Alpha Adrenergic Drugs

Question 1

What are Alpha 1 agonists drugs?

Answer 1

Mnemonic : POM
- Phenylephrine
- Oxymetazoline
- Midodrine

Question 2

What are the effects of Alpha 1 agonists?

Answer 2

• Arterioles constriction ( high BP)
• Reflex bradycardia ( low HR )

Question 3

13F + nasal congestion + uses intranasal spray.
a)- what’s the most likely agent she use ?

Answer 3

a)- POM

Question 4

16M + viral infection + has been using intranasal spray for 5days straight to treat nasal congestion.
a)- what agent was he using?
b)- what is the diagnosis?
c)- what is the prevention?

Answer 4

a)- POM
b)- Rhinitis medicamentosa
c)- Prevention by not using Intranasal Alpha1 agonists for more than 3days + use as infrequently as possible.

Question 5

24F + nose is bleeding (epistaxis) in the ED.
What is the next best step?

Answer 5

• Nasal packing

Question 6

24M + nose is bleeding (epistaxis) in the ED.
What drugs may help this patient?

Answer 6

• POM

Question 7

50F + history of dysphagia and pulmonary fibrosis + fingers turn color in the cold.
a)- what drug should be avoided in this patient?

Answer 7

a)- POM (cause they vasoconstricts)

Question 8

34F + pregnant + performing Kegel exercises to strengthen pelvic floor muscles.
1)- what muscle is not strengthen by Kegel exercises?
2)- Why?

Answer 8

1)- Internal sphincters
2)- Internal sphincters are under sympathetic control (which means catecholamines binds to alpha 1 receptors for the internal sphincters to contracts, so its not under voluntary control)

Question 9

What are alpha 1 antagonists drugs ?

Answer 9

• Phentolamine
• Phenoxybenzamine
• -osins ( prazosin, tamsulosin, terazosin )

Question 10

What are alpha 1 antagonists drugs effects ?

Answer 10

• Decrease arteriolar vasoconstriction ( not the same as vasodilation) (low BP)
• Reflex tachycardia ( high HR)

Question 11

What is Phenoxybenzamine ?

Answer 11

• Alpha 1 antagonist
• Irreversible and non-competitive drug

Question 12

What Phenoxybenzamine is used for ?

Answer 12

• To manage and treat hypertension and sweeting due to pheochromocytoma ( catecholamines secreting tumor of adrenal medulla)

Question 13

What is Phentolamine ?

Answer 13

• Alpha 1 antagonist
• Reversible competitive drug

Question 14

Tamsulosin & terazosin drugs are ?

Answer 14

• Alpha 1 antagonist
• Used for BPH ( benign prostatic hyperplasia)

Question 15

What is the other drug that could be used for BPH ?

Answer 15

• The 5alpha reductase inhibitor finasteride

Question 16

What are the side effects of TCA, anti-psychotic and first gen H1 blockers?

Answer 16

• Alpha 1 antagonist, orthostatic hypotension + fainting
• Anti-cholinergic, hot + red + dry patient with a full bladder + sometimes dry month and eyes
• Anti-H1, sedation

Question 17

What do Alpha-2 receptors do ?

Answer 17

• They serve a negative feedback on presynaptic terminals
• In other words, if a catecholamines binds to alpha2 R, then the result is decreased release of additional catecholamines from the presynaptic terminal.

Question 18

What are the alpha-2 agonists drugs ?

Answer 18

• Methyldopa
• Clonidine

Question 19

What is Methyldopa used for ?

Answer 19

• To treat HTN in pregnant women

Question 20

What are the drugs used to treat Parkinson disease?

Answer 20

• Carbidopa
• Levodopa

Question 21

What Clonidine is used for ?

Answer 21

• To treat HTN as well, but is notably used as a psych drug

Question 22

What is alpha-2 antagonist drug?

Answer 22

• Mirtazapine

Question 23

What Mitrazapine do?

Answer 23

• Stimulates appetite. Used to treat ppl with anorexia who also have depression