Adrenergics

Question 0

Phenylephrine

Answer 0

alpha-1 receptor agonist. It is used to dilate the

eye, as a nasal decongestant, to terminate episodes of paroxysmal atrial tachycardia (reflex), and to treat hypotension.

Question 1

Methoxamine

Answer 1

alpha-1 agonist used to treat orthostatic hypotension and paroxysmal atrial tachycardia

Question 2

Clonidine

Answer 2

alpha-2 agonist that acts centrally to decrease

sympathetic outflow and thereby decrease blood pressure. Analogues are used to treat glaucoma.

Question 3

Dobutamine

Answer 3

activates primarily beta-1 receptors. Used to treat

cardiogenic shock, low cardiac output. It is primarily an inotrope.

Question 4

Methyldopa

Answer 4

converted methylnorepinephrine centrally which then activates alpha-2 receptors centrally to decrease sympathetic out flow and decrease blood pressure

Question 5

Albuterol, metaproterenol, salmeterol, terbutaline

Answer 5

are all beta-2 agonist and can be used to treat bronchospasm, COPD, and bronchitis.

Question 6

Isoproterenol

Answer 6

non-specific beta one agonist. Not the agent of choice for any application, but has been used for bronchospasm, heart block, and arrhythmias.

Question 7

Pseudoephedrine

Answer 7

Mixed acting sympathomimetic. decongestant

Question 8

Ephedrine

Answer 8

release of norepinephrine and also directly stimulate receptors, in the periphery as well as in the CNS. It thus has mild stimulatory effects. It is a component of the herbal medication, Ma
Huang.

Question 10

Cocaine

Answer 10

blocks norepinephrine reuptake leading to an increase in norepinephrine and sympathetic responses. In the CNS, it has a profound stimulatory effect by blocking the reuptake of dopamine.

Question 11

Amphetamine

Answer 11

substrate for the norepinephrine transporter; it then enters the vesicles, displacing norepinephrine, which then exits the presynaptic terminal via reversal of the transporter. This drug and its analogues are stimulants. They are used to treat attention deficit hyperactivity disorder.

Question 12

Phenoxybenzamine

Answer 12

irreversible non-selective antagonist which will reduce blood pressure when sympathetic tone is high such as in patients with pheochromocytoma. Its primary adverse effect is tachycardia, due to blockade of presynaptic alpha2 receptors and reflex mechanisms.

Question 13

Phentolamine

Answer 13

competitive antagonist at both alpha-1 and alpha-2 receptors. Its primary adverse effect is tachycardia, due to blockade of
presynaptic alpha2 receptors and reflex mechanisms.

Question 14

Prazosin

Answer 14

alpha1 receptors, therefore, it is less likely to cause tachycardia than phentolamine.

Question 15

Terazosin, Doxazosin

Answer 15

alpha1 selective antagonists

Question 16

Tamsulosin

Answer 16

alpha1A and 1D antagonist that is thought to predominate in

the prostate.

Question 17

Yohimbine

Answer 17

alpha 2 receptor antagonist

Question 18

Tx Pheochromocytoma

Answer 18

Phenoxybenzamine

Question 19

Tx for Chronic hypertension

Answer 19

apha1 antagonists such prazosin are used, but generally are not used alone, because other classes of drugs are known to be efficacious in heart failure. The major side effect is orthostatic hypotension which is more likely to occur after the first few doses. Palpitation can occur.

Question 20

Tx for Peripheral vascular disease

Answer 20

occasionally prazosin or phenoxybenzamine are used to treat vasospasm in the peripheral circulation (Raynaud’s phenomenon), but other agents such as calcium channel blockers are preferred. Behavioral modifications should be tried first.

Question 21

Urinary obstruction

Answer 21

Benign prostatic hyperplasia is common in older men and
can be treated with alpa-1 antagonists such as prazosin, doxazosin, and terazosin. Tamsulosin is more selective for the receptors in the prostate and therefore, it has relatively little effect on blood pressure and can be used in patients who have had a problem with orthostatic hypotension.

Question 22

Erectile dysfunction

Answer 22

phentolamine is used as part of mixture that is injected into the penis, that facilitates erection in patients that have erectile dysfunction.

Question 23

Propranolol

Answer 23

B-blocker Non-selective Highest lipid solubility; highest 
anesthetic action (MSA)

Question 24

Timolol

Answer 24

B-blocker Non-selective Glaucoma (widely used), HPTN, MI

Question 25

Nadolol

Answer 25

B-blocker. Non-selective Long-lasting (24hr)

Hypertension, angina

Question 26

Atenolol

Answer 26

Beta-1- selective Lowest lipid solub.

Hypertension (widely used)

Question 27

Metoprolol

Answer 27

Beta-1-selective High lipid solub (MSA)

Hypertension (widely used), angina, MI

Question 28

Esmolol

Answer 28

Beta-1-selective Very short acting (10min)

Intraoperative and postoperative hypertension, arryhthmias

Question 29

Pindolol

Answer 29

Non-selective partial agonist (ISA) (MSA)

Hypertension (brady/peripheral vascular disease)

Question 30

Acebutolol

Answer 30

Hypertension (brady)

Question 31

Labetolol

Answer 31

Non-selective for beta (some ISA at beta-2) Also blocks alpha-1
Severe hypertension

Question 32

Carvedilol

Answer 32

Non-selective for beta (Also mild alpha-1 block)

CHF/hypertension

Question 33

clinical uses of beta adrenergic antagonists

Answer 33

Hypertension, ischemic heart disease, arrhythmia, heart failure, glaucoma, migraine, hyperthyroidism, performance anxiety

Question 34

Tyramine

Answer 34

component of some foods that is normally rapidly metabolized by monoamine oxidase in the liver and GI tract. Caution with MAOi use. The action of tyramine is similar to amphetamine. It can cause a hypertensive crisis, by releasing large amounts of norepinephrine.