Adrenergic Stimulants: Catecholamines + Ephedrine

Question 1

NE has little effect on

Answer 1

B2

Question 2

NE is taken

Answer 2

IV due to very short duration of action

Question 3

effect of NE is primarily to

Answer 3

vasoconstriction –> increased BP (some reflex bradycardia will slow HR)

Question 4

why does NE have little effect on pulse pressure?

Answer 4

both diastolic and systolic BP increase

Question 5

when is NE used

Answer 5

severe hypotensive crisis

Question 6

side effect of NE at injection site

Answer 6

necrosis due to vasoconstriction

Question 7

NE causes CO

Answer 7

to remain unchanged or decrease

HR decreases but SV increases

Question 8

when would NE caused increased HR

Answer 8

when given with atropine, which would block the vagal baroreceptor reflex

Question 9

NE causes ___________ to organs

Answer 9

decreased blood flow

kidney, liver, spleen

Question 10

SV and coronary flow ______ when NE is given

Answer 10

increase

Question 11

NE stimulates _______ receptors

Answer 11

a1
B1

(little effect on B2)

Question 12

Epi stimulates ________ receptors

Answer 12

Alpha
B1
B2

Question 13

how to take epi

Answer 13

IV or SC injection

short duration of action due to rapid metabolism

Question 14

effects of epi depend on

Answer 14

dose administered

Question 15

epi effects on heart

Answer 15

positive inotrope and chonotrope (B1)

Question 16

epi effects on BP

Answer 16

1. diastolic and systolic go up due to alpha stimulation

2. diastolic goes back down due to B2 mediated dilation of skeletal blood vessels —> increased pulse pressure

Question 17

epi effects on BP at high doses

Answer 17

diastolic pressure increases as alpha receptors in skeletal muscle blood vessels are stimulated

Question 18

epi effect on blood glucose

Answer 18

increases:

1. B2 - glycogenolysis
2. a2 - decreased insulin secretion

Question 19

epi effect on renin

Answer 19

increased by B1 –> contributes to increased vasoconstriction

Question 20

epi effect on free fatty acids

Answer 20

Increased by lipolysis B3

Question 21

low dose slowly given epi will

Answer 21

increase HR (little reflex slowing since mean BP stays the same)
decrease renal blood flow

Question 22

high dose rapidly given epi will

Answer 22

increase BP ALOT
BOTH systolic and diastolic
IF mean BP increases –> reflex bradycardia

Question 23

rare emergency treatment of asthma

Answer 23

epi (bronchodilation by B2)

Question 24

EMERGENT indications for epi

Answer 24

1. anaphylactic shock (restore BP, decrease bronchospasm/congestion/angioedema, reverse cardiovascular collapse)
2. MI
3. Complete heart block

Question 25

other uses for epi

Answer 25

1. local anesthetics: vasoconstriction decreases diffusion of the drug away from injection site
2. glaucoma (alpha stimulation, guess beta stimulation doesn’t matter much)

Question 26

general side effects of epi

Answer 26

tremor
throbbing HA
increased BP
tachycardia

Question 27

effects of epi in pt with CAD

Answer 27

angina due to increased O2 consumption/cardiac work

Question 28

really bad complications from extreme vasoconstriction caused by high dose epi

Answer 28

cerebral hemorrhage

ventricular arrhythmia

Question 29

contraindications to epi use

Answer 29

BETA BLOCKERS

alpha agonist effect on vasoconstriction would go unopposed – > severe htn

Question 30

ephedrine receptor effects

Answer 30

mixed acting, alpha and beta receptors
SIMILAR TO LOW DOSE EPI
also increases NE

Question 31

ephedrine vs epi

Answer 31

ephedrine has a longer duration of action but less pronounced effects.
ephedrine has high bioavailability

Question 32

how is ephedrine excreted and how can excretion be accelerated

Answer 32

urine

acidify the urine

Question 33

drug similar to ephedrine found in weight loss supplements which is off the market due to deaths from htn

Answer 33

ephedra

Question 34

drug similar used in OTC decongestants and weight loss drugs → hemorrhagic stroke in women. now off market

Answer 34

phenylpropanolamine