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Pharmacology > Adrenergic System > Flashcards

Adrenergic System Flashcards

1
Q

Sympathetic nervous system arises from

A

Thoracolumbar region

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2
Q

Important Amino acid need for the formation of Noradrenaline in neuron

A

Tyrosine

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3
Q

Rate limiting step in Noradrenaline synthesis

A

Conversion of Tyrosine to DOPA
Tyrosine hydroxylase - Rate limiting enzyme

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4
Q

Drug that inhibits Tyrosine hydroxylase enzyme

A

Metyrosine

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4
Q

VMAT-2 Receptors are present on

A

Present on Vesicles which is responsible for transportation of dopamine in vesicle

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5
Q

Example of VMAT-2 Inhibitors

A

Reserpine
New drugs - Tetrabenazine
Deutetrabenazine
Valbenazine

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5
Q

Drugs that inhibits entry of Noradrenaline in synapse

A

Guanethidine
Guanadrel

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5
Q

Drugs that prevents reuptake of Noradrenaline

A

Cocaine - increases sympathetic activity

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5
Q

Adrenergic receptors are classified into

A

Alpha receptors - Alpha-1 and Alpha-2
Beta receptors - Beta-1, Beta-2 and Beta-3

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6
Q

Alpha-1 receptors acts on

A

Blood vessels - Vasoconstriction
Eye - Mydriasis
Prostatitic urthera - contracts (decreases urine outflow)

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7
Q

Beta-1 receptors location and function

A

Heart - decreases HR (chronotropic), conduction (dromotropic) and Contractility (Inotropic)
JG cells of Kidney - Renin

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8
Q

Beta-2 receptors location and function

A

Lungs - Bronchodilation
GIT - Constipation
Bladder - Relaxes bladder - decrease urine outflow
BV - Vasodilation
Uterus - relaxes uterus
Skeletal muscles - can cause tremors
Liver - glycogenolysis, gluconeogenesis

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9
Q

Warning symptoms of Hypoglycemia

A

1) Tachycardia, Palpitations
2) tremors
3) Sweating

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10
Q

Why beta blockers are contraindicated in diabetes patient

A

Can mask warning symptoms of Hypoglycemia
Also can block the reversal

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11
Q

Sympathomimetic drugs can be divided into

A

Directly acting
Indirectly acting

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12
Q

Location and function of Beta-3 receptors

A

Lipolysis
Bladder - relaxes bladder

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13
Q

Beta-3 agonist used for overactive bladder

A

Mirabegron

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14
Q

Indirectly acting Sympathomimetics

A

Cocaine
TCA
Ephedrine
Pseudoephedrine
Amphetamine

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15
Q

Indirectly acting Sympathomimetics used as Nasal decongestants

A

Ephedrine
Pseudoephedrine

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16
Q

Effects of Amphetamine

A

Decreases sleep
Increase attention span

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17
Q

Amphetamine which is also termed as RAVE drug

A

Methylene dioxy methamphetamine

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18
Q

DOC For Narcolepsy

A

Modafinil

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18
Q

DOC for Attention deficit Hyperactivity Disorder (ADHD)

A

Methyl phenidate

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19
Q

Catecholamines can be divided into

A

Endogenous - Adrenaline, Noradrenaline, Dopamine
Exogenous - Dobutamine, Fenoldopam, Isoprenaline

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20
Q

Dopamine acts on which receptors

A

D1 - at low dose (<2mu/kg) - Vasodilation (max conc in Kidney)
Beta 1 - at intermediate dose (2-10)
Alpha-1 - at high dose (>10)

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20
Q

Uses of Dopamine

A

Acute CHF (2-10mu/kg)
Shock (>10)
DOC - if Shock+ Oliguria

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21
Q

Dobutamine acts on which receptors

A

Beta-1 receptors
Used in Acute CHF

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22
Q

Fenoldopam acts on which receptors

A

Only acts on D1 receptors - Vasodilation
Cam be indicated in Hypertensive emergency

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23
Q

Adrenaline, Noradrenaline and Isoprenaline acts on which receptors

A

Adrenaline - all receptors
Nor adrenaline - alpha -1, alpha-2, Beta-1
Isoprenaline - Beta-1 , Beta-2

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23
Q

What is effect of Noradrenaline on Heart rate

A

Decreases

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24
Q

Which drug cause maximum pulse pressure

A

Isoprenaline

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25
Q

Adrenaline can be used in

A

DOC In Anaphylactic shock i.m, 1:1000
Im Cardiac arrest while giving CPR

26
Q

What happened when alpha blocker given to patient with adrenaline producing tumor

A

Can result in vasomotor reversal of dale (Because of only beta -2 action)

27
Q

Alpha-1 agonist used as eyedrop for Fundoscopy

A

Phenylephrine

28
Q

Alpha-1 agonist drugs used in treatment of Hypotension

A

Methoxamine
Mephentermine
Midodrine

29
Q

Alpha-1 agonist used as nasal decongestant

A

Oxymetazoline
Xylomtazoline
Naphazoline

29
Q

Alpha -2 agonist drugs

A

Clonidine
Methyldopa - used in treatment of Hypertension

30
Q

Beta-2 agonist having tocolytic action

A

Ritodrine
Isoxsuprine

30
Q

Beta-2 agonist given as inhalational route

A

Salbutamol
Salmeterol
Formoterol
Terbutaline

30
Q

Alpha blockers can be divided into

A

Non selective alpha blocker
Selective alpha-1 blocker
Selective alpha-2 blocker - Yohimbine

31
Q

Reversible non Selective alpha blockers are

A

Phentolamine
Tolazoline
Used in severe Hypertension
Can cause tachycardia
Short acting

32
Q

DOC In Cheese reaction and Clonidie withdrawal

A

Phentolamine
Tolazoline

33
Q

Irreversible Non Selective alpha blocker

A

Phenoxybenzamine - used in Pheochromocytoma

33
Q

Selective alpha blockers

A

‘Zosin’
Prazosin
Terazosin
Doxazosin
Alfuzosin

33
Q

Selective alpha blockers are used in

A

Mild to moderate hypertension
Benign prostatic hyperplasia
Peripheral vascular diseases
Scorpion sting

33
Q

Selective alpha-1A blocker drugs including

A

Tamsulosin
Silodosin - not cause postural hypotension

33
Q

Important side effect of Selective alpha -1 blockers

A

Orthostatic hypotension or Postural hypotension or First dose hypotension

34
Q

Cardioselective beta blockers

A

New - Nebivolol
Beta - Betaxolol
Blockers - Bisoprolol
Acts - Acebutolol
Exclusively - Esmolol
At - Atenolol
Myo - Metoprolol
Cardium - Celiprolol

35
Q

Beta blockers having intrinsic sympathomimetic activity

A

Contain - Celiprolol
Partial - Pindolol
Agonistic - Alprenolol
Activity - Acebutolol

35
Q

Beta blockers having membrane stabilizing property

A

Black Na+ channels - local anesthetic property
Possess - Propranolol
Membrane stabilizing - Metoprolol
Or
Local - Labetalol
Anaesthetic - Acebutolol
Property - Pindolol

35
Q

Water soluble Beta blockers

A

A - Atenolol
N - Nadolol
S - Sotalol

35
Q

Longest acting beta blocker

A

Nadolol

36
Q

Shortest acting beta blocker

A

Esmolol

37
Q

Examples of third generation beta blockers

A

Any beta blockers that do Vasodilation (due to alpha blockade)
Labetalol
Carvedilol
Nebivolol

38
Q

Cardiac indications of Beta blockers

A

Hypertension
MI
Angina
CHF
Arrythmia
HOCM

38
Q

Extra cadiac indications of Beta blockers

A

Play - Performance anxiety
The - Thyrotoxicosis
G - Glaucoma
A - Akathisia
M - Migriane
E - Essential tremors

39
Q

Contraindications of beta blockers due to beta-1 blockade

A

Decreases HR - sick sinus syndrome
Decreases conduction - AV blockade
Decreases contractility - Acute CHF

40
Q

Contraindications of Beta blockers due to beta-2 blockade

A

Diabetes
Asthma
Peripheral vascular disease
Variant angina

40
Q

Types of Glaucoma

A

Open angle glaucoma
Closed angle glaucoma

41
Q

Cause of Open angle glaucoma

A

Inreased production of aqeuous humor

42
Q

Cause of closed angle glaucoma

A

Obstruction in drainage of aqeuous humor

42
Q

Aqueous humor is drained from

A

Trabecular outflow
Uveoscleral outflow

43
Q

Drugs used to decrease formation of aqeuous humor

A

Alpha -1 agonist - vasoconstriction
Beta blockers
Carbonic anhydrase inhibitor

44
Q

Alpha agonist used in glaucoma

A

Non selective alpha agonist - Adrenaline, Dipivefrine
Alpha-2 agonist - Apraclonidine , Brimonidine

44
Q

Beta blockers used in Glaucoma

A

Timolol
Carteolol
Levobunolol - longest acting
Betaxolol
Avoided in asthma patients

45
Q

Carbonic anhydrase inhibitor used in Glaucoma

A

Acetazolamide oral or iv
Brinzolamide
Dorzolamide - locally eye drops

46
Q

Drugs that increase trabecular outflow in glaucoma

A

Miotics - Cholinergic agonist - Pilocarpine
Achesterase inhibitors - Physostigmine, Echothiophate

46
Q

Side effects of Pilocarpine

A

Nasolacrimal duct stenosis

47
Q

Side effects of Achesterase inhibitors

A

Cataract

48
Q

Rho kinase inhibitors use in glaucoma

A

Netarsudil - acts by increasing outflow

49
Q

Major side effect of Rho kinase inhibitors used in Glaucoma

A

Whorl like opacities in cornea/ Cornea verticillate

50
Q

Drugs that increase uveoscleral outflow in glaucoma

A

Prostaglandins F2-alpha
Latanoprost
Bimatoprost
Travoprost
Tafluprost

50
Q

Adverse effects of Miotics

A

Nasolacrimal duct stenosis
Cataract
Retinal detachment

50
Q

Side effects of Beta blockers in Glaucoma

A

A - Asthma precipitates
B - Block - AV block
C - Acute CHF
D - Diabetes

50
Q

Side effects of PGF2-Alpha

A

Fluid in macula(macular edema)
Pigmentation of iris (Heterochromia iridis)
Growth of eyelashes (Hypertrichosis)

50
Q

Side effect of Apraclonidine

A

Lid retraction

50
Q

Side effects of Brimonidine

A

Brain suppression - contraindicated in infants less than 2 years

50
Q

Side effect of Adrenaline in Glaucoma

A

Adrenochrome - Conjunctival pigmentation

Pharmacology (14 decks)

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