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UNMC PA Pharmacology > Adrenergics > Flashcards

Adrenergics Flashcards

1
Q

Sympathomimetics can be __ acting, ___ acting, ___ and ___ acting

A

Direct, indirect, mixed

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2
Q

Direct acting sympathomimetics are agonists of ___ receptors

A

Alpha and beta

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3
Q

Indirect acting sympathomimetics MOAs

A

Promote NE release, inhibit NE reuptake, or inhibit NE activation

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4
Q

Catecholamine drugs

A

Dopamine
Norepinephrine
Epinephrine

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5
Q

Catecholamines are administered ___

A

By injection or inhalation

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6
Q

Catecholamines do/don’t cross the BBB

A

Don’t

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7
Q

Non-catecholamine sympathomimetics include:

A

Phenylephrine
Terbutaline

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8
Q

Receptor subtype selectivity depends on subtle changes in the ______ backbone

A

phenylethylamine

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9
Q

Alpha 1receptors are located in

A

Vascular smooth muscle
Iris radial muscle

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10
Q

Alpha 1 receptor functions

A

Vasoconstriction
Mydriasis without cycloplegia

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11
Q

Alpha 2 receptors are located in

A

Brainstem
Eye ciliary body

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12
Q

Alpha 2 receptor functions

A

Decrease sympathetic outflow to heart and vasculature
Decrease blood pressure
Decrease aqueous humor secretion
Decrease intraocular pressure (glaucoma)

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13
Q

Beta 1 receptor location

A

Heart

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14
Q

Beta 1 receptor functions

A

Cardiac stimulation

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15
Q

Beta 2 receptors locations

A

Bronchi
Uterus

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16
Q

Beta 2 receptor functions

A

Dilates bronchioles
Relaxes uterus
Decreases BP via vasodilation

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17
Q

Epinephrine can use which receptors?

A

Alpha 1
Alpha 2
Beta 1
Beta 2

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18
Q

Effects of epinephrine on vasculature

A

Reduced cutaneous blood flow
Can decrease (a1, low doses) or increase (B2, high doses) skeletal muscle blood flow
Controls MAP
Increase coronary blood flow (increase NO release)
Decrease renal blood flow

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19
Q

Respiratory effects of epinephrine

A

Relaxation of bronchial smooth muscle (B2)

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20
Q

Clinical uses of epinephrine

A

Increase duration of local anesthetic
Anaphylactic shock
Asthma
Topical hemostasis
Cardiac arrest

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21
Q

Frequent use of epinephrine for bronchodilation can cause

A

Tolerance via adrenergic receptor down regulation

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22
Q

Adverse effects of epinephrine

A

Hypertension
Arrhythmias
Angina
Necrosis if IV blows

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23
Q

Epinephrine drug interactions

A

General anesthetics
Alpha and beta blockers - reduce Epi efficacy
MAOIs
Tricyclic antidepressants

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24
Q

Norepinephrine acts on which receptors?

A

a1, a2, and B1

25
Q

Clinical uses of norepinephrine

A

Severe hypotension
Vasopressor for septic shock

26
Q

Isoproterenol acts on which receptors?

A

B1 and B2

27
Q

Dopamine acts on what kind of receptors?

A

Dopaminergic (D1)
Has smaller effect on B1 and a1

28
Q

Dopamine cardiovascular effects

A

Low dose: renal and coronary artery dilation
Medium dose: increase CO and stroke volume (not HR)
High dose: peripheral vasoconstriction, reduces CO by increasing afterload

29
Q

When all adrenergic receptors are stimulated, which one predominates?

A

a1

30
Q

Dopamine increases/decreases urine output

A

Increases (increased blood flow to kidneys)

31
Q

Clinical uses of dopamine

A

Shock/sepsis to maintain BP

32
Q

Phenylephrine acts on __ receptors

A

a1

33
Q

Phenylephrine causes vaso______

A

Vasoconstriction

34
Q

Clinical uses of phenylephrine

A

Nasal decongestant
Vasopressor
Mydriatic

35
Q

Adverse effects of phenylephrine

A

Hypertension
Reflex bradycardia
Restlessness
Arrhythmias

36
Q

Clonidine activates ___ receptors

A

a2 (presynaptic autoreceptor)

37
Q

Clonidine MOA

A

Reduces sympathetic outflow from CNS to heart and blood vessels to lower blood pressure

38
Q

Terbutaline activates ___ receptors

A

B2

39
Q

Clinical uses of terbutaline

A

Decrease airway resistance in asthmatics
Tocolytic (suppress premature labor by relaxing uterine smooth muscle

40
Q

Clinical uses of ephedrine

A

Nasal decongestion
Reversal of anesthesia induced hypotension

41
Q

Ephedrine is controlled because it can be used to make ___

A

Methamphetamine

42
Q

Amphetamine MOA

A

Promote release of NE and dopamine and inhibit their reuptake

43
Q

Clinical uses of amphetamine

A

ADHD (adderall)
Narcolepsy

44
Q

Adverse effects of amphetamine

A

Appetite suppression/growth retardation in children
Dependence/withdrawal/abuse
Insomnia

45
Q

Adrenergic antagonists

A

Prazosin
Tamsulosin
Propranolol
Atenolol

46
Q

Alpha 1 blockers clinical uses

A

Hypertension
Reynauds
BPH
Antidote of alpha 1 antagonist overdose

47
Q

Beta 1 blocker clinical uses

A

Hypertension
Angina/MI
Hyperthyroidism
Glaucoma
CHF
Migraine prevention

48
Q

Alpha 1 blockers

A

Prazosin
Tamsulosin

49
Q

Prazosin MOA

A

Dilation of vessels
Relaxes bladder neck and prostate

50
Q

Tamsulosin is different from Prazosin because ___

A

It favors blocking of prostate and bladder smooth muscle with little effect on blood pressure (acts specifically on a1A receptors)

51
Q

Beta blockers

A

Propanolol
Atenolol

52
Q

Propanolol cardiovascular effects

A

Decrease HR and contractility
Intitially raises BP but long-term reduces BP

53
Q

Propanolol suppresses release of ___

A

Renin

54
Q

Propanolol causes broncho____

A

Bronchoconstriction

55
Q

Adverse effects of Propanolol

A

Fatigue
Coldness
Sexual dysfunction
Bradycardia

56
Q

Contraindications of propanolol

A

Diabetes
Heart failure
Asthma/COPD

57
Q

Why should diabetics not take propanolol?

A

Decreases glycogenolysis (can’t respond to hypoglycemia)

58
Q

Atenolol is a B_ selective antagonist

A

B1

UNMC PA Pharmacology (23 decks)

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