (D2) in the limbic system

Term 3: Pharmacology (15 decks)

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