adrengenics Flashcards

1
Q

SYMPATHETIC NERVOUSSYSTEM

A

▪mediates Organ systems, blood pressure
▪Hormone (epi from adrenal medulla) vs. neurotransmitter (NE)

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2
Q

rate limiting step NE release

A

Tyr to dopa

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3
Q

NEUROTRANSMITTER TERMINATION NE vs Ach

A

▪Acetylcholine: ACh-esterase, 150ms FAST

▪Norepinephrine: Reuptake
▪Monoamine oxidase (Pregang)
▪Catechol-OMethyltransferase (postgang)

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4
Q

direct sympathetic agonists
effects depend on?

A

bind to receptors
effect depends on: route, affinity, expression of receptor subtypes

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5
Q

indirect sympathetic agonists mechanisms

A

▪Indirect: Catecholamine displacement (Amphetamines)
▪Decreased NE clearance: Reuptake inhibition

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6
Q

ADRENERGIC RECEPTORS

A

▪α1 α2
▪β1 β2
▪Dopamine
▪Sympathomimetic (sym effects) vs sympatholytic (opposes sym effects)

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7
Q

states dowregulating adrengenic receptors

A

▪Congestive Heart Failure (CHF)
▪Acidosis
▪Hypoxia
and sepsis

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8
Q

A1 functions

A

works at peripheral vas beds, sympathomimetic
▪Vasoconstriction=Blood pressure increased
▪Mydriasis (dilated pupils)
▪Urinary sphincter constriction

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9
Q

A2 functions

A

symphatolytic
▪In the vasculature
▪Inhibition of NE and ACh
▪Decreased sympathetic tone
▪Decreased BP
▪Sedation

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10
Q

B1 functions

A

sympathetimetic
▪Cardiac excitation
▪Increased rate, contractility, conduction (chronotrophy and ionotrophy with increased Ca)

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11
Q

B2 functions

A

sympathetlytic
▪Bronchodilation
▪Smooth muscle relaxation
▪Skeletal muscle vasodilation
▪Decreased vascular resistance

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12
Q

Dopa receptor function

A

▪Resistance vessel vasodilation to increase blood flow at:
▪Renal
▪Splanchnic
▪Coronary
▪Cerebral

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13
Q

catecholamines
1 ones?
where each is from?

A

▪Dopamine (DA) and norepinephrine (NE)= Primary catecholamines
▪DA – Brain and kidney
▪NE – Sympathetic nerve endings
▪Epinephrine – Adrenal medulla

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14
Q

NE binding affinties?

A

A1>B1>B2

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15
Q

NE
▪Primary neurotransmitter at?
▪Maintenance of?
BP?
▪ cardiac output changes
▪ chronotropic changes
▪ coronary blood flow

A

▪Endogenous
▪Primary neurotransmitter at sympathetic nerve endings
▪Maintenance of sympathetic tone
▪⇧BP
▪No cardiac output changes
▪Minimal chronotropic changes
▪Increased coronary blood flow

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16
Q

NE uses

A

spetic shock or hypotensive pts with fluids administered first

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17
Q

NE caution

A

porlonged use: cardiac cell death

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18
Q

Epi
▪Only released by
▪ released for?
coronary blood flow effect?
▪Caution?

A

▪Endogenous
▪Only released by adrenal medulla
▪Stress preparation
▪⇧coronary blood flow
▪Caution prolonged infusions

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19
Q

epi affinities

A

A1 at high doses and B1/2 at lower doses

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20
Q

epi uses based on dosage?
can be used for?

A

high doses: increase bp and hr
lower doses; beta effects
can be used for anaphylaxis and with LA

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21
Q

DA

A

▪Endogenous
▪NE precursor

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22
Q

DA affinities

A
  1. DA receptor
  2. A1,B1,B2 all similar
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23
Q

DA Dose-specific effects

A

▪Low dose (0.5 – 3 mcg/kg/min): DA effects
▪Intermediate (3 – 10 mcg/kg/min): B effects
▪High (10 – 20 mcg/kg/min): A effects

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24
Q

DA uses

A

can bes used as a NE reuptake inhibitor at intermediate doses to increase iono/chrono at heart and increase BP

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25
Q

caution with DA

A

can increase risk of V fib

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26
Q

dobutamine
▪ from?
▪Augments?
▪Dose-dependent increase in?
▪Alpha effects?
▪Beta-mediated effect? dose?
▪High dose increases?

A

▪Synthetic
▪Augments myocardial contractility
▪Dose-dependent increase in stroke volume and cardiac output
▪Alpha agonist AND antagonist
▪Beta-mediated vasodilation (low dose)
▪High dose increases myocardial O2 consumption

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27
Q

dobutamine affinity

A
  1. B1
  2. B2
  3. A1
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28
Q

dobutamine uses

A

B1 agonist used for cardiac stress test, unstable cardiogenic shock (short t1/2)

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29
Q

phenylephrine
▪made?
▪ A/B?
▪ metab?
▪HR?
▪Push dose?

A

▪Synthetic
▪All alpha, no beta
▪Not a catechol derivative, not metabolized by COMT BUT still by MAO
▪Can lead to baroreceptor mediated decrease in HR
▪Push dose pressor for short-term hypotension

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30
Q

phenylepherine affinity

A

A1

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31
Q

phenylepherine uses

A

push dose pressor for short term hypotension and as a nasal decongestant

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32
Q

milrinone
▪ inhibitor?
▪Inhibits breakdown of?
▪inotropy?
▪ vaso effect?
▪Increased?
▪Reduced?
▪Good in the setting of?

A

▪Phosphodiesterase-3 inhibitor
▪Inhibits breakdown of cAMP
▪Positive inotropy
▪Potent vasodilator
▪Increased diastolic relaxation
▪Reduced preload and afterload
▪Good in the setting of receptor downregulation

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33
Q

milrinone affinity?

A

no binding but has:
1. B1 like effects
2. B2 like effects

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34
Q

milrinone use

A

HF

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35
Q

vasopressin
▪AKA
▪Stored in?
▪Released when?
▪receptor agonist?
▪Neutral to negative impact on?
▪Dose dependent effects?
▪Not affected by?

A

▪AKA: antidiuretic hormone
▪Stored in posterior pituitary
▪Released when plasma osmolality increases or BP drops
▪V1 (vasoconstrict) and V2 (retain volume) receptor agonist
▪Neutral to negative impact on CO
▪Dose dependent SVR and vagal tone increase
▪Not affected by pH

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36
Q

ADH affinity? resembles effects of what receptor?

A

V1 and 2: A1 like effects

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37
Q

ADH uses

A

pts with acidosis to increase bp

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38
Q

A2 selective agonists

A

Clonidine
Dexmedetomidine
Guanfacine
Methyldopa

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39
Q

Clonidine, Dexmedetomidine, Guanfacine, Methyldopa
▪bp?
▪Effective?
▪Class effect =

A

▪Drop BP by reducing sympathetic tone
▪Effective antihypertensive
▪Class effect = sedation
A2 AGONISTS

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40
Q

long term clonidine oral effect

A

candidasis

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41
Q

Dexmedetomidine effects

A

no effects on bp, all sedative
A2 agonist

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42
Q

guanfacine use

A

ADHD; activates A2 in PF cortex to incrase focus

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43
Q

methyldopa key use

A

HTN tx during pregnancy

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44
Q

INDIRECT ACTING
SYMPATHOMIMETICS
mechanisms

A

▪Displacers of stored NE
▪Reuptake inhibition
increasing effects of endogenous NE

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45
Q

▪Amphetamine
▪ CNS uptake
▪effect?
▪Effects mediated by?

A

▪Rapid CNS uptake
▪Stimulant
▪Effects mediated by NE and DA (indirect sympathetomeitic)

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46
Q

▪Methylphenidate (Ritalin)
▪ variant?
▪ effect?
▪Use:
▪Caution?
teeth/drug tests?

A

▪Amphetamine variant/ amphetamine like molecule
▪Similar effect and abuse potential to amphetamine
▪Use: ADD-spectrum
▪Caution - UDS
no effects on teeth
postive on drug tests

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47
Q

amphetamine oral effects

A

destroys teeth

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48
Q

▪Modafinil (Provigil)
▪role?
▪Totally different from?
▪NE, DA?
▪NE, DA, 5-HT3, glutamate?; GABA?
▪Use:

A

▪Psychostimulant
▪Totally different from amphetamine but a amp like molecule
▪NE, DA reuptake inhibition
▪NE, DA, 5-HT3, glutamate increase; GABA decrease
▪Use: narcolepsy

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49
Q

▪Straterra
▪ MOA
▪CV effects
▪similar effects as what other drug?
▪Use:

A

▪Selective NE reuptake inhibition
▪No CV effects
▪Clonidine-like effect
▪Use: ADD

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50
Q

▪Cocaine
▪Local?, peripheral?
▪mechanism?
▪sign of abuse (mental)
▪Avoid?
▪Use:

A

▪Local anesthetic, peripheral sympathomimetic
▪Reuptake inhibition,especially dopamine
▪Excited delirium
▪Avoid concurrent betablockade
▪Use: epistaxis

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51
Q

Excited delirium

A

seen with cocaine abuse, increased DA in brain can lead to aggression ith increased temp folllowed by sudden res/cardaic arrest
goal would be to get pt sedated

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52
Q

why avoid betablockade with coke

A

increased risk MI, HR will decrease but A effects of coke active=vasoconstrict

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53
Q

Beta agonism and asthma
BETA-? AGONISM
▪Commonality?
▪Triggered by?
▪Angioedema?

A

BETA-2 AGONISM
▪Key to management of acute asthma
▪Common “allergy” in dentistry (7.9%)
▪Triggered by allergens, stress, food, drugs
▪Angioedema = similar but different

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54
Q

short acting beta agonsits (SABA)

A

Albuterol
Levalbuterol
Terbutaline

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55
Q

SABA used for:

A

short term control with fast onset and short duration

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56
Q

albuterol

A

acute managment, B2 agonist but also B1 so HR may increase (can pt handle?)

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57
Q

Levalbuterol

A

L sterioisomer of albuterol
used instead of albuterol for no B1 effect

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58
Q

terbutaline

A

SABA used in severe cases: IV/IM administration

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59
Q

LABAs

A

Formoterol
Salmeterol

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60
Q

LABA use
▪used in conjunction with?
▪Blocks receptors for?
▪NOT FOR?

A

▪Longer term control, used in conjunction with SABA/steroids
▪Blocks receptors 12-18h
▪NOT FOR ACUTE ATTACKS

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61
Q

dulera

A

formoterol + mometasone
LABA

62
Q

symbicort

A

formoterol +budesonide
LABA

63
Q

advair

A

salmeterol + fluticasone
LABA

64
Q

DENTAL MANAGEMENT OF ASTHMA PATIENTS
▪Minimize likelihood?
▪Talk to your patient to learn?
▪Instruct pt. to bring?
▪Decrease?

A

▪Minimize likelihood of exacerbation
▪Talk to your patient to learn their management
strategies
▪Instruct pt. to bring albuterol inhaler to all appointments
▪Decrease stressors

65
Q

▪Drug considerations of asthma pts
ASA/NSAIDS?
antihistamines?
cholergenics?
opioids?

A

▪No ASA or NSAIDS
▪Avoid histaminic drugs, triggers attack
▪Avoid antihistamines, decreased secretions= attack
▪Avoid cholinergics, increased secretions= attack
no opioids (morphine)

66
Q

in an asthma emergency administer:

A

▪Supplemental O2
▪Consider epinephrine: 0.3 mg IM (or use EpiPen)

67
Q

types of alpha receptor antagonists

A

▪Reversible
▪Concentration dependent
▪Duration dependent on t1/2

▪Irreversible
▪Body has to generate new receptors
▪Drug effect can persist even after drug is cleared

68
Q

A1 antagonists common adr

A

▪α1 blockade blocks vasoconstriction which can lead to Orthostatic hypotension

69
Q

other effect A antag

A

▪Miosis, nasal stuffiness
▪Decreased resistance to urinary flow

70
Q

phenoxybenzamine use

A

A non-comp antag for pheochromocytoma

71
Q

phentolamine
▪Blocks?
▪Decreased?
▪ADR?

A

▪Blocks α1 and α2
▪Decreased PVR and cardiac stimulation
▪ CV adverse reactions: tachycardia with ischemia due to decrased VR

72
Q

uses of phentolamine

A

pheochromocytoma
reverse LA in soft tissue
reduce extravasation rxns

73
Q

selective A1 blockers

A

prazosin
terazosin
doxazosin

74
Q

prazosin, terazosin, doxazosin
Selective?
functions?
% bioavailability

A

Selective α1 antagonists
▪Arterial and venous vascular smooth muscle relaxation and prostate relaxation
▪50% bioavailability, First pass effect

75
Q

t1/2
▪Prazosin:
▪Terazosin:
▪Doxazosin:

A

▪Prazosin: 3h
▪Terazosin: 9h
▪Doxazosin: 22h

76
Q

▪Prazosin, Terazosin, Doxazosin use?

A

chronic HTN

77
Q

what side effect is common in selective A1 blockers

A

ortho hypoten

78
Q

tamsulosin
▪effect?
▪ bioavailability?
▪More specific to?
▪Less?

A

▪Competitive α1 blocker
▪High bioavailability
▪More specific to prostate
▪Less orthostatic hypotension= safest for BPH

79
Q

beta blockers
▪Antagonize effects of?
▪Differ in affinity for?
▪β1 specificity decreases with?
▪End in?

A

▪Antagonize effects of catecholamines and beta agonists
▪Differ in affinity for β1 and β2
▪β1 specificity decreases as dose increases
▪End in -lol (-olol, -ilol,-alol)

80
Q

-olol

A

B only block

81
Q

-ilol, -alol

A

B block with likely A effects

82
Q

▪Labetalol, carvedilol receptor affinty

A

▪β1= β2 > α1 > α2

83
Q

▪Metoprolol, betaxolol, acebutolol,
esmolol, atenolol, nebivolol receptor affinty

A

▪β1»> β2

84
Q

▪Propranolol, carteolol, penbutolol,
pindolol, timolol receptor affinty

A

β1= β2

85
Q

beta 1 specific blockers, when are these useful?

A

Betaxolol
Esmolol
Acebutolol
Metoprolol
Atenolol
Nebivolol
use for asthma, do not want to affect B2 with a non-specific block

86
Q

esmolol
▪selective
▪t1/2
▪onset
▪Requires what for administration?
▪Great for?

A

▪Beta-1 selective blocker
▪Short t1/2
▪Quick onset
▪Requires central line for administration (IV)
▪Great for tight BP control in aortic dissection

87
Q

labetalol
▪blockade of
▪ b;a ratio oral and IV
▪duration of action, up to?

A

▪Beta and alpha blockade
▪3:1 oral
▪7:1 IV
▪Dose dependent duration of action, up to 20 hours

88
Q

safer Rx for asthma pts?

A

B1 specifc blockers, do not want to block B2 which could affect bronchodialtion

89
Q

nonspecific β-blockers and epi

A

▪Caution with nonspecific β-blockers and epi, nonspecific block will antagonize epi

90
Q

works at peripheral vas beds, sympathomimetic
▪Vasoconstriction=Blood pressure increased
▪Mydriasis (dilated pupils)
▪Urinary sphincter constriction

A

A1 functions

91
Q

symphatolytic
▪In the vasculature
▪Inhibition of NE and ACh
▪Decreased sympathetic tone
▪Decreased BP
▪Sedation

A

A2 functions

92
Q

sympathetimetic
▪Cardiac excitation
▪Increased rate, contractility,
conduction (chronotrophy and ionotrophy with increased Ca)

A

B1 functions

93
Q

sympathetlytic
▪Bronchodilation
▪Smooth muscle relaxation
▪Skeletal muscle vasodilation
▪Decreased vascular resistance

A

B2 functions

94
Q

▪Resistance vessel vasodilation to increase blood flow at:
▪Renal
▪Splanchnic
▪Coronary
▪Cerebral

A

Dopa receptor function

95
Q

A1>B1>B2

A

NE binding affinties?

96
Q

▪Endogenous
▪Primary neurotransmitter at sympathetic nerve endings
▪Maintenance of sympathetic tone
▪⇧BP
▪No cardiac output changes
▪Minimal chronotropic changes
▪Increased coronary blood flow

A

NE
▪Primary neurotransmitter at?
▪Maintenance of?
BP?
▪ cardiac output changes
▪ chronotropic changes
▪ coronary blood flow

97
Q

spetic shock or hypotensive pts with fluids administered first

A

NE uses

98
Q

porlonged use: cardiac cell death

A

NE caution

99
Q

▪Endogenous
▪Only released by adrenal medulla
▪Stress preparation
▪⇧coronary blood flow
▪Caution prolonged infusions

A

Epi
▪Only released by
▪ released for?
coronary blood flow effect?
▪Caution?

100
Q

A1 at high doses and B1/2 at lower doses

A

epi affinities

101
Q

high doses: increase bp and hr
lower doses; beta effects
can be used for anaphylaxis and with LA

A

epi uses based on dosage

102
Q

▪Endogenous
▪NE precursor

A

DA

103
Q
  1. DA receptor
  2. A1,B1,B2 all similar
A

DA affinities

104
Q

▪Low dose (0.5 – 3 mcg/kg/min): DA effects
▪Intermediate (3 – 10 mcg/kg/min): B effects
▪High (10 – 20 mcg/kg/min): A effects

A

DA Dose-specific effects

105
Q

can bes used as a NE reuptake inhibitor at intermediate doses to increase iono/chrono at heart and increase BP

A

DA uses

106
Q

can increase risk of V fib

A

caution with DA

107
Q

▪Synthetic
▪Augments myocardial contractility
▪Dose-dependent increase in stroke volume (SV) and cardiac output (CO)
▪Alpha agonist AND antagonist
▪Beta-mediated vasodilation (low dose)
▪High dose increases myocardial O2 consumption

A

dobutamine
▪ from?
▪Augments?
▪Dose-dependent increase in?
▪Alpha effects?
▪Beta-mediated effect? dose?
▪High dose increases?

108
Q
  1. B1
  2. B2
  3. A1
A

dobutamine affinity

109
Q

cardiac stress test, unstable cardiogenic shock (short t1/2)

A

dobutamine uses

110
Q

▪Synthetic
▪All alpha, no beta
▪Not a catechol derivative, not metabolized by COMT BUT still by MAO
▪Can lead to baroreceptor mediated decrease in HR
▪Push dose pressor for short-term hypotension

A

phenylephrine
▪made?
▪ A/B?
▪ metab?
▪Can lead to?
▪Push dose?

111
Q

A1

A

phenylepherine affinity

112
Q

push dose pressor for short term hypotension and as a nasal decongestant

A

phenylepherine uses

113
Q

▪Phosphodiesterase-3 inhibitor
▪Inhibits breakdown of cAMP
▪Positive inotropy
▪Potent vasodilator
▪Increased diastolic relaxation
▪Reduced preload and afterload
▪Good in the setting of receptor downregulation

A

milrinone
▪ inhibitor?
▪Inhibits breakdown of?
▪inotropy?
▪ vaso effect?
▪Increased?
▪Reduced?
▪Good in the setting of?

114
Q

no binding but has:
1. B1 like effects
2. B2 like effects

A

milrinone affinity

115
Q

HF

A

milrinone use

116
Q

▪AKA: antidiuretic hormone
▪Stored in posterior pituitary
▪Released when plasma osmolality increases or BP drops
▪V1 (vasoconstrict) and V2 (retain volume) receptor agonist
▪Neutral to negative impact on CO
▪Dose dependent SVR and vagal tone increase
▪Not affected by pH

A

vasopressin
▪AKA
▪Stored in?
▪Released when?
▪receptor agonist?
▪Neutral to negative impact on?
▪Dose dependent effects?
▪Not affected by?

117
Q

A1 like effects

A

ADH affinity?

118
Q

pts with acidosis to increase bp

A

ADH uses

119
Q

Clonidine
Dexmedetomidine
Guanfacine
Methyldopa

A

A2 selective agonists

120
Q

▪Drop BP by reducing sympathetic tone
▪Effective antihypertensive
▪Class effect = sedation

A

Clonidine, Dexmedetomidine, Guanfacine, Methyldopa
▪bp?
▪Effective?
▪Class effect =
A2 AGONISTS

121
Q

candidasis

A

long term clonidine oral effect

122
Q

no effects on bp, all sedative
A2 agonist

A

Dexmedetomidine effects

123
Q

ADHD; activates A2 in PF cortex to incrase focus

A

guanfacine use

124
Q

HTN tx during pregnancy

A

methyldopa key use

125
Q

▪Rapid CNS uptake
▪Stimulant
▪Effects mediated by NE and DA (indirect sympathetomeitic)

A

▪Amphetamine
▪ CNS uptake
▪effect?
▪Effects mediated by?

126
Q

▪Amphetamine variant/ amphetamine like molecule
▪Similar effect and abuse potential to amphetamine
▪Use: ADD-spectrum
▪Caution - UDS
no effects on teeth
postive on drug tests

A

▪Methylphenidate (Ritalin)
▪ variant?
▪ effect?
▪Use:
▪Caution?

127
Q

▪Psychostimulant
▪Totally different from amphetamine but a amp like molecule
▪NE, DA reuptake inhibition
▪NE, DA, 5-HT3, glutamate increase; GABA decrease
▪Use: narcolepsy

A

▪Modafinil (Provigil)
▪role?
▪Totally different from?
▪NE, DA?
▪NE, DA, 5-HT3, glutamate?; GABA?
▪Use:

128
Q

▪Selective NE reuptake inhibition
▪No CV effects
▪Clonidine-like effect
▪Use: ADD

A

▪Straterra
▪function
▪CV effects
▪?-like effect
▪Use:

129
Q

▪Local anesthetic, peripheral sympathomimetic
▪Reuptake inhibition,especially dopamine
▪Excited delirium
▪Avoid concurrent betablockade
▪Use: epistaxis

A

▪Cocaine
▪Local?, peripheral?
▪mechanism?
▪sign of abuse (mental)
▪Avoid?
▪Use:

130
Q

Albuterol
Levalbuterol
Terbutaline

A

short acting beta agonsits (SABA)

131
Q

acute managment, B2 agonist but also A1 so HR may increase (can pt handle?)

A

albuterol

132
Q

L sterioisomer of albuterol
used instead of albuterol for no A1 effect

A

Levalbuterol

133
Q

SABA used in severe cases: IV/IM administration

A

terbutaline

134
Q

Formoterol
Salmeterol

A

LABAs

135
Q

▪Advair = salmeterol + fluticasone
▪Symbicort = formoterol +budesonide
▪Dulera – formoterol + mometasone

A

LABA + steroid formulations

136
Q

▪α1 blockade blocks vasoconstriction
▪Can lead to Orthostatic hypotension

A

A antag CV pharm effects

137
Q

▪Miosis, nasal stuffiness
▪Decreased resistance to urinary flow

A

other effect A antag

138
Q

A non-comp antag for pheochromocytoma

A

phenoxybenzamine use

139
Q

▪Blocks α1 and α2
▪Decreased PVR and cardiac stimulation
▪Can lead to CV adverse reactions: tachycardia with ischemia due to decrased VR

A

phentolamine
▪Blocks?
▪Decreased?
▪ADR?

140
Q

pheochromocytoma
reverse LA in soft tissue
reduce extravasation rxns

A

uses of phentolamine

141
Q

prazosin
terazosin
doxazosin

A

selective A1 blockers

142
Q

Selective α1 antagonists
▪Arterial and venous vascular smooth muscle relaxation and prostate relaxation
▪50% bioavailability, First pass effect

A

prazosin, terazosin, doxazosin
Selective?
functions?
% bioavailability

143
Q

▪Competitive α1 blocker
▪High bioavailability
▪More specific to prostate
▪Less orthostatic hypotension= safest for BPH

A

tamsulosin (flomax)
▪effect?
▪ bioavailability?
▪More specific to?
▪Less?

144
Q

▪Antagonize effects of catecholamines and beta
agonists
▪Differ in affinity for β1 and β2
▪β1 specificity decreases as dose increases
▪End in -lol (-olol, -ilol,-alol)

A

beta blockers
▪Antagonize effects of?
▪Differ in affinity for?
▪β1 specificity decreases with?
▪End in?

145
Q

▪β1= β2 > α1 > α2

A

▪Labetalol, carvedilol receptor affinty

146
Q

▪β1»> β2

A

▪Metoprolol, betaxolol, acebutolol,
esmolol, atenolol, nebivolol receptor affinty

147
Q

β1= β2

A

▪Propranolol, carteolol, penbutolol,
pindolol, timolol

148
Q

▪Beta-1 selective
▪Short t1/2
▪Quick onset
▪Requires central line for administration (IV)
▪Great for tight BP control in aortic dissection

A

esmolol
▪selective
▪t1/2
▪onset
▪Requires what for administration?
▪Great for?

149
Q

▪Beta and alpha blockade
▪3:1 oral
▪7:1 IV
▪Dose dependent duration of action, up to 20 hours

A

labetalol
▪blockade of
▪ b;a ratio oral and IV
▪duration of action, up to?

150
Q

which beta blockers have both B and A effects?

A

labetalol and carvedilol

151
Q

which beta blockers have mainly B1 effects? (B1 specific)

A

BE A MAN
betaxolol
esmolol
atenolol
metoprolol
acebutolol
nebivolol

152
Q

which beta blockers have equal B1 and 2 effects

A

propranolol
carteolol
penbutolol
pindolol
timolol