Autonomic Drugs: Ch. 2.1: Sympathomimetics Flashcards
1
Q
Cue:
- “Do Not Disturb” sign under sleeping pregnant lady
A
- “Do Not DisTURB” = Terbutaline (beta-2 agonist)
2
Q
Drugs that mimic the actions of Epi or NE are called ______.
A
sympathomimetics
3
Q
Cue:
- compass pointing north
A
norepinephrine
4
Q
Name the 4 types of sympathetic (adrenergic) receptor subtypes.
A
- alpha 1
- alpha 2
- beta 1
- beta 2
5
Q
What receptor does albuterol work on?
A
beta-2
6
Q
_____ receptor activation at pancreatic islet cells causes increased insulin release.
A
Beta-2
7
Q
_____ receptors are found on pancreatic islet cells, causing decreased insulin release.
A
Alpha-2
8
Q
Alpha-2 adrenergic receptors are coupled to ____, which causes a decrease in intracellular cAMP levels.
A
Gi
9
Q
What is phenylephrine? What is it used to treat?
A
- an alpha-1 agonist
- tx for:
- nasal congestion
- septic shock (used as a pressor to increase SVR and BP)
- also causes mydriasis
10
Q
Cue:
- 3 dogs with red leashes pulled tight are in front of the Alpha-1 cabin; one is carrying a bone
A
- 3 dogs = 3 DAGs = IP3/DAG pathway
- tight red leashes = constricted small arteries = increased peripheral arterial resistance (vasoconstriction)
- alpha-1 = adrenergic receptor coupled to Gq
- bone = Ca++ = IP3/DAG pathway causes increased intracellular Ca++ in smooth muscle cells
11
Q
Name 5 direct sympathomimetic drugs.
A
- NE
- phenylephrine
- epi
- dobutamine
- isoproterenol
12
Q
Cue:
- Mime getting chased by a bear
A
- mime = sympathetic
- mimic = sympathomimetics
- bear = classic Fight or Flight scenario
13
Q
Beta-receptor agonists increase _____.
A
cAMP
14
Q
Activation of _____ receptors on fat cells causes decreased lipolysis and decreased release of fatty acids.
A
Alpha-2
15
Q
Cue:
- rolled-up “Welcome Inside” mat
A
- Ins = Insulin rolled up because insulin release is inhibited by Alpha-2
16
Q
- alpha 1 = G__
- alpha 2 = G__
- beta 1 = G___
- beta 2 = G___
A
- alpha 1 = Gq
- alpha 2 = Gi
- beta 1 = Gs
- beta 2 = Gs
17
Q
____ relax uterine smooth muscle to suppress labor (short term).
A
Beta-2 agonists
18
Q
Cue:
- Scout in front of Alpha-1 cabin looking thru binoculars, so his pupils look huge
A
- Alpha 1 = Gq adrenergic receptor
- large pupils = pupillary dilator muscle –> mydriasis
19
Q
What is ritodrine? What is it used for?
A
- a beta-2 agonist
- tx:
- labor suppression (short term)
- asthma
- COPD
20
Q
____ receptor activation in fat cells causes lipolysis and fatty acid release.
A
Beta-2
21
Q
Activation of Alpha-2 receptors cause ____ and therefore _____.
A
decreased sympathetic tone –> decreased BP
22
Q
What is reflex bradycardia?
A
a boost in BP –> baroreceptors stretched –> increased vagal tone –> slowed heart rate
23
Q
What does the IP3/DAG pathway lead to?
A
increased intracellular Ca++
24
Q
Alpha-2 adrenergic receptors are coupled to Gi, which causes ______.
A
a decrease in intracellular cAMP levels
25
Cue:
* "Iso-pro-tunnel" between the beta-1 and beta-2 camps
* "Iso-pro-tunnel" = isoproterenol (both beta-1 and beta-2 agonist)
26
Cue:
* "Flannel friends" carrying a single candle
* flannel friends = phenylephrine
* single candle = alpha-1 agonist
27
\_\_\_\_ receptor activation at the liver promotes gluconeogenesis.
Beta-2
28
Epinephrine acts as a hormone, while norepinephrine acts as a \_\_\_\_\_.
neurotransmitter
29
What sympathomimetic drugs can cause reflex bradycardia?
* phenylephrine
* norepinephrine
30
Beta-1 receptors are expressed on _____ cells, causing increased renin release.
renal juxtaglomerular
31
What is isoproterenol? What is it used to treat?
* both beta-1 and beta-2 agonist
* tx for:
* bradycardia
* heart block
32
Cue:
* Beta-1 bugler has a buff arm
* buff arm = increased contractility
33
Cue:
* 3 dogs with blue leashes pulled tight are in front of the Alpha-1 cabin
* 3 dogs = 3 dags = IP3/DAG pathway
* blue leashes = venous vasoconstriction
* Alpha-1 = Gq adrenergic receptor
34
What is a sympathomimetic?
* a drug that mimics the effects of sympathetic stimulators (Epi or NE) --\> activation of SNS
* aka fight or flight
35
What does the adrenal medulla release in response to stress?
epi
36
Cue:
* one candle in the window of the Alpha-1 cabin
* alpha-1 agonist = coupled to Gq = activates IP3/DAG pathway
37
What is the major NT used in the sympathetic nervous system?
NE
38
What is brimonidine? What is it used for?
* an alpha-2 receptor agonist
* tx for: chronic open-angle glaucoma
39
What is Terbutaline? What is it used for?
* a beta-2 agonist
* tx = labor suppression (short term)
40
What is mydriasis?
pupillary dilation
41
The sympathetic nervous system is particularly key in the regulation of \_\_\_\_\_.
blood pressure
42
\_\_\_\_\_ receptors are coupled to Gi, which causes a decrease in intracellular cAMP levels.
Alpha-2 adrenergic
43
Which alpha-2 agonist is used to treat chronic open-angle glaucoma?
brimonidine
44
Beta-2 receptors cause a decrease in _____ blood pressure.
diastolic
45
Cue:
* Beta-1 bugler with an "I heart Beta-and Camp" shirt
* beta-1 = adrenergic receptor coupled to Gs
* heart = receptors on cardiac muscle
* Camp = cAMP
* \*\*\* Beta-1 activation causes increased cAMP --\> increased intracellular calcium
46
What does venous vasoconstriction cause?
* decreased venous capacitance
* increased venous return
47
What is norepinephrine? What is it used for?
* an alpha-1/beta-1 agonist
* tx for septic shock
48
\_\_\_\_ receptor activation leads to increased cAMP, leading to activation of PKA, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.
Beta-2
49
Noreprinephine also activates beta-1 receptors to cause ____ in the heart.
increased contractility
50
Adrenergic receptors are coupled to ____ that function as transducers.
G proteins
51
Activation of ____ in the ciliary body of the eye causes increased aqueous humor production.
Beta-2
52
Beta-1 receptors are expressed on renal juxtaglomerular cells, causing increased ____ release.
renin
53
What is the medical term for pupillary dilation?
mydriasis
54
What is epinephrine? What is it used for?
* an alpha and beta (beta more) agonist
* tx for:
* bronchoconstriction
* anaphylactic shock
* cardiac arrest
* resuscitation
55
Cue:
* Left side of the picture is labeled "Alpha Scouts"
* alpha = alpha adrenergic receptors
56
Cue:
* "I Dream of Band Camp" shirt
* "I Dream of Band Camp" = ritodrine (beta-2 agonist)
57
Beta-2 receptor activation at pancreatic islet cells causes increased insulin release. What serum electrolyte change will therefore be seen?
decreased K+ (possible hypokalemia) bc insulin drives K+ into cells
58
Cue:
* girl wearing a "Just DO BUgling" tshirt
* Just DO BUgling = dobutamine (mostly beta-1 agonist but has a little beta-2)
59
What is dobutamine? What does it treat?
* a beta-1/beta-2 agonist
* tx for:
* refractory heart failure
* acute heart failure
* cardiogenic shock
* also used in cardiac stress testing (increased O2 demand)
60
Beta-2 receptor activation leads to \_\_\_\_, leading to activation of PKA, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.
increased cAMP
61
Cue:
* a camp tent in front of the Alpha-2 cabin that is getting packed up
* camp tent = cAMP
* Alpha 2 = Gi adrenergic receptor
* packed up = decreased cAMP levels
62
\_\_\_\_ receptors are expressed on renal juxtaglomerular cells, causing increased renin release.
Beta-1
63
Cue:
* Boy holding the dogs' leashes in front of the alpha-1 cabin is also holding a sign that says "Map increased"
* alpha-1 = Gq receptor
* MAP = mean arterial pressure aka blood pressure
* \*\*\* Alpha-1 activation increases mean arterial pressure (MAP)
64
Beta-1 activation on cardiac muscle causes _____ and therefore \_\_\_\_.
increased intracellular Ca++ --\> increased HR at the SA node
65
\_\_\_\_ receptors are found on the ciliary body in the eye, thereby decreasing aqueous humor production.
Alpha-2
66
What do respiratory beta-2 agonists usually end in?
* "-rol"
* ex: albuterol
67
Receptors coupled to _____ activate the IP3/DAG pathway.
Gq
68
What receptor does epinephrine work on?
* both alpha and beta (more alpha at high doses but beta\>alpha at low doses)
69
Beta-2 receptor activation leads to increased cAMP, leading to activation of \_\_\_\_, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.
PKA
70
Cue:
* two candles in the window of the Alpha-2 cabin and graffiti that says "Sympathy" scratched out
* Alpha 2 = Gi receptor
* sympathy scratched out = sympatholytics (decrease sympathetic tone)
71
Alpha-1 receptor activation in a vascular bed leads to \_\_\_\_\_.
arteriole and venous vasoconstriction
72
Cue:
* raft with "QISS" on the sail
* QISS = type of G protein coupled to the adrenergic receptor subtypes:
* alpha 1 = Gq
* alpha 2 = Gi
* beta 1 = Gs
* beta 2 = Gs
73
Any drug that activates Beta-1 receptors will cause _____ pulse pressure.
increased
74
\_\_\_\_\_\_ is a nonselective (but alpha\>beta) agonist.
Norepinephrine
75
Alpha-1 receptors are highly expressed in?
* smooth muscle cells
* vascular beds
* sphincters
76
NE activates _____ receptors on post-synaptic sites.
adrenergic
77
Which pts do not have an appropriate reflex bradycardia response?
those with decreased autonomic function, such as diabetics with neuropathy
78
Receptors coupled to Gq activate the _____ pathway.
IP3/DAG
79
Cue:
* Scout in front of Alpha-1 cabin is carrying a bladder canteen and is pulling the drawstring on his pants really tightly
* Alpha 1 = Gq adrenergic receptor
* bladder canteen = full bladder (urinary retention)
* tight pants = urethral sphincter and prostatic smooth muscle contraction --\> urinary retention
80
Beta-2 receptor activation leads to increased cAMP, leading to activation of PKA, causing _____ and \_\_\_\_.
* relaxation of smooth muscle and
* relaxation of coronary and skeletal muscle arteries (decreased SVR)
