Adrenergic Drugs Flashcards by Sarah Gillen

Phenylephrine

Alpha 1 agonist

Treats hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)

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Clonidine

Alpha 2 agonist

Used for hypertensive urgency (limited situations), ADHD, tourette syndrome

Adverse effects include CNS depression, bradycardia, hypotension, respiratory depression, miosis

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Norepinephrine

Mixed agonist (a1=a2, B1)

Treats hypotension and septic shock

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Epinephrine

Mixed agonist (a1=a2, B1=B2) — first aid says beta > alpha

Treats anaphylaxis, asthma, open-angle glaucoma; alpha effects predominate at high doses

Significantly stronger effect at beta-2 receptor than NE

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Dobutamine

Beta 1 agonist

Treats heart failure (inotropic > chronotropic), used in cardiac stress testing

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Isoproterenol

Beta 1 = Beta 2 agonist

Used for electrophysiologic evaluation of tachyarrhythmias; can worsen ischemia

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Terbutaline

Beta 2 = Beta 1 agonist

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Albuterol

Beta 2 agonist

Acute asthma or COPD

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Dopamine

D1=D2 agonist

Treats unstable bradycardia, heart failure, shock

Inotropic and chronotropic effects at lower doses due to beta effects; vasoconstriction at high doses due to alpha effects

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Fenoldopam

D1 agonist

Treats postoperative HTN, hypertensive crisis

Acts as a vasodilator, promotes natriuresis

Can cause hypotension and tachycardia

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Indirect adrenomimmetic(s) that inhibit uptake of DA and NE

Cocaine

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Indirect adrenomimmetic(s) that inhibit MAO

Selegiline

Phenelzine

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Indirect adrenomimmetic(s) that reverse NE and DA uptake and increase their release

Amphetamines
Methylphenidate
Tyramine (byproduct of tyrosine metabolism)

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Indirect adrenomimmetic(s) that acts as a releasing agent and direct agonist

Ephedrine

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Phentolamine

Non-selective (alpha 1 and alpha 2) antagonist (reversible)

Given to patients on MAO inhibitors who eat tyramine-containing foods

Adverse effects include orthostatic hypotension, reflex tachycardia

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Phenoxybenazmine

Non-selective (alpha 1 and alpha 2) antagonist (irreversible)

Used for pheochromocytoma (used preop) to prevent catecholamine (hypertensive) crisis

Adverse effects include orthostatic hypotension, reflex tachycardia

Alpha 1 selective anti-adrenergic drugs

Prazosin
Terazosin
Tamsulosin
Doxazosin
Alfuzosin
Silodosin

Used to tx urinary sxs of BPH; PTSD, HTN

Adverse effects include 1st dose orthostatic hypotension, dizziness, headache

Labetolol

Mixed blocker - beta and alpha 1 antagonist

Carvedilol

Mixed blocker - beta and alpha 1 antagonist

Beta 1 and beta 2 blockers (mixed)

Propranalol
Pindolol
Nadolol
Penbutolol

Beta 1 selective beta blockers

Metoprolol
Betaxolol
Acebutolol
Atenolol

Indirect acting anti-adrenergics — NE-release inhibitor

Guanethidine

Indirect acting anti-adrenergics — inhibitor of tyrosine hydroxylase

Metyrosine

Clinical uses for amphetamines

Narcolepsy
Obesity
ADHD

Clinical use for cocaine

Causes vasoconstriction and local anesthesia

why should you never give beta blockers to someone suspected of cocaine intoxication

Because that could lead to unopposed alpha-1 activation and extreme HTN

Clinical use for ephedrine

Nasal decongestion Urinary incontinence Hypotension

Applications for beta blockers

Angina pectoris — decreases HR and contractility, resulting in decreased O2 consumption MI — decreases mortality SVT (metoprolol) — decreases AV conduction velocity HTN — decreases CO, decreases renin secretion (d/t B1 receptor blockade on JG cells) HF — decreases mortality Glaucoma — decreases secretion of aqueous humor Variceal bleeding — decreases hepatic venous pressure gradient and portal HTN

Adverse effects of beta blockers

ED, bradycardia, AV block, HF, seizures, sedation, sleep alteration, dyslipidemia, asthma/COPD exacerbations