Autonomic Drugs - Sympathetics

Question 1

What is the mechanism of action of epinephrine

Answer 1

Direct sympathetic agonist

α1, α2, β2, β1

Question 2

What is epinephrine used for

Answer 2

Anaphylaxis
Glaucoma (open angle)
Asthma
Hypotension

Question 3

What is the mechanism of action of norepinephrine

Answer 3

Direct sympathetic agonist
α1, α2, and mild β1
No effect on β2

Question 4

What is norepinephrine used for

Answer 4

Hypotension (but decrease renal perfusion)

Question 5

What is the mechanism of action of isoproterenol

Answer 5

Direct sympathetic agonist

Equal agonist β1 = β2 activity

Question 6

What is isoproterenol used for

Answer 6

Torsade de pointes

Bradyarrhythmias

Question 7

What is the mechanism of action of dopamine

Answer 7

Direct sympathetic agonist

D1 = D2, mild β1 & β2 and mild α1

Question 8

What is dopamine used for

Answer 8

Shock
Heart failure
Inotropic and chronotropic

Question 9

What is the mechanism of action of dobutamine

Answer 9

Direct sympathetic agonist

β1 > β2

Question 10

What is dobutamine used for

Answer 10

Heart failure, cardiac stress, stress testing

Inotropic and chronotropic

Question 11

What is the mechanism of action of phenylephrine

Answer 11

Direct sympathetic agonist

α1 > α2

Question 12

What is phenylephrine used for

Answer 12

Hypotension (vasoconstrictor)
Ocular procedures (mydriatic)
Rhinitis (decongestant)

Question 13

What is the mechanism of action of albuterol/salmeterol/terbutaline

Answer 13

Direct sympathetic agonist

β2 > β1

Question 14

What is albuterol/salmeterol/terbutaline used for

Answer 14

Metaproternol and albuterol for acute asthma
Salmeterol for long term asthma or COPD
Terbutalne to reduce premature uterine contraction

Question 15

What is the mechanism of action of ritodrine

Answer 15

Direct sympathetic agonist

β2 only

Question 16

What is ritodrine used for

Answer 16

Reduces premature uterine contractions

Question 17

What is the mechanism of action of ampetamine

Answer 17

Indirect general agonist

Releases stored catecholamines

Question 18

What is ampetamine used for

Answer 18

Narcolepsy
Obesity
ADD

Question 19

What is the mechanism of action of ephedrine

Answer 19

Indirect general agonist

Releases stored catecholamines

Question 20

What is ephedrine used for

Answer 20

Nasal decongestion
Urinary incontinence
Hypotension

Question 21

What is the mechanism of action of cocaine

Answer 21

Indirect general agonist

Reuptake inhibitor

Question 22

What is cocaine used for

Answer 22

Vasconstriction and local anesthesia

Question 23

What is the mechanism of action of clonidine/methyldopa

Answer 23

Centrally acting α2 agonist

Question 24

What is clonidine/methyldopa used for

Answer 24

Hypertension

Question 25

What is the mechanism of action of phenoxybenzamine

Answer 25

Nonselective α blocker

Question 26

What is phenoxybenzamine used for

Answer 26

Pheochromocytoma

Question 27

What are toxicities to phenoxybenzamine

Answer 27

Orthostatic hypotension | Reflex tachycardia

Question 28

What is the mechanism of action of phentolamine

Answer 28

Nonselective α blocker

Question 29

What is phenoxybenzamine used for

Answer 29

Patients on MAOi eating tyramine containing foods

Question 30

What are toxicities to phenoxybenzamine

Answer 30

Orthostatic hypotension | Reflex tachycardia

Question 31

What is the mechanism of action of the -osins

Answer 31

α1 selective blocker

Question 32

What are the -osins used for

Answer 32

Hypertension | Urinary retention in BPH

Question 33

What are toxicities to the -osins

Answer 33

1st dose orthostatic hypotension Dizziness Headache

Question 34

What is the mechanism of action of mirtazapine

Answer 34

α2 selective blocker

Question 35

What is mirtazapine used for

Answer 35

Depression

Question 36

What are toxicities to mirtazapine

Answer 36

Sedation Increase serum cholesterol Increase appetite

Question 37

What is the mechanism of action of the -lols

Answer 37

Beta blocker

Question 38

Name clinical applications of the -lols

Answer 38

``` Angina pectoris MI SVT Hypertension CHF Glaucoma ```

Question 39

What are toxicities of the -lols

Answer 39

Impotence Exacerbation of asthma Bradycardia, AV block Sleep alteration

Question 40

What are the β1 selective antagonists

Answer 40

``` Acebutolol Betaxolol Esmolol (short acting) Atenolol (no CNS entry) Metoprolol ```

Question 41

What are the nonselective antagonist (β1 = β2)

Answer 41

Timolol Propranolol Nadolol PIndolol

Question 42

What are the nonselective α and β antagonist

Answer 42

Labetalol | Carvedilol

Question 43

What are the β-agonists

Answer 43

Pindolol | Acebutolol