Adrenergic Drugs

Question 1

Norepinephrine: binding, physiologic effects, and indications

Answer 1

binding: b1, a1 & a2
effects: increase in systolic pressure (b1) and decrease in HR (baroreceptor reflex)
Indications: Shock

Question 2

Norepinephrine: toxicity and contraindications

Answer 2

toxicity: Ischemia
contraindications: Pre-existing vasoconstriction or ischemia

Question 3

Epinephrine: binding, physiologic effects, and indications

Answer 3

binding: greater affinity for beta receptors
effects (low dose): increased systolic pressure and HR (b1) and decreased diastolic pressure (b2)
effects (high dose): increase in systolic and diastolic pressure (a receptors), increase in HR
additional effects: bronchodilation and decreased bronchial secretions (alpha 1)
Indications: anaphylaxis, cardiac arrest, bronchospasm

Question 4

Epinephrine: toxicity

Answer 4

Arrhythmias

Question 5

Dopamine: binding, physiologic effects, and indications

Answer 5

binds: d1, d2, b1, a1, a2
cardiac- low dose: dereased TPR (d) increased CO (b1)
Cardiac- high dose: increased MAP and TPR (a1 a2)
indications: cardiogenic shock

Question 6

Dopamine: toxicity

Answer 6

Low BP (low dose), Ischemia (high dose)

Question 7

Isoproterenol: binding, effects, indications

Answer 7

binding: non-selective beta agonist
effects: initial increase in CO and systolic bp (b1)… but drop in diastolic (b2) brings down systolic too…also see increase in HR and bronchodilation (b2)
indications: bradycardia/ heart block when TPR high

Question 8

isoproterenol: toxicity and contraindications

Answer 8

toxicity: Tachyarrhymias
contraindications: angina w/ arrhythmias

Question 9

Dopbutamine binding, effects, indications

Answer 9

binding: beta 1 selective agonist
effect: increase CO
indications: short term for congestive heart failure or cardiogenic shock

Question 10

Dopbutamine toxicity

Answer 10

hypotension ( activates b2 if too high of dose)

Question 11

Tertbutaline/ Albuterol Type, effects, indications

Answer 11

type: Beta 2 agonist
effects: bronchodilation, uterine relaxation
indications: bronchospasm, COPD

Question 12

Tertbutaline/ Albuterol toxicity

Answer 12

tachycardia (b1), muscle tremor (b2..activating Ach release), Tolerance

Question 13

Phenylephrine type, effects, indications

Answer 13

type: alpha 1 agonist
effect: increase TPR and map, decrease HR (baroreflex), pupillary dilation, decrease bronchiole and sinus secretions
indications: hypotension during anesthesia, SV tachycardia, Mydriatic agent, nasal congestion

Question 14

Phenylephrine toxicity

Answer 14

hypertension

Question 15

Clonidine type, effect, indications

Answer 15

type: a2 agonist
effects: acute increase in BP (a2), then reduced bp (central effect from inhibition of sympathetic sys)
indications: hypertension from symp activation

Question 16

Clonidine Toxicity

Answer 16

dry mouth (saliva from sympathetic), hypertensive crisis

Question 17

Indirect Acting sympathomimetics list

Answer 17

either work as reuptake blockers or releasing agents
amphetamine
methamphetamine
methylphenidate
ephedrine
pseudoephedrine
tyramine

Question 18

indirect acting sympathomimetics: effects, indication

Answer 18

similar to NE
cardio: increase in diastolic BP (a1 and 2), increase in systolic (b1),
CNS stimulant
Anorexia
Indications: ADD, narcolepsy, nasal decongestion

Question 19

Indirect acting sympathomimetics: toxicity, contraindications

Answer 19

Contraindications: MAO inhibitors
Toxicity: Tachycardia

Question 20

Nonselective BB list

Answer 20

propranolol, nadolol, Timolol

Question 21

Nonselective BB effect and indications

Answer 21

decreased HR, contractility, renenin, sympathetic activation
see inhibition of aqueous humor
indications: hypertension, angina, glaucoma, heart failure

Question 22

Nonselective BB toxicicy and contraindications

Answer 22

toxicity: bronschospasm, masks symptoms of hypoglycemia, bradycardia.
Contra: asthma, sinus bradycardia, 2/3 degree heart block, cardiogenic shock

Question 23

B1 blocker list

Answer 23

Metoprolol, atenolol, esmolol

Question 24

B1 effects and indications

Answer 24

decrease, HR, decreased contractility, renin and sympathy activation
indications: hypertension, angina, arrhthmia

Question 25

B1 toxicity and contraindications

Answer 25

tox: hypotension, bradycardia
contra: sinus bradycardia, 2/3 deg heart bock, cardiogenic shock

Question 26

Pindolol type, effect, indications

Answer 26

type: partial agonist BB
effect: same as other BBs, decreasing BP, contttractility, renin, sympathetic activation
indications: hypertension

Question 27

Pindolol toxicity and contraindications

Answer 27

toxicity: hypotension
contraindications: sinus bradycardia, 2/3 degree heart block, cardiogenic shock

Question 28

Phentolamine type, effects, indications

Answer 28

type: reversible a blocker
effects: Decrease BP, increased chronotrophy and ionotropy
indications: hypertension w/ pheochromocytoma, vasoconstrictor induced extravasation

Question 29

Phentolamine Toxicity

Answer 29

Prolonged hypotension, refelex tachycardia

Question 30

Phenoxybenzamine type, effects, indications

Answer 30

type: irrreversible a blocker
effects: Decrease BP, increased chronotrophy and ionotropy
indications: hypertension w/ pheochromocytoma, vasoconstrictor induced extravasation

Question 31

Phenoxybenzamine toxicity

Answer 31

Prolonged hypotension, refelex tachycardia