Autonomic Pharmacology Flashcards

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1
Q

Actions of adrenergic receptors

A
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2
Q

Examples of alpha 1 adrenergic agonists, overall effect?

A

Phenylephrine, midodrine, oxymetazoline

vasoconstriction

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3
Q

Uses for each alpha 1 adrenergic agonist

A
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4
Q

Examples of alpha 2 adrenergic agonsists

A

Clonidine, Dexmedetomidine – “Precedex”

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5
Q

Uses of alpha 2 adrenergic agonsists

A

Methyldopa - lowers blood pressure, pregnancy safe

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6
Q

Beta non specific adrenergci agonist example and use

A

Isoproterenol

  • inotropic, chronotropic
  • treatment for arrythmias
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7
Q

Beta 1 specific adrenergci agonist example and use

A

Dobutamine

  • inotropic, mild chronotropic
  • cardiogenic shock
  • pharmacologic stress testing
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8
Q

Beta 2 specific adrenergic agonist examples abnd uses

A

Albuterol, Levalbuterol, Salmeterol

  • bronchodilators
  • Hint: -terols

Terbutaline

  • tocolytic
  • delays uterine contractions
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9
Q

Epinephrine sensitivty for alpha vs. beta receptors

A
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10
Q

Adrenergic agonists where α = β examples and uses

A

Epinephrine

  • Cardiac Arrest
  • Anaphylaxis
  • Hemostasis

Ephedrine, Pseudoephedrine

  • first orally available sympathomimetic
  • bronchodilation, nasal decongestant
  • base ingredient for manufactured drugs of abuse
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11
Q

Adrenergic agonists where α = β1 >> β2 and use

A

Norepinephrine – “Levophed”

  • Hypotension
  • Shock (all forms)
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12
Q

Mixed adrenergic agonist where β > α and use

A

Dopamine

  • preference for beta-1 and alpha-1
  • shock (cardiogenic and neurogenic)
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13
Q

Mixed adrenergic agonist where α > β and use

A

Phentermine - “fen-phen”

  • Appetite suppressant
  • Remember sympathetic relationship with lipolysis and glycogenolysis
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14
Q

Examples of indirect adrenergic agonists

A

Amphetamine blocks VMAT, indirectly stops reuptake through DAT, longer time for neurotransmitter in synapse

Cocaine blocks DAT directly

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15
Q

Metabolism of epinephrine and norepinephrine

A
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16
Q

Drugs that cause MAO inhibition

A

Selegiline, Tyramine Overload

17
Q

Side effects of adrenergic agonists

A
18
Q

Nonspecific adrenergic antagonists with α1> α2 example and use

A

Phenoxybenzamine

  • advantages peri-operatively
  • CNS availability
19
Q

Nonspecific adrenergic antagonist with α1= α2 example

A

Phentolamine

reversible

20
Q

alpha 1 antagonist examples and uses

A

Prazosin, Terazosin, Doxazosin

  • can be used in hypertension
  • may be more appropriate for Pheo
  • BPH
  • Hint: -zosin

Tamsulosin

  • BPH
  • urinary retention
21
Q

Pheochromocytoma symptoms

A

P – palpitations

H – headache, hypertension

E – episodic sweating

22
Q

Therapeutic uses for beta adrenergic antagonists

A
  • Treatment of arrhythmia, angina
  • Increased survival after myocardial infarction
  • Decrease stress on blood vessels in ruptured aneurysm
  • Treatment for social anxiety
  • Treatment for thyroid storm
  • Treatment of chronic hypertension
23
Q

Beta-nonspecific antagonists examples and uses

A

Atenolol, Metoprolol

-Prolong survival after ACS

Esmolol

  • fast on/off

Propranolol

  • Hyperthyroidism
  • Anxiety/Tremors

Timolol

-glaucoma

Hint: -olol

24
Q

α/β mixed antagonists examples and uses

A

Labetalol

  • high blood pressure

Carvedilol

  • high blood pressure
  • congestive heart failure
25
Q

β ADRENERGIC ANTAGONISTS side effects

A
  • Bradycardia
  • Decreased myocardial activity
  • Bronchoconstriction
  • Hypoglycemia

Abrupt withdrawal effects

Interactions with cocaine

26
Q

Actions of cholinergic receptors (M1-M3)

A
27
Q

Direct cholinergic agonists and uses

A

Metacholine - challenge test, bronchoconstriction

Pilocarpine, Carbachol - opening of canal of schlemm (eye drainage)

28
Q

What is the function of cholinesterase

A

Breaks down acetylcholine in the synapse (stops parasympathetic response)

29
Q

Cholinesetrase inhibitors examples and uses

A
30
Q

Side effects of cholinergic agonists

A
31
Q

Examples of muscarinic antagonists and uses

A

Atropine

  • treatment for bradycardia
  • eye dilation

Scopolamine

  • motion sickness

Oxybutynin

  • overactive bladder

Ipratropium, Tiotropium

  • bronchodilation
  • anti-secretion

Benztropine

  • motion sickness
  • antipsychotic dystonia
32
Q

Side effects of muscarinic antagonists

A
33
Q

Action of nicotinic receptors

A
34
Q

Neuromuscular Junction Antagonists depolarizing agents

A
35
Q

Neuromuscular Junction Antagonists Non-Depolarizing Agents

A
36
Q

Second messengers for cholinergic receptors

A
37
Q

Adrenergic receptor second messengers

A