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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
What occurs if you give someone high doses of dopamine
The effects will mimic those of epinephrine
26
Which receptors are important in the treatment of asthma and why
Beta 2 because the Beta 2 receipts in the bronchial smooth muscles = bronchodilation
27
What effects does Alpha 2 have on the eye
Increases outflow of aqueous humor to help decrease intraoccqular pressure
28
What do Beta agonists do in the eye and what are they used for
They decrease the production of aqueous humor helpful to treat open angle glaucoma
29
What effects to catecholamines have on the CNS
They do not enter the CNS But can cause nervousness or feeling of impending doom from tachycardia and tremors
30
What effect for amphetamines have on the CNS
They DO enter the CNS and result in improved attention, better mood, psychotic behavior
31
What receptors does norepinephrine work on
Potent agonist for alpha 1, alpha 2, and beta 1 receptors
32
When is norepinephrine used
In the ICU for treatment of shock
33
When is dopamine utilized
Treatment of cariogenic shock and septic shock in the UCU
34
What are the differences between dopamine and norepinephrine
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
35
What do isoproterenol act on
Beta 1 and 2 receptors only
36
When is isoproterenol used
Occasionally in the treatment of AV node block
37
What is doputamine
Beta 1 receptor agonist Stimulant for cardiac stress testing Pressor for those in acute heart failure inotrope post cardiac surgery
38
What is the MOA for dobutamine
Increases cardiac rate and output with few vascular effects *direct acting sympathomimetics
39
What is phenylephrine
Alpha 1 receptor agonist Induces reflexive bradycardia Nasal decongestant
40
What is the MOA for phenylephrine
Causes vasoconstriction and increase systolic and diastolic pressure
41
What are some indirect acting sympathomimetics
Amphetamine Methamphetemine Methylphenidate cocaine
42
What is the MOA for indirect acting sympathomimetics
causes release of catecholamines like dopamine and norepinephrine at nerve terminals powerful CNS stimulant
43
When are indirect acting sympathomimetics used
ADD/ADHD management Weight loss Narcolepsy
44
What is the MOA for cocaine
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
What is the MOA for ephedrine and pseudoephedrine
Release stored norepinephrine from nerve endings agonize both alpha and beta receptors
46
What does ephedrine do specifically to the body
Raises SBP and DBP by vasoconstriction and increase CO Can treat hypotension
47
What has ephedrine been replaced by
epinephrine
48
What does pseudoephedrine do specifically to the body
Treats nasal congestion via vasoconstriction
49
What type of drug is albuterol
Sympathomimetic Short acting beta 2 agonist
50
What is the MOA for albuterol and what is it used for
Causes bronchodilation Used in asthma and COPD
51
What are side effects of albuterol
tremor restlessness anxiety tachycardia
52
What are some long acting bronchodilators
Salmeterol formoterol
53
What type of drug is phenoxybenzamine
Alpha receptor antagonist
54
What is phenoxybenzamine used for
Used in the treatment of pheochromocytoma
55
What is pheochromocytoma
Tumor of the adrenal medulla or sympathetic ganglion cells that secrete catecholamines
56
What is the MOA of phenonxybenzamine
Attenuates catecholamine induced vasoconstriction
57
What receptor does prazosin act on
Alpha 1
58
What in the MOA for prazosin
Decreases PVR which leads to lower BP *makes it a good antihypertensive
59
Why is prazosin not generally a first line drug
Has inferior cardiovascular outcomes compared to other anti-hypertensives
60
What type of drug is tamsulosin
Selective alpha 1 antagonist
61
What is the MOA for tamsulosin
greater potency for inhibiting prostate smooth muscle contraction vs vascular smooth muscle and therefore has less effect on standing blood pressure
62
How do beta receptor antagonists work
Occupy beta receptors and competitively reduce receptor occupancy by catecholamines
63
What are beta receptor antagonist used for
Treat hypertension, angine arrythmia, MI, hyperthyroidism, heart failure, glaucoma
64
What do beta 1 receptors act on
heart and juxtaglomerular cells
65
what do beta 2 receptors act on
Respiratory, uterine, vascular smooth muscle Skeletal muscle Human liver
66
What do beta 3 receptors act on
bladder fat cells
67
What cardiovascular effects do beta antagonists have
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
Negative side effects of beta receptor antagonists
Increased airway resistance Decreased glycogenolysis Decreased HDL Increased VLDL sexual impairments
69
What type of drug is propanolol
Effects beta 1 and beta 2 receptors equally beta receptor antagonist
70
What is the MOA for propranolol
Diminishes CO and depresses SA and AV nodal activity which will minimize angina
71
When is propranolol primarily used
Hypertension and angina management
72
What other things can propranolol be used for besides cardiac issues
anxiety migraine tremors
73
What beta receptor antagonists are selective to beta 1
metoprolol antenolol esmolol nebivolol
74
What makes the beta 1 selective drugs better than propranolol
Better for those with bronchoconstrictive disorders little effect on peripheral resistance and carbohydrate metabolism
75
What is metoprolol typically used for
Management of CHF
76
What type of drug is acebutolol
beta 1 antagonist
77
What is the MOA for acebutolol
hypertension management in those with moderate bradycardia
78
What type of drugs are labetolol and carvedilol
Non-selective lPH 1 beta antagonists
79
When is lebatolol typically used
hypertensive emergencies to lower bp rapidly
80
when is carvedilol used
Chronic heart failure management
81
What type of drug is timolol and nadolol
potent non-selective beta receptors
82
When is timolol typically used
primarily in glaucoma treatment Not for closed angle attacks
83
What is the MOA for timolol
Diminishes aqueous humor production by ciliary body
84
When is nadolol used
Reduce angina frequency and intensity
85
What is alpha 1 receptor in charge of
vasoconstriction increased peripheral resistance mydriasis increased blood pressure
86
What is the alpha 2 receptor in charge of
inhibiting transmitter release from presynaptic terminals inhibition of NE release Inhibition of insulin release
87
What is beta 1 in charge of
Increased rate, force of contraction, AV conduction velocity in the heart = tachycardia Increased renin release from kidneys increased lipolysis
88
What is beta 2 in charge of
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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