ANS SNS Drugs Flashcards
1
Q
Describe adrenaline 6
A
- Adrenaline is an endogenous catecholamine that stimulates both α and β receptors.
- Indicators for use include anaphylaxis and in combination with anaesthetics.
- Epinephrine is a potent vasoconstrictor and cardiac stimulant. Adrenaline results in positive inotropic (modifying force/speed of contraction of the heart) and chronotropic (change heart rate) effects on the heart (β1).
- There is also vasoconstriction in the vascular beds (α)
- β2 receptors are activated causing vasodilation in smooth and bronchodilation.
- Hyperglycemia results from increased glycogenolysis (β2) and decreased insulin release (α2)
- Side effects include: headache and prolonged use may result in peripheral vasoconstriction
2
Q
Describe dopamine 5
A
- Dopamine is an adrenergic agonist
- Indications for use include: cardiogenic and septic shock, acute hypotension and severe HF
- Low dose dopamine activates dopaminergic receptors in the renal blood vessels resulting in increased CAMP leading to renal dilation and diuresis (increased urine production).
- Higher dose dopamine has positive inotropic and chronotropic effects on the heart by activating β1 receptors
- Large doses activate α1 receptors resulting in vasoconstriction of the VSM
- Side effects include hypertension, nausea and arrhythmias
3
Q
Describe dobutamine 4
A
- Dobutamine is a direct acting sympathomimetic
- It is a β1-selective-adrenergic agonist
- It is indicated for acute failure
- By selectively stimulating the β1 receptors in the heart, dobutamine stimulates positive inotropic and chronotropic effects resulting in an increased cardiac output
- Side effects include atrial fibrillation
4
Q
Describe phenylephrine 4
A
- Phenylephrine is a direct acting sympathomimetic
- It is an α1 adrenoceptor agonist.
- Use of phenylephrine is indicated for nasal decongestant, hypotension and in mydriatic (dilation)eye exams.
- Stimulation of the of α1 receptors results in:
A) vasoconstriction (nasal mucosa for is example)
B) increased BP
C) mydriasis in the eye - Side effects include HT and headache
5
Q
Describe oxymetazoline and xylometazoline 4
A
- Oxymetazoline and xylometazoline are direct acting sympathomimetics
- They are α adrenergic agonists
- They are used as nasal decongestants, but may only be used for 5 days max or patient is at risk of rebound congestion .
- Topical nasal spray results in stimulation of α1 receptors resulting in local vasoconstriction of nasal mucosa and conjunctiva
6
Q
Describe salbutamol
A
- Salbutamol is a direct acting sympathomimetic
- Salbutamol is a β2 adrenergic receptor agonist
- Salbutamol is indicated for use in asthma and COPD
- Stimulation of the β2 receptors relaxes the bronchial smooth muscle resulting in bronchodilation
- Inhalers:
A. Salbutamol is short acting
B. Salmeterol is long acting
C. Indicaterol is ultra-long acting - Side effects include restlessness, tremor, tachycardia or arrhthmia
7
Q
Describe ephedrine
A
- Ephedrine is a mixed acting sympathomimetic drug that is banned by the FDA because of life threatening CV reactions
- Ephedrine is an α and β receptor agonist and promotes the release of NE from nerve endings
- Long DOA
- Enters the CNS with a mild stimulant effect
8
Q
Describe pseudoephedrine
A
- Pseudoephedrine is mixed acting sympathomimetic drug that was banned by the FDA
- Ephedra enantiomers (same effect as ephedrine)
- Was available as an over the counter decongestant
9
Q
Describe α methyldopa 4
A
- α methyl dopa is central acting α2 agonist
- α methyldopa is used to treat hypertension in pregnancy
- α methyldopa stimulates α2 receptors in the brain leading to decreased sympathetic outflow ( decr HR, decreased CO, decr PR —> decr BP)
- α methyldopa inhibits the synthesis of catecholamines, dopamine and serotonin
10
Q
Describe phenoxybenzamine 6
A
- Phenoxybenzamine is an α adrenergic sympatholytic
- Phenoxybenzamine is a non-selective α adrenergic antagonist (24 hours)
- Phenoxybenzamine is used to treat pheochromacytoma (pre op) and rynaud’s disease.
- phenoxybenzamine is a vasodilation, reduces peripheral resistance
- Side effects include: postural hypotension, nasal stiffness, decreased ejaculation
- Phenoxybenzamine is contraindicated in CV disease
11
Q
Describe phentolamine
A
- Phentolamine is an α adrenoceptor sympatholytic.
- Phentolamine is an α1 and α2 antagonist (4hours)
- Phentolamine is used to treat pheochromacytoma and in HPT crisis (MAO-1 tyramine food, clonidine withdrawal)
- Side effects include postural hypotension, arrhythmias and angin
- Contraindicated in IHD
12
Q
Describe prazosin 4
A
- Prazosin is an α adrenoceptor sympatholytic
- Prazosin is a selective α1 antagonist
- Prazosin is used to treat hypertension
- Side effects include postural hypotension, drowsiness, headache and nasal congestion
13
Q
Describe terazosin 4
A
- Terazosin is an α adrenergic sympatholytic
- Terazosin is a selective α1 antagonist
- Terazosin is used to treat hypertension
- Side effects include postural hypotension, drowsiness, headache and nasal congestion
14
Q
Describe doxazosin 4
A
- Doxazosin is a α adrenergic sympatholytic
- Doxazosin is a selective α1 antagonist
- Doxazosin is used to treat hypertension
- Side effects include postural hypotension, drowsiness, headache and nasal congestion
15
Q
Describe tamsulosin 4
A
- Tamsulosin is an α adrenergic sympatholytic
- Tamsulosin is a α1a antagonist.
- Tamsulosin is used to treat benign prostatic hypertrophy (BPH)
- Side effects include retrograde ejaculation and floppy iris syndrome
16
Q
Describe alfuzosin 4
A
- alfuzosin is an α adrenergic sympatholytic
- alfuzosin is a α1a antagonist.
- alfuzosin is used to treat benign prostatic hypertrophy (BPH)
- Side effects include retrograde ejaculation and floppy iris syndrome
17
Q
Describe propanalol
A
- Propranolol is a β adrenoceptor blocker
- Propranolol blocks β1 and β2 receptors
- Propranolol is indicated for the treatment of:
a) hypertension
b) migraine
c) hyperthyroidism
d) angina pectoris
e) mycardial infarction - Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
18
Q
Describe Nadolol
A
- Nadolol is a β adrenoceptor blocker
- Nadolol blocks β1 β2 receptors
- Nadolol is indicated for use in hypertension
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
19
Q
Describe pindolol
A
- Pindolol is a β adrenoceptor blocker
- Pindolol blocks β1 β2 receptors
- Pindolol is indicated for use in hypertension
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
20
Q
Describe timolol
A
- Timolol is a β adrenoceptor blocker
- Timolol blocks β1 β2 receptors
- Timolol is indicated for use in hypertension and glaucoma
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
21
Q
Describe antenolol
A
- Atenolol is a β adrenoceptor blocker
- Atenolol blocks β1 receptors
- Atenolol is indicated for use in hypertension, angina and myocardial infarction
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
22
Q
Describe bisoprolol
A
- Bisoprolol is a β adrenoceptor blocker
- Bisoprolol blocks β1 receptors
- Bisoprolol is indicated for use in hypertension, angina and myocardial infarction
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
23
Q
Describe esmolol
A
- Esmolol is a β adrenoceptor blocker
- Esmolol blocks β1 receptors
- Esmolol is indicated for use in hypertension, angina and myocardial infarction
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
24
Q
Describe metoprolol
A
- Metprolol is a β adrenoceptor blocker
- Metprolol blocks β1 receptors
- Metprolol is indicated for use in hypertension, angina and myocardial infarction
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
25
Q
Describe acebutolol
A
- Acebutolol is a β adrenoceptor blocker
- Acebutolol blocks β1 receptors
- Acebutolol is indicated for use in hypertension
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
26
Q
Describe carvedilol
A
- Carvedilol is a β adrenoceptor blocker
- Carvedilol blocks β1 β2 α1 receptors
- Carvedilol is indicated for use in hypertension, non-acute congestive heart failure
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
27
Q
Describe labetelol
A
- Labetolol is a β adrenoceptor blocker
- Labetolol blocks β1 β2 α1 receptors
- Labetolol is indicated for use in hypertension
- Side effects include:
i. Bronchospasm
ii. Bradycardia
iii. Heart block/ failure
iv. Fatigue
v. Impotence in males
vi. Hypoglycemia
vii. Cold extremities
viii. Vivid dreams
28
Q
Describe the effects of propranolol 7
A
- Cardiovascular:
I. Negative inotropic and chronotropic effects
II. Depress SA and AV nodal activity
III. CO, workload and oxygen consumption are reduced owing to the β1 blockade
IV. Reduce renin - Vascular
I. Peripheral vasoconstriction