Autonomic

Question 1

Alpha agonist

Answer 1

Systemically, ↑ mean blood pressure via vasoconstriction
l ↑ BP may elicit a reflex bradycardia
l Cardiac output may be ↓ but also offset by ↑ venous return

Question 2

Alpha 2

Answer 2

Stimulate prejunctional receptors in the CNS to decrease sympathetic outflow.
Primary use is in mild to moderate HTN.
l Drugs and uses: clonidine and methyldopa (mild to moderate hypertension

Question 3

Beta agonist

Answer 3

Systemically, ↓ mean BP via vasodilation (β2) and ↑ HR (β1) l Drugs and uses:
− Isoproterenol (β1 = β2)
− Dobutamine (β1 > β2): congestive heart failure
− Selective β2 agonists:
o Salmeterol, albuterol, and terbutaline used in asthma
o Terbutaline, used in premature labor

Question 4

Norepinephrine (α1, α2, β1)

Answer 4

Norepinephrine
Effect of Norepinephrine on Heart Rate and Blood Pressure
• α1:↑TPR,↑BP
• β1:↑HR,↑SV,↑CO,
↑ pulse pressure • Potential reflex
bradycardia
• No effect on β2

Question 5

Epinephrine

Answer 5

α1, α2, β1, β2

Question 6

Effect of Low-dose Epinephrine

Answer 6

• β1:↑HR,↑SV,↑CO, ↑ pulse pressure
• β2:↓TPR,↓BP

Question 7

Effect of Medium-Dose Epinephrine on Heart Rate and Blood Pressure

Answer 7

β1:↑HR,↑SV,↑CO, ↑ pulse pressure
• β2:↓TPR,↓BP
• α1:↑TPR,↑BP

Question 8

Effect of High-dose Epinephrine Is Similar to Norepinephrine

Answer 8

α1:↑TPR,↑BP • Potential reflex
bradycardia
• β1:↑HR,↑SV,↑CO,
↑ pulse pressure • β2:↓TPR,↓BP

Question 9

α1

Answer 9

α1
Eye—radial (dilator) muscle Arterioles (skin, viscera)
Contraction :mydriasis
Veins and arteries
Contraction—↑ TPR—↑ diastolic pressure,
↑ afterload
Contraction—↑ venous return—↑ preload
bladder
Contraction—urinary retention
Male sex organs

Vas deferens—ejaculation
Liver increased glycogenolysis
Kidney decreased renin release

Question 10

Alpha2

Answer 10

Prejunctional nerve terminals Platelets
Pancreas
↓ transmitter release and NE synthesis Aggregation
↓ insulin secretion

Question 11

β1

Answer 11

SA node 
Increased heart rate
Positive chronotropy 
AV node
Increases conduction velocity (dromotopy)
Atrial and ventricular muscle
↑ force of contraction (positive inotropy), conduction velocity, CO and oxygen consumption
 His-Purkinje
↑ automaticity and conduction velocity
Kidney
 ↑ renin release

Question 12

Beta 2

Answer 12

Blood vessels
Vasodilation
Uterus relaxation
Bronchioles dilation
Skeletal muscle increased contractions tremor
Liver increasedglycogenolysis
Pancreas increased insulin

Question 13

D1 peripheral

Answer 13

Renal, mesenteric, coronary vasculature
Vasodilation—

in kidney ↑ RBF, ↑ GFR, ↑ Na+ secretion