Adrenergic Drugs Part 1 - Dr. Konorev Flashcards

1
Q

3 direct acting adrenomimetic drugs

A
  1. Alpha agonists
  2. Mixed alpha and beta agonists
  3. Beta agonists
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2
Q

4 Indirect adrenomimetics

A
  1. Inhibits re-uptake of DA and NE
  2. Inhibits MAO
  3. Reverse NE and DA uptake mechanisms and increase their release
  4. Releasing agent AND a direct adrenergic R agonist
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3
Q

Alpha agonists

A
  1. Phenylephrine

2. Clonidine

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4
Q

Mixed a and b agonists

A
  1. NE

2. Epi

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5
Q

B agonists

A
  1. Dobutamine
  2. Isoproterenol
  3. Albuterol
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6
Q

Inhibit is reuptake of NE and DA

A

Cocain

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7
Q

Inhibits MAO

A

Selegiline

phenelzine

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8
Q

Reverse NE and DA uptake mechanism and increase release of them

A
  1. Amphetamines
  2. Mythylphenidate
  3. Tyramine
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9
Q

Releasign agent AND direct adrenergic R agonist

A

Ephedrine

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10
Q

Cholenergic drugs control what

A

ACh release at adrenal medulla (N), or skeletal muscles voluntary (N), preganglionic synapse (N), parasympathetic involuntary muscles (M), sympathetic only if sweat glands (M)

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11
Q

Adrenergic drugs act where

A

Post synaptic ganglion at sympathetic involuntary muscles (cardiac, SM, glands, nerves ) = NE
AND
Postsynaptic ganglion at renal vascular SM = D

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12
Q

a1 type R does what biochem pathway

A

Increase IP3 and DAG

= Gq

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13
Q

a2 type R does what biochem pathway

A

Decrease cAMP to inhibit PKA

= Gi (so is D2)

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14
Q

B type R does what biochem pathway

A

Increase cAMP to activate PKA

=Gs (so is D1)

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15
Q

Direct vs indirect acting adrenergic drugs

A
  1. Direct = direct action on R

2. Indirect = increase or decrease concentration of NE or D at the receptor area

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16
Q

Phenylephrine R

A

A1 >a2

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17
Q

Clonidine R

A

A2 >a1

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18
Q

NE R

A

A1 and A2, and B1

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19
Q

Epi R

A

a1 and a2 and B1 ad B2

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20
Q

Dobutamine R

A

B1 > B2

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21
Q

Isoproterenol R

A

B1 and B2

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22
Q

Albuterol R

A

B2&raquo_space; B1

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23
Q

A1 actions

4

A
  1. Vascular SM = contraction **
  2. Pupils = dilation by contraction of dilator muscle
  3. Prostate = contraction
  4. Heart = increase Contraction Force
24
Q

A2 acts where

5

A
  1. Neurons = TR release
  2. Platelet = aggregation
  3. Adrenergic and cholinergic nerve terminals = inhibit TR release
  4. Some vascular SM = contraction
  5. Fat = inhibit Lypolysis
25
Q

B1 action

1

A

Heart and juxtaglomerular cells = increase Force and Rate of contraction , increase RENIN release (higher BP)

26
Q

B2 actions

3

A
  1. Resp**, uterine, vascular SM = relaxation
  2. Skeletal muscle = K+ reuptake (repolarization)
  3. Liver = glycogenolysis + gluconeogenesis
27
Q

B3 actions

2

A
  1. Relax bladder detrusor muscle

2. Active Lypolysis in fat cells

28
Q

D1
D2 actions
1 each

A

D1 : smooth muscles : dilate renal BVs

D2 : never endings : TR release

29
Q

B1 does what mostly

A

Increase heart contraction and force , HR, AV conductance

30
Q

B2 and A1 does what mostly when activated together

A
  1. Increase BP, NO change in mean arterial P, decrease congestion in bronchial mucosa (A1)
  2. Decrease in diastolic BP at times
    Muscle tremors, K+ uptake, liver metabolism, RELAX bronchial muscles **(B2)
31
Q

More severe elevation of BP NE or Epi

A

Norepinephrine because it does not activate B2 receptors also

32
Q

More increase in HR NE or Epi

A

Epi because
In NE the more severe increase in BP = BARORECEPTORS stimulated so ——> bradycardia
(Epi is higher HR)

33
Q

Phenylephrine HR and BP

A

A1 : High BP and
low HR as body compensates from BARORECEPTORS
Mydriasis (pupil dilation)

34
Q

Clonidine BP and HR

A

Low BP and low HR,
Vasoconstriction (peripheral a2 R, only not very prominent)
A2

35
Q

Isoproterenol

A
B1 = CO increase high HR
B2 = bronchodilation, vasodilation low BP
36
Q

Dobutamine effects

A

B1 : heart rate increase

37
Q

Albuterol effects

A

B2 : bronchodilation

38
Q

Indirect acting adrenomimetics have what properties

A

Lipophilic and cross BBB and effect CNS , unlike catacholamines, = EXCEPT tyramine **

39
Q

Tryamine is used for

A

Evaluate peripheral adrenergic function

40
Q

TX hypotensive EM, hemorrhagic shock, overdose of antihypertensives, CNS depressants

A

NE and Phenylephrine

41
Q

TX chronic hypotension

A

Ephedrine

42
Q

TX Cardiogenic shock

A

Dobutamine

43
Q

TX Heart failure

A

Short term dobutamine in acute HF

44
Q

TX HTN

A

A2- agonists for long-term tx

45
Q

EM TX for AV block and cardiac arrest

A

Epinephrine and isoproterenol

46
Q

TX depression

A

Phenelzine and Selegiline

47
Q

TX Narcolepsy

A

Amphetamines and methylphenidate

48
Q

TX ADHD, learning problems, hyperkinetic behavior

A

Methylphenidate

49
Q

TX Obesity

A

Ephedrine (B3) and Amphetamines = to increase energy expenditure and lower appetite

50
Q

TX bronchial asthma

A

Albuterol

51
Q

TX decongestion of mucous membranes

A

Phenylephrine and ephedrine

52
Q

TX anaphylaxis

A

Epinephrine (tax cardiac depression , severe hypotension, bronchospasms)

53
Q

TX ophthalmic application : examining retina and inducing mydriasis

A

Phenylephrine

54
Q

TX glaucoma

A

A2- selective agonists

55
Q

GU : TX stress urinary incontinence

A

Ephedrine (B3)