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Pharmacology > adrenergic drugs (agonists and antagonists) > Flashcards

adrenergic drugs (agonists and antagonists) Flashcards

1
Q

Direct sympathomimetics - drugs and mechanism of action

A
  1. albuterol - β2 more than β1
  2. salmoterol - β2 more than β1
  3. dobutamine - β1 more than β2, α
  4. dopamine - D1=D2 more than β, and β more than α
  5. epinephrine - β more than α (but α predominate at high doses)
  6. fenodlopam - D1
  7. isoproterenol - β1 = β2
  8. midodrine - a1
  9. norepinephrine - a1 more than α2 more than β1
  10. phenylephrine - α1 more than α2
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2
Q

Albuterol, slameterol - mechanism of action and clinical use

A

β2 more than β1
albuterol for acute asthma or COPD
salmeterol for long term asthma or COPD control

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3
Q

dobutamine - mechanism of action and clinical use

A

β1 more than β2, α

  1. HF (inotropic more than chronotropic)
  2. cardiac stress testing
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4
Q

epinephrine - mechanism of action and clinical use

A

β more than α (but α predominate at high doses)

1. anaphylaxis 2. asthma 3. open-angle glaucoma

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5
Q

dopamine - mechanism of action and clinical use

A

D1=D2 more than β, and β more than α
1. unstable bradycardia
2. HF 3. shock
β predominates at lower doses, α at higher

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6
Q

fenoldopam - mechanism of action and clinical use

A

D1 1. postoperative hypertension 2. hypertensive crisis 3. vasodilatero (coronary, peripheral, renal, splachinc) 4. promotes natriureis

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7
Q

fenoldopam - side effects

A

can cause hypotension and tachycardia

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8
Q

isoproterenol - mechanism of action and clinical use

A

β1=β2

electrophysiologuc evaluation of tachyarrhythimas

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9
Q

isoproterenol - side effects

A

can worsen ischemia

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10
Q

Milodrine - mechanism of action and clinical use

A

α1

autonomic insifficiency and postural hypotension

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11
Q

Milodrine - side effects

A

may exacerbate supine hypertension

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12
Q

norepinephrine - mechanism of action and clinical use

A

a1 more than α2 more than β1
hypotension
spetic shock

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13
Q

phenylephrine - mechanism of action and clinical use

A

α1 more than α2

hypotension (vasoconstriction), ocular procedures (mydriatic), rhinitis (decongestant)

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14
Q

Indirect sympathomimetics - drugs

A
  1. amphetamines
  2. cocaine
  3. ephedrine
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15
Q

amphetamine - mechanism of action

A
  1. indirect general agonist
  2. reuptake inhibitor
  3. releases stored catecholamines
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16
Q

cocaine - mechanism of action

A
  1. indirect general agonist

2. reuptake inhibitor

17
Q

ephedrine - mechanism of action

A
  1. indirect general agonist

2. releases stored catecholamines

18
Q

amphetamine - clinical use

A
  1. Narcolepsy
  2. obesity
  3. ADHD
19
Q

ephedrine - clinical use

A
  1. Nasal congestion
  2. urinary incontinence
  3. hypotension
20
Q

cocaine - clinical use

A

vasoconstriction and local anesthesia

21
Q

cocaine - β blockers

A

never give β-blockers if cocaine intoxication is suspected –> it can lead to unopposed α1 activation –> extreme hypertension

22
Q

epinephrine vs norepinephrine according to effects at β2 receptors

A

epinephrine has significantly stronger effect at β2 receptor than norepinephrine

23
Q

norepinephrine effects on cardiovascular system

A

increases systolic and diastolic pressures (α1 mediated) –> increases MAP

24
Q

isoproterenol effects on cardiovascular system

A

causes β2 mediated vasodilation resulting in decreased MAP and increaed heart rate through β1 and reflex activity

25
Q

norepinephrine vs epinephrine vs isoproterenol according to HR

A

norepinephrine –> reflex bradycardia
epinephrine –> β1 mediated tachycardia
isoproterenol –> β1 and refelx mediated tachycardia (higher than epinephrine)

26
Q

norepinephrine vs epinephrine vs isoproterenol according to BP

A

norepinephrine –> increases systolic, diastolic, and MAP
epinephrine –> increases systolic (a1) and decreases diastolic (β2) (slightly increased MAP)
isoproterenol –> increases systolic (heart) and decreases diastolic (more than epinephrine), (slightly decreased MAP)

27
Q

norepinephrine vs epinephrine vs isoproterenol according to peripheral resistance

A

norepinephrine –> increased (unopposed α1)
epinephrine –> decreased (β2>a1)
isoproterenol –> more decreased (unopposed β2)

28
Q

norepinephrine vs epinephrine vs isoproterenol according to cardiac output

A

norepinephrine –> unchanged
epinephrine –> increased
isoproterenol –> more increased

29
Q

norepinephrine vs epinephrine vs isoproterenol according to pulse pressure

A

norepinephrine –> increased
epinephrine –> increased
isoproterenol –> more increased

30
Q

sympatholytics - mechanism of action

A

α2 agonists

31
Q

sympatholytics (α2 agonists) drugs

A
  1. clonidine
  2. guanfacine
  3. α-methyldopa
  4. Brimonidine
32
Q

clonidine - clinical use

A
  1. hypertensive urgency (limited situations)
  2. ADHD
  3. Tourette syndrome
33
Q

clonidine - side effects

A
  1. CNS depression
  2. bradycardia
  3. hypotension
  4. respiratory depression
  5. miosis
34
Q

α-methyldopa - clinical use

A

hypertension in pregnancy

35
Q

α-methyldopa - side effects

A
  1. direct coomps + hemolysis

2. SLE-like syndrome

36
Q

guanfacine - clinical use

A
  1. hypertensive urgency (limited situations)
  2. ADHD
  3. Tourette syndrome
37
Q

guanfacine - side effects

A
  1. CNS depression
  2. bradycardia
  3. hypotension
  4. respiratory depression
  5. miosis
38
Q

Brimonidine - clinical use

A

Glaucoma

Pharmacology (9 decks)

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