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Pharmacology II > Adrenergic Stimulants > Flashcards

Adrenergic Stimulants Flashcards

1
Q

Cocaine, Tyramine, Amphetamines and MAOIs are an example of what type of adrenergic effector?

A

indirect acting

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2
Q

This type of adrenergic effector has the following characteristics:

inhibits reuptake

increases synth and release

acts presynaptically

A

indirect acting

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3
Q

This type of adrenergic effector has the following characteristics…

active on target tissues

mimics SNS stimulation

A

direct acting

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4
Q

This type of adrenergic effector has the following characteristics…

stops indirect acting, enhances direct acting

A

denervation

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5
Q

The only adrenergic receptor that is inhibitory is…

A

Alpha 2

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6
Q

What are the 6 types of adrenergic receptor?

A

alpha 1 and alpha 2

beta 1, beta 2, beta 3

Dopamine 1

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7
Q

what is the specific agonist for alpha 1?

A

phenylephrine

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8
Q

what is the specific agonist for alpha-2?

A

clonidine

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9
Q

What is the specific agonist for beta 1?

A

dobutamine

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10
Q

what is the specific agonist for beta 2?

A

albuterol

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11
Q

what is the specific agonist for beta 3?

A

mirabegron

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12
Q

What is the agonist for dopamine receptors?

A

fenoldopam

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13
Q

Name the receptor:

Isoproterenol > Epi/NE

A

Beta 1

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14
Q

Name the receptor:

Isoproterenol > Epi&raquo_space; NE

A

Beta 2

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15
Q

Name the receptor:

Isoproterenol = NE > Epi

A

beta 3

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16
Q

Which catecholamines are non-specific adrenergic receptor activators?

A

NE

Epi

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17
Q

This catecholamine is rarely used clinically, causes severe vasoconstriction, but can increase BP in severe hypotension

A

Norepinephrine

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18
Q

Which two drugs activate alpha 1 and beta 1 receptors, causing an increase in HR and BP>

A

epi and NE

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19
Q

alpha 1 activation causes…

A

vasoconstriction

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20
Q

beta 1 activation causes…

A

increased HR and contractility

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21
Q

This drug has the following indications:

anaphylaxis

emergency tx of cardiac arrest/heart block

decrease local anesthetic distro

glaucoma

A

epinephrine

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22
Q

describe the receptor affinity of norepineprine…

A

alpha = beta1&raquo_space; beta2

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23
Q

describe the receptor affinity of epinephrine

A

beta 1 = beta 2 > alpha 1

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24
Q

what is a contraindication for use of epinephrine?

A

beta blocker use

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25
The following are adverse effects for which drug? ``` Tremor Tachycardia HTN HA Vasoconstriction/necrosis ``` Angina (CAD pts.)
epinephrine
26
Low dose epinephrine activates beta 2 receptors. What effect does this have on HR and by what mechanism?
beta 2 activation = skeletal muscle vasodilation baroreflex doesn't activate HR remains elevated
27
High dose eopinephrine causes a decreased HR by what mechanism?
alpha-1 activation overrides beta 2. Increased diastolic leads to increased MAP Increased MAP activates baroreflex which slows HR
28
An alpha blocker given in the presence of epinephrine will have what effect?
stabilize systolic pressure by allowing beta-2 vasodilation to occur
29
a beta blocker given in the presence of epinephrine will have what effect?
prevents increased HR and contractility elevate BP, decrease CO
30
What are the three alpha 1 agonists?
phenylephrine, pseudoephedrine, oxymetazoline
31
This alpha 1 agonist is indicated for... hypotensive emergency nasal decongestion mydriasis
phenylephrine
32
What are precautions when giving phenylephrine
caution in HTN and BPH
33
This drug is an alpha 1 agonist that has a similar mechanism as phenylephrine, but is more effective
pseudoephedrine
34
this alpha 1 agonist is delivered topically to cause vasoconstriction of the eye and nasal mucosa...
oxymetazoline (Afrin & Visine)
35
for whom should you give oxymetazoline with caution
HTN | Acute Angle Closure Glaucoma
36
what three drugs are considered alpha 2 agonists?
clonidine, methyldopa, tizanidine
37
These alpha agonists have the following indications: HTN Addiction Hot Flashes Pre-Anesthesia
Clonidine and Methyldopa
38
Which alpha 2 agonist is the DOC for HTN during pregnancy?
methyldopa
39
these alpha agonists can cause xerostomia and sedation
clonidine and methyldopa
40
these alpha agonists stimulate alpha 2 receptors in the brain, causing a decreased SNS response to relevant sites
clonidine and methyldopa
41
What are three precautions/contraindications for clonidine and methyldopa
no used as monotherapy due to CNS effects No rapid withdrawal of clonidine due to HTN crisis Clonidine patch cannot get heated
42
By what mechanism do clonidine and methyldopa decrease HTN?
decrased SNS leads to decreased renin secretion, which leads to decreased BP
43
This alpha agonist should be considered when spasticity control is important. It is used to treat neurological conditions to reduce muscle spasticity...
tizanidine
44
What is the major adverse effect of tizanidine?
asthenia, weakness
45
is tizanidine useful in BP therapy?
no
46
Which 4 drugs are considered beta agonists?
isoproterenol, dobutamine, albuterol, mirabegron
47
This non-specific beta agonist is useful in the emergency treatment of cardiac arrest and complete heart block...
isoproterenol
48
This beta agonist is a potent beta 1 and beta 2 agonist leading to skeletal, renal and mesenteric vasodilation and increased HR
isoproterenol
49
a large dose of isoproterenol can have what adverse effects?
tachycardia palpitations arrhythmia
50
This beta agonist is useful in treating: cardiogenic shock HFrEF Cardiac Stress Testing
Dobutamine
51
By what mechanism does dobutamine increase HR?
increased contractility and CO
52
describe the half-life of dobutamine...
2 minutes
53
This beta agonist when given in patients with HTN can rapidly increase their BP
dobutamine
54
Which beta agonist is useful in treating asthma?
albuterol
55
What are three adverse effects from albuterol?
tachycardia tremor Palpitations
56
This is the only beta 3 agonist
mirabegron
57
this beta agonist causes detrusor relaxation and increased bladder capacity...
mirabegron
58
which beta agonist is useful in treating overactive bladder?
mirabegron
59
What are two adverse effects of mirabegron?
HTN | sinus tachycardia
60
a low dose of dopamine actives the _____ receptors in the ______, leading to what?
D1 receptors in Kidney Leads to renal vasodilation
61
A moderate dose of dopamine activates the _______ receptor in the ________ leading to what?
Beta 1 receptors in heart Leads to inotropic fx
62
A high dose of dopamine activates the _______ receptors in the _________ leading to what?
alpha receptors in the vessels leading to vasoconstriction
63
When is dopamine indicated?
short term tx of severe heart failure
64
When is dopamine contraindicated?
use with MAOIs
65
This dopamine receptor agonist can cause reflex tachycardia and flushing...
fenoldopam
66
When is fenoldopam indicated?
HTN emergency
67
Describe the mechanism by which fenoldopam decreases BP...
dilation of renal vascular beds
68
HTN emergency parameters...
SBP > 180 or DBP > 120 + end organ damage
69
describe the half life of fenoldopam...
5 minutes
70
What five drugs are indirect sympathomimetics?
amphetamine, methylphenidate, methamphetamine, cocaine, tyramine
71
This drug class works via the following mechanism: uptake by NET leads to NT displacement and increased NE release Increased NE in the cleft leads to denervation. Denervation causes constriction with phenylephrine, decreased constriction with amphetamines
indirect sympathomimetics
72
These drugs are CNS stimulants that are DOC for ADHD and can be used to treat narcolepsy...
amphetamine and methylphenidate
73
What are adverse effects with high dose amphetamine/methylphenidate administration?
cerebral hemorrhage convulsions coma
74
What are normal adverse effects of amphetamine and methylphenidate?
tremor tachycardia htn psychosis
75
cocaine is a reuptake inhibitor for...
dopamine and NE
76
cocaine can be used as a ____
local anesthetic
77
cocaine is synergistic with what drug? How?
amphetamine cocaine blocks NET so entire amphetamine and NE dose goes to synaptic cleft
78
In young, otherwise healthy adults, cocaine use can have what adverse effects?
HTN | Stroke
79
What are the three common side effects of cocaine use?
tachycardia arrhythmia MI
80
What is a long-term side effect of cocaine use?
psychosis
81
This is the dinner party drug... found in pepperoni, salami, cheese, beer, wine and nuts...
tyramine
82
This drug causes increased catecholamine release, forming octopamine, a false transmitter
tyramine
83
who should avoid tyramine?
MAOI use
84
Describe the breakdown of tyramine...
rapid hydrolization by MAO
85
What is an adverse effect of tyramine?
tachypylaxis

Pharmacology II (23 decks)

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