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Sketchy Medical > Autonomic Sympathetic Drugs: Sympathomimetics > Flashcards

Autonomic Sympathetic Drugs: Sympathomimetics Flashcards

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USMLE® Step 1 flashcards
1
Q

Alpha 1 is coupled to

A

Gq

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2
Q

Alpha 2 is coupled to

A

Gi

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3
Q

Beta 1 is coupled to

A

Gs

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4
Q

Beta 2 is coupled to

A

Gs

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5
Q

Alpha 1 receptor coupled to Gq causes

A

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

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6
Q

alpha-1 activation causes

A
  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
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7
Q

alpha-1 activation at pupillary dilator muscle causes

A

mydriasis (pupillary dilation)

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8
Q

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

A

pupillary dilator muscle

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9
Q

alpha-2 agonists are

A

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

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10
Q

alpha-2 receptor coupled to Gi

A

alpha-2 receptor coupled to Gi → decreased cAMP

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11
Q

presynaptic alpha-2 receptors cause

A

presynaptic alpha-2 receptors cause inhibition of neurotransmitter release

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12
Q

alpha-2 activation at pancreatic islet cells

A

decreases insulin release

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13
Q

alpha-2 activation inhibits

A

lipolysis and release of fatty acids

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14
Q

alpha-2-activation

A
  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
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15
Q

activation of alpha-2 at ciliary body

A

decreases aqueous humor production

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16
Q

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

A

ciliary body

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17
Q

brimonidine is

A

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

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18
Q

beta receptor agonists increase

A

cyclic AMP (cAMP)

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19
Q

beta-1 receptors are found on

A

cardiac myocytes (including SA and AV nodes)

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20
Q

beta-1 activation causes

A

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

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21
Q

beta-1 activation increases

A
  1. heart rate (SA node)
  2. cardiac contractility
  3. renin release (JGA cells)
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22
Q

beta-1 activation results in increased

A

cardiac output

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23
Q

beta-2 activation leads to

A

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

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24
Q

beta-2 activation causes

A

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

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25
Q

beta-2 activation stimulates

A

lipolysis and release of free fatty acids

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26
Q

beta-2 receptor activation at the liver promotes

A

gluconeogenesis

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27
Q

beta-2 activation at pancreatic islet cells

A

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

28
Q

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

A

hypokalemia

29
Q

beta-2 activation can cause hypokalemia due to

A

increased insulin activity

30
Q

beta-2 activation at ciliary body increases

A

aqueous humor production

31
Q

Alpha 1 agonist

A
  1. phenylephrine
32
Q

phenylephrine treats

A

nasal congestion (alpha-1 mediated vasoconstriction)

33
Q

phenylephrine causes

A
  1. mydriasis (activates alpha-1 at pupillary dilator muscle)
  2. reflex bradycardia (response to alpha-1 increase in MAP)
34
Q

Phenylephrine increases

A
  1. MAP (alpha-1 increase in SVR)
  2. systolic pressure (alpha-1 arteriolar constriction)
  3. diastolic pressure (alpha-1 venous constriction)
35
Q

NORepinephrine ________ agonist

A

alpha>beta1 agonist

36
Q

norepinephrine has some

A

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

37
Q

Norepinephrine increases

A
  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)
38
Q

norepinephrine causes

A

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

39
Q

In Septic Shock

A

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

40
Q

DOBUtamine

A

beta-1>beta-2 agonist

41
Q

dobutamine is primarily a

A

beta-1 agonist

42
Q

dobutamine increases

A
  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)
43
Q

dobutamine has some

A

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

44
Q

dobutamine causes

A

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

45
Q

Dobutamine can decrease

A

diastolic pressure (beta-2 arteriolar dilation)

46
Q

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

A
  1. norepinephrine
  2. dobutamine
  3. Isoproterenol
  4. epinephrine
47
Q

dobutamine can be used in

A

cardiogenic shock

48
Q

dobutamine increases contractility and CO to treat

A

cardiogenic shock

49
Q

isoproterenol

A

beta-1=beta-2 agonist

50
Q

isoproterenol increases

A

heart rate and contractility (beta-1 effects)

51
Q

isoproterenol causes

A

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

52
Q

isoproterenol decreases

A
  1. DIAstolic pressure (beta-2 vasodilation and decreased SVR)
  2. MAP (beta-2 decrease in SVR)
53
Q

Isoproterenol decreases diastolic pressure

A
  1. beta-2 arteriolar dilation

2. beta-2 vasodilation and decreased SVR

54
Q

beta-2 agonists relax

A

uterine smooth muscle

55
Q

prevents premature labor (beta-2 relaxes the uterus)

A
  1. Terbutaline

2. Ritodrine

56
Q

beta-2 agonists used for bronchodilation have _____ suffix

A

“-rol”

57
Q

beta-2 agonists used for bronchodilation have “-rol” suffix

A
  1. albuterol
  2. formoterol
  3. salmeterol
58
Q

EPInephrine

A

beta>alpha agonist

59
Q

at LOW doses, epinephrine’s ______ effects predominate

A

at LOW doses, epinephrine’s BETA AGONIST effects predominate

60
Q

epinephrine causes

A

epinephrine causes bronchodilation (beta-2 effects)

61
Q

at LOW doses, epinephrine decreases

A

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

62
Q

Epinephrine increased

A

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

63
Q

at HIGH doses, epinephrine’s ______ effects predominate

A

at HIGH doses, epinephrine’s ALPHA AGONIST effects predominate

64
Q

Epinephrine increases MAP

A
  1. MAP (alpha-1 increase in SVR)

2. systolic pressure (alpha-1 arteriolar constriction)

65
Q

Epinephrine can decrease

A

diastolic pressure (beta-2 arteriolar dilation)

66
Q

epinephrine increases SVR and bronchodilates to treat

A

anaphylactic shock

Sketchy Medical (46 decks)

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