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Medical Pharmacology > Andrenergics > Flashcards

Andrenergics Flashcards

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USMLE® Step 1 flashcards
1
Q

Metaraminol

A
  • Adrenergic agonist – a1 selective (a1&raquo_space; a2)
  • Long acting (no OH) B1/A1 receptor stimulant - vasoconstriction, mydriasis, piloerection, increased cardiac output, inhibit GI motility
  • Hyperactive sympathetic symptoms
  • Vasopressor (hypotension – not shock)
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2
Q

Methoxamine

A
  • Adrenergic agonist – a1 selective
  • Vasoconstriction, mydriasis, piloerection, increased cardiac output, inhibit GI motility
  • Hyperactive sympathetic symptoms
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3
Q

Phenylephrine

A
  • Adrenergic agonist – a1 selective (a1 = a2)
  • Long acting (no OH) - vasoconstriction, mydriasis, piloerection, increased cardiac output, inhibit GI motility
  • Hyperactive sympathetic symptoms
  • Nasal decongestant, vasopressor, mydriatic, overcome hypotension, local vasoconstrictor
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4
Q
  • a-methyldopa
  • Clonidine
  • Guanabenz
A
  • Adrenergic agonist – a2 selective
  • Inhibit NE release by nerve terminal - decreased total peripheral resistance, HR, and cardiac output)
  • Sedation, xerostomia, anorexia, fluid retention, vivid dreams, CNS stimulation
  • Can be used for hypertension
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5
Q

Amphetamine

A 
*Adrenergic agonist – mixed a/b, 
NE releasing agent
*Block NE reuptake and reverse transport to release intraneuronal NE (a1 and B1 receptors)
*Hyperactive sympathetic symptoms
*Vasopressor
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6
Q

Ephedrine

A

*Adrenergic agonist – mixed a/b,
NE releasing agent
*Long acting (no OH), directly stimulates a1 and B1 receptors - relax bronchial smooth muscle (B2), elevation of cardiac output and arterial pressure
*Hyperactive sympathetic symptoms
*Vasopressor, mydriatic, nasal decongestant, CNS stimulant, chronic orthostatic hypotension, stress incontinence

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7
Q

Dipivefrin

A
  • Adrenrgic agonist – mixed a/b
  • Hyperactive sympathetic symptoms
  • Open angle glaucoma
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8
Q

Epinephrine

A

*Adrenergic agonist – mixed a/b – a1 = a2, B1 = B2
*B receptors are 10x more sensitive than A – low dose will see only B effects
Relax bronchial smooth muscle, very potent vasoconstrictor and cardiac stimulant, decreased total peripheral resistance (B2)
*Hyperactive sympathetic symptoms
*Anaphylactic shock, severe allergic reactions, open glaucoma, slow profuse bleeding, increase systolic BP (B1/A1 effects), heart block/cardiac arrest

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9
Q

Norepinephrine

A
  • Adrenergic agonist – mixed a/b – a1 = a2, B1»B2
  • Vasoconstriction to increase peripheral resistance (a1 receptors) and increase cardiac output (B1 receptors)
  • Hyperactive sympathetic symptoms
  • Vasopressor (shock) (IV only)
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10
Q

Dobutamine

A
  • Adrenergic agonist – B1 selective
  • Increase force cardiac contraction, increase cardiac output
  • Hyperactive sympathetic symptoms
  • Congestive heart failure, cardiogenic shock following MI
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11
Q

Isoproterenol

A
  • Adrenergic agonist – B non-selective
  • Very potent B agonist with very little a activity - relax bronchial smooth muscle (B2 stimulation), cardiac stimulant (B1), vasodilator
  • Hyperactive sympathetic symptoms
  • AV block, asthma – increase in cardiac output and decreased MAP with vasodilation
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12
Q

Albuterol

A
  • Adrenergic agonist – B2 selective
  • Skeletal muscle vasodilation, smooth muscle relaxation
  • Hyperactive sympathetic symptoms
  • Bronchial asthma
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13
Q

Metaproterenol

A
  • Adrenergic agonist – B2 selective
  • Skeletal muscle vasodilation, smooth muscle relaxation
  • Hyperactive sympathetic symptoms
  • Vasopressor (hypotension – not shock), bronchial asthma
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14
Q

Terbutaline

A
  • Adrenergic agonist – B2 selective
  • Relax bronchial smooth muscle
  • Hyperactive sympathetic symptoms
  • Asthma, relax pregnant uterus
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15
Q

Bromocriptine

A
  • Adrenergic agonist – dopamine (D2)
  • Decreases neurotransmitter release
  • Postural hypotension, cardiac arrhythmias
  • Anti-parkinson agent with CNS effects
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16
Q

Dopamine

A
  • Adrenergic agonist – dopamine, D1 = D2
  • Vasoconstriction (a1), increase cardiac output (B1), dilate renal blood vessels (DA1)
  • Hyperactive sympathetic symptoms
  • Vasopressor, very effective for shock, cardiogenic shock following MI
17
Q

Doxazosin

A
  • Adrenergic antagonist – a1 selective&raquo_space;» a2
  • Vasodilation
  • Excessive dilation
  • Urinary obstruction
18
Q

Prazosin

A
  • Adrenergic antagonist – a1 selective&raquo_space;» a2
  • Competitive reversible - little or no tachycardia due to a1 selectivity, vasodilation
  • Hypotension
  • Hypertension – oral – 12 hours – urinary obstruction
19
Q
  • Tamsulosin

- Terazosin

A
  • Adrenergic antagonist – a1 selective&raquo_space;» a2
  • Vasodilation
  • Excessive dilation
  • Urinary obstruction
20
Q

Phenoxy-benzamine

A
  • Adrenergic antagonist – a non-selective a1 > a2
  • Noncompetitive irreversible – alkylates a1 and a2 (can’t bind NE) and inhibits NET (NE can’t reuptake) - postural hypotension and tachycardia (reflex activation of adrenergic nervous system)
  • Hypotension
  • Lasts about 24 hours – oral or IV – pheochromocytoma (management of hypertension post-op)
21
Q

Phentolamine

A
  • Adrenergic antagonist – a non-selective a1 = a2
  • Competitive reversible – inhibits both a1 and a2 - vasodilation, but increased NE release (increased cardiac output and tachycardia)
  • Dirty drug – activity with muscarinic receptors and histamine
  • Pheochromocytoma – preoperative management of hypertension/ inoperative or metastatic tumors
22
Q

Labetalol

A
  • Adrenergic antagonist – mixed a/b – B1 = B2 > a1 > a2
  • Inhibit cardiac output, causes vasodilation
  • Cardiac failure
  • Anti-hypertensive
23
Q

Atenolol

A
  • Adrenergic antagonist – B1 selective&raquo_space;» B2
  • Cardiac specificity - 6-9 hours – inhibit cardiac output
  • Fewer CNS effects – inability to cross BBB – caution with asthma and COPD – cardiac failure
  • Effective anti-hypertensive w/o constriction of bronchial smooth muscle (asthma)
24
Q

Betaxolol

A
  • Adrenergic antagonist – B1 selective&raquo_space;» B2
  • Cardiac specificity - 14-22 hours – inhibit cardiac output
  • Caution use with asthma/COPD – cardiac failure
  • Effective anti-hypertensive w/o constriction of bronchial smooth muscle (asthma), open glaucoma
25
Q

Metoprolol

A
  • Adrenergic antagonist – B1 selective&raquo_space;» B2
  • Cardiac specificity – effective prophylactic agent to prevent recurrence of MI - 3-4 hours – inhibit cardiac output
  • Caution use with asthma/COPD, ataxia and dizziness – cardiac failure
  • Effective anti-hypertensive w/o constriction of bronchial smooth muscle (asthma)
26
Q

Nadolol

A
  • Adrenergic antagonist – B nonselective B1 = B2
  • 14-24 hours – inhibits cardiac output
  • Fewer CNS effects – inability to cross BBB – cardiac failure
  • Antihypertensive
27
Q
  • Carteolol
  • Levobunolol
  • Metipranolol
A
  • Adrenergic antagonist – B nonselective
  • Reduce aqueous humor production – block B1 on ciliary body
  • Open angle glaucoma
28
Q

Pindolol

A
  • Adrenergic antagonist – B nonselective B1 = B2
  • 3-4 hours – inhibits cardiac output
  • Cardiac failure
  • Antihypertensive
29
Q

Propranolol

A
  • Adrenergic antagonist – B nonselective B1 = B2
  • 3-6 hours – inhibits cardiac output
  • Ataxia and dizziness, cardiac failure
  • Antihypertensive, anti-arrhythmic, angina pectoris, migraines, prophylactics to prevent MI
30
Q

Timolol

A
  • Adrenergic antagonist – B nonselective B1 = B2
  • 4-5 hours – inhibits cardiac output
  • Cardiac failure
  • Prophylactics to prevent MI, antihypertensive, angina pectoris, decrease IOP (glaucoma)
31
Q

a-methyldopa

A
  • False transmitter
  • Enters both PNS and CNS – replaces DOPA in synthetic pathway (a-methyl NE is made) - Potent stimulation within brainstem affecting vasomotor center - hypotension
  • Sedation, dizziness, sleep disturbances, impotence, dry mouth, nasal congestion, postural hypotension
  • Antihypertensive agent
32
Q

Guanethidine

A
  • Synaptic vesicle depletion and membrane depolarization
  • Transported into adrenergic neurons via NET – reduces NE release
  • Minimal adverse side effects – doesn’t cross BBB
  • Orally effective hypertensive agent
33
Q

Reserpine

A
  • Synaptic vesicle depletion (pre-junctional)
  • Depletes stores of NE in both CNS and PNS by blocking transport into vesicles
  • Primarily in CNS (sedation, depression), increased GI motility (ulcers)
  • Very potent, orally effective, long duration
34
Q
  • Cocaine

- DMI (desmethyl-imipramine)

A
  • Amine I transport inhibitor
  • Synaptic levels of NE rise and allow further sympathetic simulation
  • Hyperactive sympathetic stimulation
  • Hemostasis during surgery
35
Q

Tyramine

A
  • NE releasing agent
  • Increases NE release into synapse – increased sympathetic effects
  • Potentially dangerous for individuals on MAO inhibitors (elevates arterial pressure)
  • Vasopressor (shock or hypotension)
36
Q

Pseudoephedrine

A
  • NE releasing agent
  • Increases NE release into synapse
  • Nasal congestion
37
Q
  • Acetazolamide
  • Dichlorphenamide
  • Dorzolamide
A
  • Carbonic anhydrase inhibitor
  • Reduce HCO3 production (required for aqueous humor production)
  • Decrease aqueous humor production – open angle glaucoma
38
Q

Botulinum Toxin A

A
  • Misc. ophthalmology
  • Blocks ability of ACh vesicles to move to nerve terminal surface and fuse – leads to relaxation in skeletal muscle
  • Blepharospasm (eyelid problem) and squinting (extraocular muscles)

Medical Pharmacology (26 decks)

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