Autonomic Pharmacology Flashcards
Actions of adrenergic receptors
Examples of alpha 1 adrenergic agonists, overall effect?
Phenylephrine, midodrine, oxymetazoline
vasoconstriction
Uses for each alpha 1 adrenergic agonist
Examples of alpha 2 adrenergic agonsists
Clonidine, Dexmedetomidine – “Precedex”
Uses of alpha 2 adrenergic agonsists
Methyldopa - lowers blood pressure, pregnancy safe
Beta non specific adrenergci agonist example and use
Isoproterenol
- inotropic, chronotropic
- treatment for arrythmias
Beta 1 specific adrenergci agonist example and use
Dobutamine
- inotropic, mild chronotropic
- cardiogenic shock
- pharmacologic stress testing
Beta 2 specific adrenergic agonist examples abnd uses
Albuterol, Levalbuterol, Salmeterol
- bronchodilators
- Hint: -terols
Terbutaline
- tocolytic
- delays uterine contractions
Epinephrine sensitivty for alpha vs. beta receptors
Adrenergic agonists where α = β examples and uses
Epinephrine
- Cardiac Arrest
- Anaphylaxis
- Hemostasis
Ephedrine, Pseudoephedrine
- first orally available sympathomimetic
- bronchodilation, nasal decongestant
- base ingredient for manufactured drugs of abuse
Adrenergic agonists where α = β1 >> β2 and use
Norepinephrine – “Levophed”
- Hypotension
- Shock (all forms)
Mixed adrenergic agonist where β > α and use
Dopamine
- preference for beta-1 and alpha-1
- shock (cardiogenic and neurogenic)
Mixed adrenergic agonist where α > β and use
Phentermine - “fen-phen”
- Appetite suppressant
- Remember sympathetic relationship with lipolysis and glycogenolysis
Examples of indirect adrenergic agonists
Amphetamine blocks VMAT, indirectly stops reuptake through DAT, longer time for neurotransmitter in synapse
Cocaine blocks DAT directly
Metabolism of epinephrine and norepinephrine
Drugs that cause MAO inhibition
Selegiline, Tyramine Overload
Side effects of adrenergic agonists
Nonspecific adrenergic antagonists with α1> α2 example and use
Phenoxybenzamine
- advantages peri-operatively
- CNS availability
Nonspecific adrenergic antagonist with α1= α2 example
Phentolamine
reversible
alpha 1 antagonist examples and uses
Prazosin, Terazosin, Doxazosin
- can be used in hypertension
- may be more appropriate for Pheo
- BPH
- Hint: -zosin
Tamsulosin
- BPH
- urinary retention
Pheochromocytoma symptoms
P – palpitations
H – headache, hypertension
E – episodic sweating
Therapeutic uses for beta adrenergic antagonists
- 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
Beta-nonspecific antagonists examples and uses
Atenolol, Metoprolol
-Prolong survival after ACS
Esmolol
- fast on/off
Propranolol
- Hyperthyroidism
- Anxiety/Tremors
Timolol
-glaucoma
Hint: -olol
α/β mixed antagonists examples and uses
Labetalol
- high blood pressure
Carvedilol
- high blood pressure
- congestive heart failure
β ADRENERGIC ANTAGONISTS side effects
- Bradycardia
- Decreased myocardial activity
- Bronchoconstriction
- Hypoglycemia
Abrupt withdrawal effects
Interactions with cocaine
Actions of cholinergic receptors (M1-M3)
Direct cholinergic agonists and uses
Metacholine - challenge test, bronchoconstriction
Pilocarpine, Carbachol - opening of canal of schlemm (eye drainage)
What is the function of cholinesterase
Breaks down acetylcholine in the synapse (stops parasympathetic response)
Cholinesetrase inhibitors examples and uses
Side effects of cholinergic agonists
Examples of muscarinic antagonists and uses
Atropine
- treatment for bradycardia
- eye dilation
Scopolamine
- motion sickness
Oxybutynin
- overactive bladder
Ipratropium, Tiotropium
- bronchodilation
- anti-secretion
Benztropine
- motion sickness
- antipsychotic dystonia
Side effects of muscarinic antagonists
Action of nicotinic receptors
Neuromuscular Junction Antagonists depolarizing agents
Neuromuscular Junction Antagonists Non-Depolarizing Agents
Second messengers for cholinergic receptors
Adrenergic receptor second messengers
