Adrenergics Flashcards by Ryan Hutten

Tissues and actions of Alpha 1 receptors

Vascular smooth muscle contraction

Pupillary dilator muscle contraction

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Tissues and actions of Alpha 2 receptors

Inhibition of transmitter release in adrenergic and cholinergic nerve terminals

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Tissues and action of Beta 1 receptors

Stimulation of the rate and force of cardiac contraction

Stimulation of renin release from the JGA

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Tissues and action of Beta 2 receptors

Relaxation of respiratory, uterine and vascular smooth muscle
Act on somatic motor nerve terminals and can cause tremor

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Tissues and action of Dopamine 1 receptors

Renal and other splanchnic blood vessel relaxation

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What G-protein class is coupled with α1 adrenergic receptors?

Gq –> activate PLC to produce IP3 and DAG and increase intracellular Ca2+ levels

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What G-protein class is coupled with α2 adrenergic receptors?

Gi –> decrease NT release by inhibition of Adenylyl cyclase

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What G-protein class is coupled with β1 adrenergic receptors?

Gs –> activate adenylyl cyclase to increase cAMP

Responsible for increased Ca current in phase 4 depolarization of the heart –> increased HR

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Epinephrine mechanism of action

α and β agonist

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Epinephrine indication

anaphylaxis
shock
cardiac arrest
heart block

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Norepinephrine mechanism of action

α and β1 agonist

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Norepinephrine indication

acute hypotension due to shock

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Dopamine mechanism of action

D1 and β-agonist at low infusion rate

α agonist at higher infusion rate

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Dopamine indication

Cardiogenic shock

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Isoproterenol mechanism of action

nonselective β agonist

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Isoproterenol indication

transient heart block

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Dobutamine mechanism of action

β1 agonist (selective)

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Dobutamine indication

Short term Rx for low cardiac contractility (CHF or cardiogenic shock)

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Terbutaline mechanism of action

β2 agonist (selective)

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Terbutaline indication

Prevent and reverse bronchospasm in asthma, bronchitis and emphysema

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Albuterol mechanism of action

β2 agonist (selective)

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Albuterol indication

Bronchial smooth muscle relaxation

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Phenylephrine mechanism of action

α1 agonist

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Phenylephrine indication

Pressor agent for anesthesia, nasal congestion
Pupllary dilation
Supraventricular tachycardia

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Clonidine mechanism of action

α2 agonist

Clonidine indication

Hypertension

Amphetamine mechanism of action

Indirect sympathomimetic

Amphetamine indication

ADHD

Methylphenidate mechanism of action

Indirect sympathomimetic

Methylphenidate indication

ADHD

Ephedrine mechanism of action

Indirect sympathomimetic

Ephedrine indication

Pressor agent with anesthesia

Pseudoephedrine mechanism of action

Indirect sympathomimetic

Pseudoephedrine indication

Nasal decongestant

Tyramine mechanism of action

Displaces NE

Tyramine indication

Not therapeutic

Propranolol mechanism of action

β blocker

Propranolol indication

Hypertension Angina due to atherosclerosis Myocardial infarction

Timolol mechanism of action

β blocker

Timolol indication

Glaucoma

Nadolol mechanism of action

β blocker

Nadolol indication

Long term angina | Hypertension

Atenolol mechanism of action

β1 blocker

Atenolol indication

Hypertension Angina Myocardial infarction

Metoprolol mechanism of action

β1 antagonist

Metoprolol indication

Hypertension | Long term angina Rx

Pindolol mechanism of action

β-antagonist (partial agonist activity)

Pindolol indication

Hypertension

Esmolol mechanism of action

β1 blocker

Esmolol indication

Supraventricular tachycardia

Phenoxybenzamine mechanism of action

α blocker

Phenoxybenzamne indication

Pheochromocytoma

Phentolamine mechanism of action

α blocker

Phentolamine indication

Test for pheochromocytoma | Rx for pheochromocytoma before surgery

Prazosin mechanism of action

α1 blocker

Prazosin indication

Hypertension

Doxazosin mechanism of action

α1 antagonist

Doxazosin indication

Prostatic hyperplasia | Hypertension

Terazosin mechanism of action

α1 blocker

Terazosin indication

Prostatic hyperplasia | Hypertension

Rank the half lives of the β blockers from fastest to slowest

Propranolol = Timolol > Nadolol

Which β1 blocker has the shortest half life?

Esmolol has the shortest half life of the β1 blockers (9 min, compared to hours for atenolol and metoprolol)

Epinephrine toxicity

Arrhythmias

Norepinephrine toxicity

Ischemia due to over-vasoconstriction

Norepinephrine contraindication(s)

Preexisting vasoconstriction/ischemia

Dopamine toxicity

Low blood pressure | Ischemia

Isoproterenol toxicity

Tachyarrhythmias

Isoproterenol contraindications

Angina w/ arrhythmias

Dobutamine toxicity

Hypotension (β2 effect at high doses)

Terbutaline and albuterol toxicity

Tachycardia (β1) Muscle tremor (β2) Tolerance (β2)

Phenylephrine toxicity

Hypertension

Clonidine toxicity

``` Dry mouth Hypertensive crisis (after acute withdrawal) ```

Toxicity associated with indirect acting sympathomimetics

Tachycardia

Contraindications for indirect acting sympathomimetics

Rx with MAO inhibitors within 2 weeks

Toxicity of non-selective β blockers

Bronchospasm Masking symptoms of hypoglycemia Bradycardia

Contraindications of non-selective β blockers

*ASTHMA* Sinus bradycardia 2nd and 3rd degree heart block Cardiogenic shock

Toxicity of β1 blockers

Hypotension | Bradycardia

Contraindications of β1 blockers

Sinus bradycardia 2nd and 3rd degree heart block Cardiogenic shock

Toxicity of Pindolol

Hypotension

Contraindications of Pindolol

Sinus bradycardia 2nd and 3rd degree heart block Cardiogenic shock

Toxicity of non selective α blockers

Prolonged hypotension | Reflex tachycardia

Toxicity of α1 blockers

Orthostatic hypotension