Adrenergic Drugs Flashcards
Norepinephrine: binding, physiologic effects, and indications
binding: b1, a1 & a2
effects: increase in systolic pressure (b1) and decrease in HR (baroreceptor reflex)
Indications: Shock
Norepinephrine: toxicity and contraindications
toxicity: Ischemia
contraindications: Pre-existing vasoconstriction or ischemia
Epinephrine: binding, physiologic effects, and indications
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
Epinephrine: toxicity
Arrhythmias
Dopamine: binding, physiologic effects, and indications
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
Dopamine: toxicity
Low BP (low dose), Ischemia (high dose)
Isoproterenol: binding, effects, indications
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
isoproterenol: toxicity and contraindications
toxicity: Tachyarrhymias
contraindications: angina w/ arrhythmias
Dopbutamine binding, effects, indications
binding: beta 1 selective agonist
effect: increase CO
indications: short term for congestive heart failure or cardiogenic shock
Dopbutamine toxicity
hypotension ( activates b2 if too high of dose)
Tertbutaline/ Albuterol Type, effects, indications
type: Beta 2 agonist
effects: bronchodilation, uterine relaxation
indications: bronchospasm, COPD
Tertbutaline/ Albuterol toxicity
tachycardia (b1), muscle tremor (b2..activating Ach release), Tolerance
Phenylephrine type, effects, indications
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
Phenylephrine toxicity
hypertension
Clonidine type, effect, indications
type: a2 agonist
effects: acute increase in BP (a2), then reduced bp (central effect from inhibition of sympathetic sys)
indications: hypertension from symp activation
Clonidine Toxicity
dry mouth (saliva from sympathetic), hypertensive crisis
Indirect Acting sympathomimetics list
either work as reuptake blockers or releasing agents amphetamine methamphetamine methylphenidate ephedrine pseudoephedrine tyramine
indirect acting sympathomimetics: effects, indication
similar to NE
cardio: increase in diastolic BP (a1 and 2), increase in systolic (b1),
CNS stimulant
Anorexia
Indications: ADD, narcolepsy, nasal decongestion
Indirect acting sympathomimetics: toxicity, contraindications
Contraindications: MAO inhibitors
Toxicity: Tachycardia
Nonselective BB list
propranolol, nadolol, Timolol
Nonselective BB effect and indications
decreased HR, contractility, renenin, sympathetic activation
see inhibition of aqueous humor
indications: hypertension, angina, glaucoma, heart failure
Nonselective BB toxicicy and contraindications
toxicity: bronschospasm, masks symptoms of hypoglycemia, bradycardia.
Contra: asthma, sinus bradycardia, 2/3 degree heart block, cardiogenic shock
B1 blocker list
Metoprolol, atenolol, esmolol
B1 effects and indications
decrease, HR, decreased contractility, renin and sympathy activation
indications: hypertension, angina, arrhthmia
B1 toxicity and contraindications
tox: hypotension, bradycardia
contra: sinus bradycardia, 2/3 deg heart bock, cardiogenic shock
Pindolol type, effect, indications
type: partial agonist BB
effect: same as other BBs, decreasing BP, contttractility, renin, sympathetic activation
indications: hypertension
Pindolol toxicity and contraindications
toxicity: hypotension
contraindications: sinus bradycardia, 2/3 degree heart block, cardiogenic shock
Phentolamine type, effects, indications
type: reversible a blocker
effects: Decrease BP, increased chronotrophy and ionotropy
indications: hypertension w/ pheochromocytoma, vasoconstrictor induced extravasation
Phentolamine Toxicity
Prolonged hypotension, refelex tachycardia
Phenoxybenzamine type, effects, indications
type: irrreversible a blocker
effects: Decrease BP, increased chronotrophy and ionotropy
indications: hypertension w/ pheochromocytoma, vasoconstrictor induced extravasation
Phenoxybenzamine toxicity
Prolonged hypotension, refelex tachycardia
