Adrenergic Drugs

Question 1

Direct acting - Non-selective

Answer 1

Adrenaline (a1a2b1b2), Noradrenaline (a1a2b1), isoprenaline (b1b2)

Question 2

Direct selective -a1

Answer 2

phenylephrine, methoxamine, oxymetazoline, xylometazoline

Question 3

direct selective a2

Answer 3

clonidine, guanabenz, guanfacine, methyldopa

Question 4

direct selective b1

Answer 4

dopamine, dobutamine, salbutamol

Question 5

direct selective b2

Answer 5

salbutamol, salmeterol, terbutaline, formoterol, fenoterol, metaproterenol, clebuterol

Question 6

Mixed acting

Answer 6

a1a2b1b2 releasing: ephedrine

Question 7

Indirect acting releasing agents

Answer 7

Amphetamine, tyramine

Question 8

Indirect acting uptake inhibitor

Answer 8

cocaine

Question 9

Indirect acting MAO/ COMT inhibitor

Answer 9

pargyline, entacapone

Question 10

Noradrenaline action

Answer 10

equipotent to Epinephrine (adr) on B1, less potent on alpha, little effect on B2

Question 11

Noradrenaline pharmacodynamics

Answer 11

similar to epinephrine, especially on arterioles and small veins VC and TPR increase, increase SBP and DBP, compensatory vagal reflex slows heart rate, cardiac output decrease, CBF increase

Question 12

Noradrenaline indications

Answer 12

serious acute hypotensive (vascular collapse, systolic <50

Question 13

Noradrenaline adverse effects

Answer 13

anorexia, palpitations, headaches, HBP

Question 14

Dopamine mechanism

Answer 14

direct catecholamine, acts on adrenergic and dopaminergic D1, D2, D3

Question 15

Dopamine pharmacodynamics

Answer 15

Positive inotropism (activates B1, increased myocardial contractility, increased cardiac output), increase SBP little effect DBP, low doses enhance GFR, RBF, increase plasma Cl

Question 16

Dopamine indications

Answer 16

shock (in patients with oliguria, low diuresis - cariogenic, traumatic, hypovolemic) , acute pulmonary edema, chronic refractory congestive heart failure

Question 17

Dopamine SE

Answer 17

tachycardia, arrhythmia, angina

Question 18

Dobutamine mechanism

Answer 18

direct B1 agonist, no dopaminergic receptors

Question 19

Dobutamine pharmacodynamics

Answer 19

strong positive inotropic, limited increase in HR (medium chronotropic), increase CO and CBF

Question 20

Dobutamine indications

Answer 20

congestive HF (after MI), chronic congestive HF

Question 21

Dobutamine SE

Answer 21

arrhythmia (ventricular ectopy), increased ventricular rate in AFib, angina

Question 22

Ephedrine mechanism

Answer 22

mixed, indirectly by releasing NE in sympathetic ends, directly by acting on a and B

Question 23

Ephedrine pharmacodynamics

Answer 23

Similar to epinephrine & NE, lasts longer and not destroyed by MAO, high SBP and DBP by cardiac stimulation and VC

Question 24

Ephedrine indications

Answer 24

hypotension, rhinitis (decongestant), bronchial asthma (not often due to tachyphylaxis)

Question 25

Sympatholytic Alpha blockers - Synthetic Nonselective (a1 and a2)

Answer 25

phentolamine, phenoxybenzamine, tolazoline

Question 26

Symp. Alpha blockers - Synthetic selective (a1)

Answer 26

doxazosin, prazosin, terazosin

Question 27

Symp Alpha blockers Natural ergot alkaloids ANTIMIGRAIN

Answer 27

ergotamine, dihydroergotamine, methysergide

Question 28

Symp Alpha blockers Natural ergot alkaloids ANTIISCHEMIA

Answer 28

ergotoxine, dihydroergotoxine

Question 29

Symp Alpha blockers Natural ergot alkaloids UTERINE CONTRACTION STIMULANTS

Answer 29

nicergoline, ergometrine, methylergometrine

Question 30

Ergotamine mechanisms

Answer 30

glomerular a blocker after high doses; a adrenergic drug after low doses (therapeutic)

Question 31

Ergotamine pharmacodynamics

Answer 31

antimigraine, weak increase in uterine tone

Question 32

Ergotamine therapeutic uses

Answer 32

Migraine, vascular cause headaches

Question 33

Ergotoxine pharmacodynamics

Answer 33

VD by eliminating spasms, increases CBF, retinal BF, muscular BF, if sympathetic tone is increased in VW: bradycardia

Question 34

Ergotoxine indications

Answer 34

Chronic treatment in : cerebral atherosclerosis, ischemic cerebral, retinal circulation, vestibular; Raynaud, obliterating arteriopathies (low efficiency)

Question 35

Ergometrine pharmacodynamics

Answer 35

Stimulates tone, frequency, amplitude of uterine contraction, hemostatic uterine action closing venous sinuses in myometrium

Question 36

Ergometrine indications

Answer 36

prophylaxis and treatment of postpartum and post- abortum bleedings, lochie retention