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Pharm module 4 CNS I > Alpha and Beta receptors > Flashcards

Alpha and Beta receptors Flashcards

1
Q

What are adrenoreceptor agonists (sympathomimetics)

A

Drugs that mimic the actions of epinephrine or norepinephrine

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2
Q

What is the MOA of sympathomimetic drugs

A

Activate adrenoreceptors, leading to some or all of the characteristic effects of endogenous catecholamine

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3
Q

What are the subtypes of adrenoreceptors

A

Alpha 1
Alpha 2
Beta 1
Beta 2
Beta 3
Dopamine

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4
Q

What do the Alpha 1 subtypes act on

A

innervated vascular smooth muscle
Pupillary dialator
Pilomotor smooth muscle
Prostate
Heart contractions

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5
Q

What does the Alpha 2 subtype act on

A

Postsynaptic CNS neurons
Platelets
Fat cells
Some vascular smooth muscle
Adrenergic / cholinergic nerve terminals

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6
Q

What does Beta 1 act on

A

The heart

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7
Q

What does beta 2 act on

A

Lungs, liver, and smooth muscle

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8
Q

What does beta 3 act on

A

Bladder
fat cells

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9
Q

What do dopamine 1 receptors act on

A

Smooth muscle
* states of septic / cariogenic shock

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10
Q

What do dopamine 2 receptors act on

A

Nerve endings
*anti-psychotics

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11
Q

What activates alpha 1 receptors

A

Arterial and venous vasoconstriction

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12
Q

What happens when alpha 1 gets activated

A

It will be counteracted by the autonomic baroreflex mechanism causing
rise in BP -> increase vagal tone-> Slowing of Hr

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13
Q

What is an example of an alpha 1 agonist

A

Phenylepherine

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14
Q

What happens if you give alpha 2 agonist as a local administration

A

Vasoconstriction in that specific area occurs

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15
Q

What happens if Alph 2 agonist is given systemically

A

Inhibition of sympathetic tone causing reduced blood pressure

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16
Q

What is the systemic effect of beta receptor activation

A

Increase in CO which increases contractility and HR through direct activation of the SA node

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17
Q

What is the overall net effect or purpose of giving a beta receptor agonist

A

Systolic BP will increase slightly
Diastolic BP will decrease
Overall MAP decreases

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18
Q

What is the purpose of MAP

A

Knowing the perfusion pressure in the body

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19
Q

What is chronotropy

A

Increased pacemaker activity and heart rate

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20
Q

What is dromotropy

A

Increased conduction velocity in the AV node with decrease in refractory period

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21
Q

What is inotropy

A

Increased intrinsic myocardial contractility and accelerated relaxation

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22
Q

What does isoproterenol activate

A

Beta 1 and beta 2 receptors

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23
Q

What does epinephrine activate

A

Both alpha and beta receptors

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24
Q

What occurs when a dopamine receptor is activated

A

Vasodilation of renal, splanchnic, coronary, and cerebral vessels

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25
Q

What occurs if you give someone high doses of dopamine

A

The effects will mimic those of epinephrine

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26
Q

Which receptors are important in the treatment of asthma and why

A

Beta 2 because the Beta 2 receipts in the bronchial smooth muscles = bronchodilation

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27
Q

What effects does Alpha 2 have on the eye

A

Increases outflow of aqueous humor to help decrease intraoccqular pressure

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28
Q

What do Beta agonists do in the eye and what are they used for

A

They decrease the production of aqueous humor

helpful to treat open angle glaucoma

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29
Q

What effects to catecholamines have on the CNS

A

They do not enter the CNS

But can cause nervousness or feeling of impending doom from tachycardia and tremors

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30
Q

What effect for amphetamines have on the CNS

A

They DO enter the CNS and result in improved attention, better mood, psychotic behavior

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31
Q

What receptors does norepinephrine work on

A

Potent agonist for alpha 1, alpha 2, and beta 1 receptors

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32
Q

When is norepinephrine used

A

In the ICU for treatment of shock

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33
Q

When is dopamine utilized

A

Treatment of cariogenic shock and septic shock in the UCU

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34
Q

What are the differences between dopamine and norepinephrine

A

Dopamine is the metabolic precursor for norepinephrine

Dopamine has better renal blood supply

Better treatment in those with hypotension and severe heart failure who are also oliguric

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35
Q

What do isoproterenol act on

A

Beta 1 and 2 receptors only

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36
Q

When is isoproterenol used

A

Occasionally in the treatment of AV node block

37
Q

What is doputamine

A

Beta 1 receptor agonist

Stimulant for cardiac stress testing

Pressor for those in acute heart failure
inotrope post cardiac surgery

38
Q

What is the MOA for dobutamine

A

Increases cardiac rate and output with few vascular effects

*direct acting sympathomimetics

39
Q

What is phenylephrine

A

Alpha 1 receptor agonist

Induces reflexive bradycardia

Nasal decongestant

40
Q

What is the MOA for phenylephrine

A

Causes vasoconstriction and increase systolic and diastolic pressure

41
Q

What are some indirect acting sympathomimetics

A

Amphetamine
Methamphetemine
Methylphenidate
cocaine

42
Q

What is the MOA for indirect acting sympathomimetics

A

causes release of catecholamines like dopamine and norepinephrine at nerve terminals

powerful CNS stimulant

43
Q

When are indirect acting sympathomimetics used

A

ADD/ADHD management

Weight loss

Narcolepsy

44
Q

What is the MOA for cocaine

A

Blocks cellular uptake of norepinephrine into the adrenergic neuron, causing an increase NE in the synapse

Also blocks the reuptake of dopamine and serotonin

45
Q

What is the MOA for ephedrine and pseudoephedrine

A

Release stored norepinephrine from nerve endings

agonize both alpha and beta receptors

46
Q

What does ephedrine do specifically to the body

A

Raises SBP and DBP by vasoconstriction and increase CO

Can treat hypotension

47
Q

What has ephedrine been replaced by

A

epinephrine

48
Q

What does pseudoephedrine do specifically to the body

A

Treats nasal congestion via vasoconstriction

49
Q

What type of drug is albuterol

A

Sympathomimetic

Short acting beta 2 agonist

50
Q

What is the MOA for albuterol and what is it used for

A

Causes bronchodilation

Used in asthma and COPD

51
Q

What are side effects of albuterol

A

tremor
restlessness
anxiety
tachycardia

52
Q

What are some long acting bronchodilators

A

Salmeterol
formoterol

53
Q

What type of drug is phenoxybenzamine

A

Alpha receptor antagonist

54
Q

What is phenoxybenzamine used for

A

Used in the treatment of pheochromocytoma

55
Q

What is pheochromocytoma

A

Tumor of the adrenal medulla or sympathetic ganglion cells that secrete catecholamines

56
Q

What is the MOA of phenonxybenzamine

A

Attenuates catecholamine induced vasoconstriction

57
Q

What receptor does prazosin act on

A

Alpha 1

58
Q

What in the MOA for prazosin

A

Decreases PVR which leads to lower BP

*makes it a good antihypertensive

59
Q

Why is prazosin not generally a first line drug

A

Has inferior cardiovascular outcomes compared to other anti-hypertensives

60
Q

What type of drug is tamsulosin

A

Selective alpha 1 antagonist

61
Q

What is the MOA for tamsulosin

A

greater potency for inhibiting prostate smooth muscle contraction vs vascular smooth muscle and therefore has less effect on standing blood pressure

62
Q

How do beta receptor antagonists work

A

Occupy beta receptors and competitively reduce receptor occupancy by catecholamines

63
Q

What are beta receptor antagonist used for

A

Treat hypertension, angine arrythmia, MI, hyperthyroidism, heart failure, glaucoma

64
Q

What do beta 1 receptors act on

A

heart and juxtaglomerular cells

65
Q

what do beta 2 receptors act on

A

Respiratory, uterine, vascular smooth muscle

Skeletal muscle

Human liver

66
Q

What do beta 3 receptors act on

A

bladder
fat cells

67
Q

What cardiovascular effects do beta antagonists have

A

Lower bp in patients with hypertension

negative inotropic and chronotropic effects
-chronic heart failure
-angina
-immediate post MI

Decreased CO->hypotension-> compensatory/reflexive rise in PVR

68
Q

Negative side effects of beta receptor antagonists

A

Increased airway resistance

Decreased glycogenolysis

Decreased HDL

Increased VLDL

sexual impairments

69
Q

What type of drug is propanolol

A

Effects beta 1 and beta 2 receptors equally

beta receptor antagonist

70
Q

What is the MOA for propranolol

A

Diminishes CO and depresses SA and AV nodal activity which will minimize angina

71
Q

When is propranolol primarily used

A

Hypertension and angina management

72
Q

What other things can propranolol be used for besides cardiac issues

A

anxiety
migraine
tremors

73
Q

What beta receptor antagonists are selective to beta 1

A

metoprolol
antenolol
esmolol
nebivolol

74
Q

What makes the beta 1 selective drugs better than propranolol

A

Better for those with bronchoconstrictive disorders

little effect on peripheral resistance and carbohydrate metabolism

75
Q

What is metoprolol typically used for

A

Management of CHF

76
Q

What type of drug is acebutolol

A

beta 1 antagonist

77
Q

What is the MOA for acebutolol

A

hypertension management in those with moderate bradycardia

78
Q

What type of drugs are labetolol and carvedilol

A

Non-selective lPH 1 beta antagonists

79
Q

When is lebatolol typically used

A

hypertensive emergencies to lower bp rapidly

80
Q

when is carvedilol used

A

Chronic heart failure management

81
Q

What type of drug is timolol and nadolol

A

potent non-selective beta receptors

82
Q

When is timolol typically used

A

primarily in glaucoma treatment

Not for closed angle attacks

83
Q

What is the MOA for timolol

A

Diminishes aqueous humor production by ciliary body

84
Q

When is nadolol used

A

Reduce angina frequency and intensity

85
Q

What is alpha 1 receptor in charge of

A

vasoconstriction
increased peripheral resistance
mydriasis
increased blood pressure

86
Q

What is the alpha 2 receptor in charge of

A

inhibiting transmitter release from presynaptic terminals

inhibition of NE release

Inhibition of insulin release

87
Q

What is beta 1 in charge of

A

Increased rate, force of contraction, AV conduction velocity in the heart = tachycardia

Increased renin release from kidneys

increased lipolysis

88
Q

What is beta 2 in charge of

A

Vasodilation
bronchodilation
decrease peripheral resistance
increased glucagon release
relaxed uterine contraction
increased muscle / liver glycogenesis

Pharm module 4 CNS I (2 decks)

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