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Cardio > Adrenergic Pharm > Flashcards

Adrenergic Pharm Flashcards

1
Q

Where do adrenergic drugs take effect?

A

SNS

  • a and B receptors (NE) - cardiac muscle, smooth muscle, glands, nerve terminals
  • D1 receptors (dopamine) - renal vascular smooth muscle
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2
Q

Where do cholenergic drugs take effect?

A

PNS

*MAChR (ACh) - cardiac muscle, smooth muscle, glands, nerve terminals, sweat glands

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3
Q

Are sweat glands under sympathetic or parasympathetic control?

A

Sympathetic

  • but controlled by MAChR/ACh, and therefore affected by cholenergic drugs
  • cholinomimetics and AChE inhibitors can induce sweating, anticholinergics can inhibit sweating
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4
Q

G protein and effects of

a1 receptors

A

Gq, increased IP3, DAG

*increased Ca actvates PKC

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5
Q

G protein and effects of

a2 receptors

A

Gi, decreased cAMP

*decreased PKA activity

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6
Q

G protein and effects of

B receptors

A

Gs, increase cAMP

*increased PKA activity

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7
Q

G protein and effects of

D1 receptors

A

Gs, increase cAMP

*increased PKA activity

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8
Q

G protein and effects of

D2 receptors

A

Gi, decrease cAMP

*decreased PKA activity

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9
Q

Phenylephrine MOA

A

a1 agonist

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10
Q

Clonidine MOA

A

a2 agonist

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11
Q

Dobutamine MOA

A

B1 > B2 agonist

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12
Q

Isoprotenol MOA

A

B1 = B2 agonist

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13
Q

Albuterol MOA

A

B2 > B1 agonist

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14
Q

Effects of a1 activation

*Phenylephrine, Norepinephrine

A

Vasoconstriction

*agonists can cause reflex bradycardia (phenylephrine, norepinephrine)

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15
Q

Effects of a2 activation

*Clonidine

A

Sympatholytic, decreased BP and HR

*also cause platelet aggregation

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16
Q

Effects of B1 activation

A

Increased HR and contractility, increased renin release

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17
Q

Effects of B2 activation

A

Respiratory, uterine and vascular smooth muscle relaxation

  • K+ uptake in skeletal muscle
  • Gluconeogenesis and glycogenolysis in liver
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18
Q

Effects of B3 activation

A

Relaxation of detrusor muscle

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19
Q

Effects of D1 activation

A

Dilates renal vasculature

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20
Q

Effects of D2 activation

A

modulates neurotransmitter release in brain

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21
Q

Effects of epinephrine

A
  • Increased HR and contractility (B1)
  • Increases SBP, decreases bronchial secretions (a1)
  • Decreases DBP, relaxes bronchial SM, muscle tremor due to K+ uptake, liver glycogenolysis and gluconeogenesis (B2)
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22
Q

Adrenergic receptors found in the skin and mucous membranes

A

mostly a1

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23
Q

Adrenergic receptors found in the skeletal muscle

A

a1 and B2

24
Q

Adrenergic receptors found in the kidneys and brain

A

D1 and a1

25
Q

Effects of norepinephrine

A
  • Potent vasoconstriction, increased BP (a1)
  • Decreased HR (reflex bradycardia)
  • Increased contractility (B1)

*no B2 effects

26
Q

Effects of nonselective B agonists (B1=B2)

*Isoproterenol

A
  • Increased HR and contractility (B1)
  • Vasodilation, decreased BP (B2)
  • Bronchodilation (B2)
27
Q

In a patient in hypotensive emergency, what can be used to increase blood pressure?

A

a1 agonist effects: Norepinephrine, phenylephrine

28
Q

In a patient with chronic hypotension, what can be used to increase blood pressure?

A

Ephedrine

*indirect adrenomimetic, increases NE and dopamine release and is direct receptor agonist

29
Q

What can be given to a patient in cardiogenic shock?

A

Dobutamine

  • B1 agonist
  • can also be used short term in acute HF
30
Q

What adrenomimetic can be given to treat HTN?

A

Clonidine

31
Q

Emergency therapy for complete AV block and cardiac arrest

A

Epi, isoproterenol

32
Q

Adrenomimetics used to help treat depression

A

Phenelzine, Selegiline

*MAO inhibitors

33
Q

Adrenomimetics used for narcolepsy (sudden sleep attacks)

A

Amphetamines, methylphenidate

*Methylphenidate also used for ADHD

34
Q

Adrenomimetics used for appetite suppression in obesity

A

Ephedrine, amphetamines

35
Q

Adrenomimetic used to treat asthma

A

Albuterol

36
Q

Adrenomimetic used to treat nasal decongestion

A

Phenylephrine, ephedrine

37
Q

Treatment for anaphylaxis

A

Epi

38
Q

Cocaine MOA

A

NE and DA reuptake inhibitor

39
Q

Amphetamines, methylphenidate, tyramine MOA

A

Increased NE and DA release, inhibited reuptake

40
Q

Ephedrine MOA

A

Increased NE and DA release, and direct receptor agonist

41
Q

Metyrosine MOA

A

indirect acting adrenergic antagonist

*inhibits tyrosine hydroxylase

42
Q

Guanethidine MOA

A

indirect acting adrenergic antagonist

*depletes and prevents storageof NE

43
Q

Phentolamine, Phenoxybenzamine MOA and difference

A

Non-selective a1/a2 receptor antagonists

  • Phentolamine non-covalent bonding and therefore shorter acting (reversible)
  • Phenoxybenzamine covalent bonding and therefore longer acting (irreversible)
  • treatment for catecholamine excess in pheochromocytoma
  • phentolamine can also be injected into the penis to treat ED
44
Q
  • osin drugs MOA

* Prazosin, Tamulosin, Doxazosin

A

Selective a1 receptor inhibitors

45
Q

Alpha antagonists used for essential HTN treatment

A

Prazosin, Doxazosin

*non-selective alpha blockers are NOT used for HTN (phentolamine, etc.)

46
Q

Alpha antagonist used for chronic urinary obstruction in BPH

A

Tamulosin

*greater selectivity for a1a receptors (vs a1b), which contributes most to prostate smooth muscle contraction

47
Q

Labetalol, Carvedilol MOA

A

Mixed B and a1 antagonists

48
Q

Propanolol, Pindolol, Nadolol MOA

A

Non-selective B1 and B2 antagonists

49
Q

Acebutolol, Betaxolol, Atenolol, Metropolol MOA

A

Selective B1 antagonists

50
Q

B blockers that are pure antagonists

A
  • Atenolol
  • Nadolol
  • Propanolol

*highest risk of bradycardia

51
Q

B blockers that are partial agonists

A
  • Acebutolol
  • Labetalol
  • Pindolol

*lower risk of bradycardia

52
Q

B blockers that are inverse agonists

A
  • Betaxolol
  • Metropolol

*lower risk of bradycardia

53
Q

B blockers used in heart failure

A

Metoprolol, Carvedilol

54
Q

Beta blocker used in glaucoma

A

Betaxolol

55
Q

B blocker used in hyperthyroidism

A

Propanolol

Cardio (18 decks)

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