Autonomics V Flashcards

1
Q

What are the receptors that epinepherine acts on?

A

alpha and beta receptors

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2
Q

Small doses of epinepherine act on what two receptors? What does this elicit?

A

Beta 1, increases pulse pressure, HR, SV, and CO

Beta 2-decrease TPR

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3
Q

Moderate doses of epinepherine act on what receptors? What does this elicit?

A

Beta 1 increased pulse pressure
Beta 2 -decrease TPR (slight)
Alpha 1 increased TPR (larger)

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4
Q

Higher doses of epinepherine act on what receptors? What does this elicit?

A

mainly alpha 1 to increase TPR

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5
Q

Why is it that epinepherine works on the beta receptors at low doses, but at high doses the alpha receptors dominate?

A

More specific to beta

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6
Q

What is the effect of administration of epinephrine SQ?

A

local vasoconstriction

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7
Q

What is the effect of epinepherine on the heart? What is the receptor utilized here?

A

Tachycarida–beta 1

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8
Q

What is phentolamine?

A

Alpha receptor blocker

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9
Q

What happens to BP if you give Phentolamine before epinepherine? Why?

A

Phen before epi = decreased BP since beta 2 effect of epi predominates

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10
Q

What are the types of drugs that pts may be taking that contraindicate epinepherine?

A

alpha 1 blockers

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11
Q

What happens if you administer epi to a pt taking beta blockers?

A

Overshoot BP

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12
Q

What is the main site of action for epinephrine as far as TPR goes?

A

Arterioles and precapillary sphincters

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13
Q

What happens with cutaneous blood flow with epi administration?

A

Redistribution of blood flow

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14
Q

What happens with blood flow to muscles with epinepherine administration?

A

Increased

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15
Q

What happes to cerebral blood flow with epinepherine administration?

A

No effect

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16
Q

What happes to renal blood flow with epinepherine administration?

A

Decreased

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17
Q

What happes to coronary blood flow with epinepherine administration?

A

Increased

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18
Q

What does inotropy mean?

A

Contraction process

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19
Q

What does lusitropy mean?

A

Relaxation process

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20
Q

What is the effect of epi on vascular smooth muscle?

A

Contraction

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21
Q

Are beta blockers a concern when using epinephrine locally?

A

No

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22
Q

What are the receptors that NE works on?

A

Beta 1 and alpha

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23
Q

Does NE have much effect on beta 2 receptors?

A

No

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24
Q

What is the effect of NE on TPR?

A

Increases

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25
Q

What is the effect of NE on SBP? DBP? Pulse pressure?

A

Increases

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26
Q

What is the main therapeutic use of NE?

A

Raise BP

27
Q

What are the receptors that dopamine acts on?

A

D1, D2, beta1, alpha 1

28
Q

What is the effect of dopamine on the urianry output?

A

Diuretic/natriuretic effects

29
Q

Why is dopamine ineffective if administered orally?

A

MAO and COMT will degrade it

30
Q

What is the role of dopamine in the CNS?

A

regulation of movement (think parkinsons)

31
Q

What is the effect of dopamine in low doses?

A

diuresis/natureis and vasodilation

32
Q

What is the effect of dopamine activation of D1 on the proximal tubule?

A

Decrease Na/K ATPase (increased Na excretion)

33
Q

What is the effect of dopamine on the D2 receptors on the peripheral circulation nerves?

A

Decreases NE release

Decreased alpha adrenergic stimulation

34
Q

What are the effects of dopamine in moderate doses?

A

Increased inotropic effects

Increased SBP and pulse pressure (both through beta 1 effects)

35
Q

What are the effects of dopamine in high doses?

A

Vasoconstriction via alpha 1 receptors

36
Q

Why should hypovolemia be correcte prior to dopamine administration?

A

Increased heart rate without increased volume is bad

37
Q

What is dopamine contraindicated in patients on MAOIs?

A

MAOIs inhibit breakdown of dopamine,

38
Q

What are the therapeutic uses of dopamine?

A

Severe congestive heart failure,

Cardiogenic shock

39
Q

What are the receptors that ephedrine acts on? How does it act on them?

A

Alpha 1, alpha 2, beta 1, beta 2

Mixed action

40
Q

How is ephedrine administered?

A

Orally

41
Q

What is pseudoephedrine? what is it used for?

A

Ephedrine enantiomer

Decongestant

42
Q

What are the two indirect acting/releasing adrenergic agonists?

A

Amphetamine

Tyramine

43
Q

Why are amphetamine and tyramine’s effect completely abolished if reserpine is administered prior?

A

Cannot pack catecholamines into vesicles

44
Q

What is the MOA of amphetamine?

A

Goes into a nerve terminal, and displaces NE in the vesicle. Causes release of the vesicle

45
Q

What are the cardiovascular effects of amphetamine?

A

Activates alpha and beta receptors, increasing systolic and diastolic BPs

46
Q

What is the effect of amphetamine on bladder sphincter contraction?

A

Increases

47
Q

What is the MOA of tyramine?

A

inhibits NE and Epi via shunting catecholamine synthesis down different pathway

48
Q

What receptors does prazosin act on? Antagonist or agonist?

A

Alpha 1

Antagonist

49
Q

What receptors does terozosin act on?Antagonist or agonist?

A

alpha 1

Antagonist

50
Q

What receptors does doxazosinact on? Antagonist or agonist?

A

alpha 1

Antagonist

51
Q

What receptors does phenoxybenamine act on? Antagonist or agonist?

A

alpha 1 > alpha 2

Antagonist

52
Q

What receptors does phentolamine act on?Antagonist or agonist?

A

alpha 1 = alpah 2

Antagonist

53
Q

What receptors does yohimbine act on?Antagonist or agonist?

A

alpha 2 > alpha 1

antagonist

54
Q

What receptors does rauwoscine act on?Antagonist or agonist?

A

alpha 2 > alpha 1

antaonist

55
Q

What receptors does torazoline act on?Antagonist or agonist?

A

alpha 2 > alpha 1

antagonist

56
Q

What are the effects of alpha receptor antagonists on BP?

A

Decrease

57
Q

What are the effects of alpha receptor antagonists on HR?

A

Increase

58
Q

What are the effects of alpha receptor antagonists on the eye?

A

miosis

59
Q

What are alpha receptor antagonists used for?

A

Hypertensive emergencies

60
Q

What type of drug would you use to treat pheochromocytoma?

A

alpha receptor antagonist

61
Q

Why are alpha receptor antagonists used to treat urinary obstructions?

A

Reduces resistance

62
Q

How long is the duration of action of pheonoxybenzamine (dibenzyline)?

A

long

63
Q

What is prazosin (minipress) used for?

A

Relaxation of arterial and venous prostate smooth muscle

64
Q

What is tamsulosin (flomax) used for?

A

BPH