Adrenergic Drugs Flashcards by Elizabeth Mazza

direct acting alpha agonists

Penylephrine, Clonidine

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mixed alpha and beta agonists

NE, Epi

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beta agonists

Dobutamine, Isoproterenol, Albuterol

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dopamine agonist

Inotropin

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What indirect adrenomimetic inhibits the re-uptake of DA and NE?

Cocaine

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What indirect adrenomimetics inhibit MAO?

Selegiline, Phenelzine

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What indirect adrenomimetics reverse NE and DA uptake, increasing their release?

Amphetamines, Methyphenidate, Tyramine

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What indirect adrenomimetic is a releasing agent and a direct adrenergic receptor agonist?

Ephedrine

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non-selective (a1 and a2) receptor antagonists

Phentolamine, Phenoxybenzamine

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a1 receptor selective antagonists

Prazosin, Tamsulosin, Doxazosin

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mixed blockers (b and 1a antagonists)

labetalol, carvedilol

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b1 and b2 adrenoreceptor blockers

propranolol, pindolol, nadolol

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b1 selective blockers

metoprolol, betaxolol, acebutolol, atenolol

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NE release inhibitor

guanethidine

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tyrosine hydroxylase inhibitor

metyrosine

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what do adrenergic drugs modulate?

they control the function of the SNS

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What does Gq pathway stimulation lead to?

increase in IP3, DAG

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What does Gi pathway stimulation lead to?

decrease in cAMP

What does Gs pathway stimulation lead to?

increase in cAMP

What receptor types stimulate Gq?

alpha 1A, 1B, 1D

What receptor types stimulates Gi?

alpha 2A, 2B, 2C

- D2, D3, D4

What receptor types Gs?

beta 1, 2, 3

- D1, D5

What are the effects of Epi on cardiac function?

positive inotropy
increases HR
increases conduction velocity at AV node

What are the effects of Epi on vascular tone?

increases systolic BP

- may decrease diastolic BP and total peripheral vascular resistance (MAP unchanged)

What are the effects of Epi on skeletal muscle?

- relaxes bronchial muscle | - decreases bronchial secretion and congestion within bronchial mucosa

Other effects of Epi?

- causes muscle tremor, increases potassium uptake by skeletal muscle (b2) - enhances liver glycogenolysis and gluconeogenesis (b2) - increases FFA in blood - increases renin release (b1)

What are the effects of NE on cardiac?

- reduces HR - potent vasoconstrictor - increases peripheral vascular resistance and BP

What are the clinical uses of adrenergic agonists on CV conditions?

- to increase BP - heart failure - hypertension (alpha-2 agonists) - emergency therapy for complete AV block and cardiac arrest

What are the clinical uses of adrenergic agonists on CNS conditions?

- narcolepsy (amphetamines, methylphenidate) - ADHD (methylphenidate) - obesity (ephedrine, amphetamines)

What are the other clinical uses of adrenergic agonists?

- bronchial asthma - anaphylaxis - ophthalmic conditions (glaucoma, retinal exam) - GI: stress urinary incontinence

What are the adverse effects of adrenergic agonists of CV system?

- increase BP - increase cardiac work - sinus tachycardia, serious ventricular arrhythmias

What are the adverse effects of adrenergic agonists on CNS?

- insomnia - lack of appetite - anxiety, restlessness - psychoses - convulsions, hemorrhagic stroke

What are the clinical uses of alpha antagonists?

- pheocromocytoma - chronic (essential hypertension) - erectile dysfunction - BPH

What are the adverse effects of alpha antagonists?

- postural HTN - tachycardia - fluid and salt retention - impaired ejaculation - nasal stuffiness

What are the pharmacodynamics of beta-blockers on CV system?

- negative inotropy - negative chronotropy - slow AV node conduction

What are the pharmacodynamics of beta-blockers on on blood vessels?

- initial rise in peripheral resistance | - chronic use decreases PVR

What are the pharmacodynamics of beta-blockers on RAS?

inhibit renin release

What are the pharmacodynamics of beta-blockers on respiratory system?

increase airway resistance

What are the pharmacodynamics of beta-blockers on the eye?

reduce production of acqueous humor -> reduce intraocular pressure

What are the metabolic effects of beta-blockers?

- inhibit lipolysis - increase VLDL, decrease HDL, reduce HDL/LDL ratio - inhibit glycogenolysis and gluconeogenesis

What are the clinical uses of beta-blockers?

- HTN - angina pectoris - MI - cardiac arrhythmias - heart failure - glaucoma - hyperthyroidism

What are the adverse effects of beta-blockers on CNS?

- sedation - sleep disturbance - depression

What are the adverse effects of beta-blockers on respiratory system?

- increase airway resistance | - trigger bronchospasm/asthma attack

What are the adverse effects of beta-blockers on CV system?

- decrease HR, contractility and excitability - exacerbation of peripheral vascular disease NOTE: may also trigger hypoglycemic episodes