Adrenergic Receptor Agonists Flashcards
Physiologic Effect at Alpha 1 Receptors
- Vasoconstriction (most smooth muscle responds to alpha 1 stimulation by constriction)
- Increased peripheral resistance
- Increased blood pressure
- Affects arterioles in skin, mucosa, viscera, kidneys, veins, uterus, and spleen
Physiologic Effect at Alpha 2 Receptors
- Inhibition of NE release and ACh release
- Inhibition of insulin release
- Affects presynaptic nerve endings and postsynaptic nerves in CNS
Physiologic Effect at Beta 1 Receptors
- Primarily affects the heart and kidneys
- Tachycardia
- Increased lipolysis
- Increased myocardial contractility
- Increased renin release
Physiologic Effect at Beta 2 Receptors
- Affects arterioles/arteries, bronchial muscle, pregnant uterus
- Vasodilation
- Slightly decreased peripheral resistance
- Bronchodilation
- Increased muscle and liver glycogenolysis
- Increased release of glucagon
- Relax uterine smooth muscle
Physiologic Effect at Dopamine 1 Receptors
- Dilates renal, splanchnic, and cerebral arterioles and increases blood flow to kidneys and other viscera
Norepinephrine (Levophed) Class
Non-selective agonist
Norepinephrine MOA
Agonist: α1, α2, β1
Norepinephrine Effects
Alpha 1: vasoconstriction and increased bp
Beta 1: Increased hr, conduction, and contractility
Norepinephrine Indications
Restore bp in acute hypotension or during cardiac arrest
Alpha Agonist Uses
- Control hemorrhage
- Contain local anesthetic
- Nasal decongestant
- Allergic (anaphylactic) shock
- Glaucoma
- Hypotension
- Shock
Norepinephrine Side Effects
- Hypertension
- Arrhythmias
- Headache
Epinephrine Class
Non-selective agonist
Epinephrine MOA
Agonist: α1, (α2), β1, β2
Epinephrine Indications
- Control hemorrhage
- Hypotension
- Shock
- Allergic reaction
- Cardiac Arrest
- AV Block
- Glaucoma
Epinephrine Effects
- Alpha 1: vasoconstriction and increased bp
- Beta 1: Increased heart rate and contractivilty
- Beta 2: vasodilation, decreased diastolic pressure, bronchodilation
Epinephrine Side Effects
- Palpitations
- Arrhythmias
- Headache
- Tremors
Amphetamine and Dextroamphetamine Class
Indirect Acting Agonist, CNS Stimulant
Amphetamine and Dextroamphetamine MOA
Increase amount of catecholamines in synaptic cleft by releasing intracellular stores of NE, dopamine, and seratonin
Amphetamine and Dextroamphetamine Effects
- Increased alertness
- Decreased fatigue
- Decreased appetite
- Insomnia
Amphetamine and Dextroamphetamine Side Effects
Though to be the result of adrenergic activity
- Vertigo
- HTN
- Confusion
- Nausea
- Diarrhea
- Insomnia
- Anxiety
Amphetamine and Dextroamphetamine Indications
Amphetamine 1. Narcolepsy 2. Recreation Dextroamphetamine 1. ADHD
Phenylephrine (Neo-synephrine) Class
α1-selective α agonist
Phenylephrine (Neo-synephrine) MOA
Agonist: α1
Phenylephrine (Neo-synephrine) Indications
- Nasal and ocular decongestant
- Treatment of drug induced hypotension
- Diet aids
Phenylephrine Side Effects
- HTN
2. Reflex bradycardia
Clonidine (Catapres) Class
α2-selective α agonist
Clonidine (Catapres) MOA
Agonist: CNS α2, decreases sympathetic outflow from vasomotor center
Clonidine (Catapres) Indications
- HTN
- Prevents withdrawal syndrome from opioids and alcohol
- Shock
Clonidine (Catapres) Side Effects
- Sedation
2. Retention of salt and water
α-methyldopa (Aldomet) Class
α2-selective α agonist
α-methyldopa (Aldomet) MOA
Metabolite (a-methylnorepinephrine) activates CNS a2 receptors
α-methyldopa (Aldomet) Indications
- Hypertension
α-methyldopa (Aldomet) Side Effects
- Sedation
Isoproteranol (Isuprel) Class
Non-selective β agonist
Isoproteranol (Isuprel) MOA
Agonist: β1, β2
Beta 1: Increased heart rate, conduction, and contractility
Beta 2: vasodilation and dec diastolic BP, bronchodilation
Isoproteranol (Isuprel) Indications
- Cardiac Arrest
- AV Block
- Shock
Isoproteranol (Isuprel) Side Effects
- Palpitations
- Arrhythmias
- Headache
- Tremor
Dobutamine (Dobutrex) Class
β1-selective β agonist
Dobutamine (Dobutrex) MOA
Agonist: β1
Increases cardiac contractility, cardiac output, and heart rate
Dobutamine (Dobutrex) Indications
- Cardiogenic shock
- Acute CHF
- Heart Block
Albuterol (Proventil, Ventolin) Class
β2-selective β agonist
Albuterol (Proventil, Ventolin) MOA
Agonist: β2
Relaxes bronchial, uterine, and vascular smooth muscle
Albuterol (Proventil, Ventolin) Indications
- Prevent or treat bronchospasm
- Mild exercise-induced asthma
- COPD
Albuterol (Proventil, Ventolin) Side Effects
- Tachycardia
- Tremors
- May mask progressively more severe inflammation
Terbutaline (Breathine) MOA
Adrenergic receptor agonist
Terbutaline (Breathine) Therapeutics
Prevent or reverse exercise induced bronchospasm, mild asthma, COPD, early labor
Terbutaline (Breathine) SE
- Can mask progressively severe inflammation
2. Tachycardia, muscle tremor
Terbutaline (Breathine) Misc
10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose –> side effects); can be used night symptoms, but not ideal
Fenoldopam (Corlopam) MOA
Agonist, D1 receptor only
Fenoldopam (Carlopam) Therapeutics
Increase blood flow at renal, mesenteric, and cerebral arteries
Fenoldopam (Carlopam) Misc
~ 10 minute half life
Dopamine MOA
Agonist at D1, alpha 1, and Beta 1 receptors
Dopamine Therapeutics
Shock, renal failure, hypotension
Dopamine SE
Vasoconstriction at high doses
Dopamine Misc
Low dose = Direct @ D1 Receptors
Medium dose = Direct @ Beta 1, some Indirect
High dose = Direct @ Alpha 1, some Indirect