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INT 208: Pharmacology > Autonomic NS 2: Adrenaline/epinephrine > Flashcards

Autonomic NS 2: Adrenaline/epinephrine Flashcards

1
Q

Chemistry of Adrenaline

A
  • Alkaloid obtained from suprarenal medulla
  • Catecholamine; with L-isomer 20x D-isomer
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2
Q

Adrenaline is formed from the amino acid—-

A

Tyrosine

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3
Q

Oxidation of Adrenaline forms—-

A

adrenochrome

toxic pink Hallucinogen

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4
Q

Oral absorption of adrenaline

A

ineffective, due to:
* Gastric enzymes
* rapid metabolism by liver
* cause VC of mucous membrane (through A1) leading to poor absorption

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5
Q

Subcutaneous absorption of Adrenaline

A

causes VC, leading to:
* slow absorption
* long duration

why it’s given with Local anesthesia for prolonged action

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6
Q

Intravenous adminstration of adrenaline

A

FATAL;
causes Ventricular fibrilation

due to most of the dosage directly affecting the heart

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7
Q

Intracardiac Adminstration of Adrenaline is used for

A

Cardiac resuscitation

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8
Q

Adrenaline inhilation is used for

A

Bronchial Asthma

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9
Q

effect of Adrenaline adminstration on CNS

A

Catecholamines don’t pass blood brain barrier

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10
Q

Effect of Adrenaline on the heart

A

Increase all Cardiac properties:
* Positive Ionotropic
* Postive Chronotropic
* Positive dromotropic

It increases total cardiac output

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11
Q

excessive Adrenaline effect on the heart causes

A
  • first: arrhythmia
  • then, Ventricular fibrilation
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12
Q

effect of adrenaline on BV

A
  • through Alpha1 : General VC (skin & mucous membrane)
  • Through Beta2: VD of Coronary & skeletal BVs
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13
Q

Explain why adrenaline is not useful in angina

A

It increases Cardiac work, which is theoretically impaired by the presence of the Angina (ischemia)

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14
Q

Describe the effect of Adrenaline on Blood pressure

A
  1. Systolic pressure depends on Cardiac output (& a little on Peripheral resistance)
  2. Diastolic pressure depends mainly on Peripheral resistance
  3. Since Adrenaline increases Cardiac output
  4. It increases Systolic Blood pressure
  5. With slight variation in disatolic Blood pressure
  6. As a result: pulse pressure increases
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15
Q

pressor (vasoconstrictor) effect of adrenaline can be reversed by

A

Alpha blocker

acts on Alpha 1 (which causes decrease general VC)

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16
Q

effect of Adrenaline on the eye

A
  • Mydrasis (pupil dilatation)
  • Decrease IOP (treatement for open angle glaucoma)
17
Q

effect of adrenaline on the respiratory system

A
  • Vasoconstriction–> Decrease secretions (alpha 1)
  • Bronchodilatation (beta 2)
18
Q

effect of adrenaline on GIT

A
  • Relaxation of GIT wall (by a1,2 B1,2)
  • Contaction of all GIT sphincters (Alpha 1)
19
Q

effect of Adrenaline on urinary tract

A
  • Contraction of sphincters & trigone (Alpha 1)
  • Relaxation of wall of urinary bladder (Beta 2)
20
Q

effect of Adrenaline on Sex organs

A
  • Male: ejaculation
  • Female: Utrine relaxation (beta 2)
21
Q

effect of adrenaline on glands

A

results in thick Viscid secretion, due to VC & decrease BF to the glands

22
Q

effect of adrenaline on action of skeletal muscles

A
  • VD of blood flow to Skeletal Muscles (Beta 2)
  • Facilitate Neuromuscular transmission (alpha1&2)
  • accelerate fatigue recovery
23
Q

effect of adrenaline on Metabloism

A

increases blood glucose level:
* Decreases insulin secretion
* Increase glycogenolysis—> increase lactate
* Increases Lipolysis—-> free fatty acid
* increase K+ uptake by muscles —> hypokalemia
* activation of factor V—-> increase coagulation
* increase Caloregic action (increase O2 consumption by 20%)

24
Q

effect of adrenaline on Allergies

A

Physiological antagonist of Histamine;
* VC
* Hypertension
* Bronchodilatation

25
Q

Adrenaline dose Subcutaneous

A

Adrenaline/HCl: 1/1000, 0.5 cc = 0.5 mg

26
Q

Adrenaline dose Intramuscular

A

Adrenaline/HCl: 1/500, 0.5 cc in oil

27
Q

Adrenaline dose oral inhalation (nebulizer)

A

Adrenaline/HCl: 1/100

28
Q

Local use of Adrenaline

A
  1. given with Local anesthesia to delay anesthesia absorption & prolong use
  2. used in epistaxis/nose bleed (as nasal Pack) as it is hemostatic (activates factor V)
  3. Decongestion of nose & eyes (VC of Mucous membrane)
  4. Inhilation for Bronchal Asthema
29
Q

describe how Dipivefrine is used to treat Open angle Glaucoma

A

it’s a prodrug of Adrenaline, that is Diffusible, lipophilic & less toxic
* it has the same effect of Adrenaline on IOP (decreases it)

30
Q

Antiallergic use for Adrenaline

A
  • Bronchal Asthema
  • anaphylactic shock
  • Angioneurotic edema urticaria
31
Q

CVS use for adrenaline

A

Cardiac resuscitation (intracardiac) in cardiac arrest

32
Q

usage of adrenaline during labour

A

relaxes uterus & prevents formation of Contraction ring

prefered utrine relaxants as Ritodrine/isoxsuprine

33
Q

Metabolic usage of Adrenaline

A

Hypoglycemic coma

Glucose IV is more prefered

34
Q

side effects of Adrenaline

A

Alpha:
* Hypertension & Cerebral hemorrhage (extreme hypertension)
* Can cause gangrene when given with local anesthesia (extreme VC)

Beta:
* Arrhythmia
* palpitation
* Tachycardia

Effect of adrenaline is exagerated with:
* Supersensitive receptors
* MAOI (prolongation of adrenaline)
* Sympatholytics (inhibit MAO enzyme)

35
Q

Contraindications of Adrenaline

A
  • Not to be given to hypertensive patients
  • Not to be given with local anesthesia in peripheral parts of the body (fingers, toes)
  • Not to be given to pateints with Ischemica heart disease or arrhythmia
  • Not to be given with MAOI, sympatholytics or ganglion blockers as this will exagerate its effect

INT 208: Pharmacology (30 decks)

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