Autonomic Sympathetic Drugs: Sympathomimetics

Question 1

Alpha 1 is coupled to

Answer 1

Gq

Question 2

Alpha 2 is coupled to

Answer 2

Gi

Question 3

Beta 1 is coupled to

Answer 3

Gs

Question 4

Beta 2 is coupled to

Answer 4

Gs

Question 5

Alpha 1 receptor coupled to Gq causes

Answer 5

alpha-1 receptor coupled to Gq → IP3-DAG cascade → increased intracellular calcium (smooth muscle cell)

Question 6

alpha-1 activation causes

Answer 6

1. increased peripheral arterial resistance (vasoconstriction at small arteries, arterioles, precapillary sphincters)
2. increased mean arterial pressure (MAP)
3. increased venous return (venoconstriction)
4. at pupillary dilator muscle causes mydriasis (pupillary dilation)
5. urethral sphincter and prostatic smooth muscle contraction
6. Urinary retention

Question 7

alpha-1 activation at pupillary dilator muscle causes

Answer 7

mydriasis (pupillary dilation)

Question 8

alpha-1 activation at _______ ________ _____ causes mydriasis (pupillary dilation)

Answer 8

pupillary dilator muscle

Question 9

alpha-2 agonists are

Answer 9

alpha-2 agonists are sympatholytics (act centrally to decrease sympathetic tone)

Question 10

alpha-2 receptor coupled to Gi

Answer 10

alpha-2 receptor coupled to Gi → decreased cAMP

Question 11

presynaptic alpha-2 receptors cause

Answer 11

presynaptic alpha-2 receptors cause inhibition of neurotransmitter release

Question 12

alpha-2 activation at pancreatic islet cells

Answer 12

decreases insulin release

Question 13

alpha-2 activation inhibits

Answer 13

lipolysis and release of fatty acids

Question 14

alpha-2-activation

Answer 14

1. alpha-2 activation at pancreatic islet cells decreases insulin release
2. alpha-2 activation inhibits lipolysis and release of fatty acids
3. activation of alpha-2 at ciliary body decreases aqueous humor production

Question 15

activation of alpha-2 at ciliary body

Answer 15

decreases aqueous humor production

Question 16

activation of alpha-2 at ______ ________ decreases aqueous humor production

Answer 16

ciliary body

Question 17

brimonidine is

Answer 17

brimonidine is an alpha-2 agonist used to treat chronic open angle glaucoma (decreases aqueous humor production)

Question 18

beta receptor agonists increase

Answer 18

cyclic AMP (cAMP)

Question 19

beta-1 receptors are found on

Answer 19

cardiac myocytes (including SA and AV nodes)

Question 20

beta-1 activation causes

Answer 20

beta-1 activation causes increased cyclic AMP → increased intracellular calcium

Question 21

beta-1 activation increases

Answer 21

1. heart rate (SA node)
2. cardiac contractility
3. renin release (JGA cells)

Question 22

beta-1 activation results in increased

Answer 22

cardiac output

Question 23

beta-2 activation leads to

Answer 23

beta-2 activation leads to bronchoDILATION (increased cyclic AMP → activates PKA)

Question 24

beta-2 activation causes

Answer 24

beta-2 activation causes coronary and skeletal muscle vasoDILATION → decreases systemic vascular resistance (SVR)

Question 25

beta-2 activation stimulates

Answer 25

lipolysis and release of free fatty acids

Question 26

beta-2 receptor activation at the liver promotes

Answer 26

gluconeogenesis

Question 27

beta-2 activation at pancreatic islet cells

Answer 27

beta-2 activation at pancreatic islet cells stimulates insulin release → moves glucose into cells

Question 28

beta-2 activation can cause _______ due to increased insulin activity

Answer 28

hypokalemia

Question 29

beta-2 activation can cause hypokalemia due to

Answer 29

increased insulin activity

Question 30

beta-2 activation at ciliary body increases

Answer 30

aqueous humor production

Question 31

Alpha 1 agonist

Answer 31

1. phenylephrine

Question 32

phenylephrine treats

Answer 32

nasal congestion (alpha-1 mediated vasoconstriction)

Question 33

phenylephrine causes

Answer 33

1. mydriasis (activates alpha-1 at pupillary dilator muscle) 2. reflex bradycardia (response to alpha-1 increase in MAP)

Question 34

Phenylephrine increases

Answer 34

1. MAP (alpha-1 increase in SVR) 2. systolic pressure (alpha-1 arteriolar constriction) 3. diastolic pressure (alpha-1 venous constriction)

Question 35

NORepinephrine ________ agonist

Answer 35

alpha>beta1 agonist

Question 36

norepinephrine has some

Answer 36

norepinephrine has some beta-1 activity (primarily an ALPHA AGONIST)

Question 37

Norepinephrine increases

Answer 37

1. MAP (alpha-1 increase in SVR) 2. systolic pressure (alpha-1 arteriolar constriction) 3. diastolic pressure (alpha-1 venous constriction) 4. cardiac contractility (activates beta-1)

Question 38

norepinephrine causes

Answer 38

norepinephrine causes reflex bradycardia (response to alpha-1 increase in MAP)

Question 39

In Septic Shock

Answer 39

septic shock (phenylephrine and norepinephrine increase SVR and venous return to treat distributive/hypovolemic shock)

Question 40

DOBUtamine

Answer 40

beta-1>beta-2 agonist

Question 41

dobutamine is primarily a

Answer 41

beta-1 agonist

Question 42

dobutamine increases

Answer 42

1. heart rate, contractility, and cardiac output (beta-1 effects) 2. PULSE PRESSURE, difference between systolic and diastolic (beta-1 increase in contractility) 3. systolic pressure (beta-1 increase in CO)

Question 43

dobutamine has some

Answer 43

beta-2 activity (primarily a BETA-1 AGONIST)

Question 44

dobutamine causes

Answer 44

dobutamine causes vasodilation → decreases SVR (effects mild due to minimal beta-2 activity)

Question 45

Dobutamine can decrease

Answer 45

diastolic pressure (beta-2 arteriolar dilation)

Question 46

______ increases PULSE PRESSURE, difference between systolic and diastolic (beta-1 increase in contractility)

Answer 46

1. norepinephrine 2. dobutamine 3. Isoproterenol 4. epinephrine

Question 47

dobutamine can be used in

Answer 47

cardiogenic shock

Question 48

dobutamine increases contractility and CO to treat

Answer 48

cardiogenic shock

Question 49

isoproterenol

Answer 49

beta-1=beta-2 agonist

Question 50

isoproterenol increases

Answer 50

heart rate and contractility (beta-1 effects)

Question 51

isoproterenol causes

Answer 51

isoproterenol causes vasodilation → decreases SVR (beta-2 effects)

Question 52

isoproterenol decreases

Answer 52

1. DIAstolic pressure (beta-2 vasodilation and decreased SVR) 2. MAP (beta-2 decrease in SVR)

Question 53

Isoproterenol decreases diastolic pressure

Answer 53

1. beta-2 arteriolar dilation | 2. beta-2 vasodilation and decreased SVR

Question 54

beta-2 agonists relax

Answer 54

uterine smooth muscle

Question 55

prevents premature labor (beta-2 relaxes the uterus)

Answer 55

1. Terbutaline | 2. Ritodrine

Question 56

beta-2 agonists used for bronchodilation have _____ suffix

Answer 56

"-rol"

Question 57

beta-2 agonists used for bronchodilation have "-rol" suffix

Answer 57

1. albuterol 2. formoterol 3. salmeterol

Question 58

EPInephrine

Answer 58

beta>alpha agonist

Question 59

at LOW doses, epinephrine's ______ effects predominate

Answer 59

at LOW doses, epinephrine's BETA AGONIST effects predominate

Question 60

epinephrine causes

Answer 60

epinephrine causes bronchodilation (beta-2 effects)

Question 61

at LOW doses, epinephrine decreases

Answer 61

at LOW doses, epinephrine decreases DIAstolic pressure (beta-2 vasodilation and decreased SVR)

Question 62

Epinephrine increased

Answer 62

epinephrine increased heart rate and cardiac contractility (beta-1 effects)

Question 63

at HIGH doses, epinephrine's ______ effects predominate

Answer 63

at HIGH doses, epinephrine's ALPHA AGONIST effects predominate

Question 64

Epinephrine increases MAP

Answer 64

1. MAP (alpha-1 increase in SVR) | 2. systolic pressure (alpha-1 arteriolar constriction)

Question 65

Epinephrine can decrease

Answer 65

diastolic pressure (beta-2 arteriolar dilation)

Question 66

epinephrine increases SVR and bronchodilates to treat

Answer 66

anaphylactic shock