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Pharmacology II > Cardio Autonomic pharmacology > Flashcards

Cardio Autonomic pharmacology Flashcards

1
Q

Epinephrine selectivity

A

a1 agonist
a2 agonist
B1 agonist
B2 agonist

(Mixed alpha beta receptor agonist)

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2
Q

Epinephrine uses

A

1: drug of choice for anaphylactic shock
2: prolong duration of local anesthetic

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3
Q

Describe how epinephrine acts in anaphylactic shock

A

1: Supports BP (increased vasoconstriction -a1, decreased fluid loss and edma- a1, increased cardiac output- increased HR and contractility- B1)
2: Supports breathing (bronchial smooth muscle relaxation - B2, decreased mucous secretion- a1, decreased pulmonary edema- a1)
3: inhibit release of mediators of anaphylaxis (B2)

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4
Q

Norepinephrine selectivity

A

a1
a2
B1

(mixed alpha beta agonist)

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5
Q

Norepinephrine

A

a1- vascular resistance

B1- increased cardiac contractility

(both work together to increase bp)

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6
Q

Norepinephrine uses

A

1: Cardiogenic shock
2: Septic shock

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7
Q

Side effects of mixed alpha beta agonists

A

Extension of pharmacological effects

1: Tachy (B1)
2: Arrhythmia (B1)
3: Hypertensive crisis (a1)
4: Dry mouth, mild depression, sedation (a2)
5: Closed angle glaucoma

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8
Q

Name the a1 selective agonists

A

Phenylephrine**
Methoxamine
Midodrine

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9
Q

a1 selective agonist MOA

A

vasoconstriction

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10
Q

a1 selective agonist uses

A

1: Reduce Bleeding
2: Hypotensive crisis
3: Nasal decongestion

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11
Q

a2 selective agonists

A

Methyldopa

Clonidine

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12
Q

Methyldopa MOA

A

prodrug (can be used in hypertension during pregnancy)

acts ONLY on the CNS to increase sympathetic outflow and lower blood pressure

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13
Q

Clondine MOA

A

works on both the CNS (lower sympathetic outflow) and PNS (lower NE release)

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14
Q

Uses of a2 selective agonists

A

Hypertension

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15
Q

Methyldopa side effects

A

Positive direct coombs & Hemolytic anemia

lupus erythematosus

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16
Q

B1 selective agonists

A

Dobutamine

Dopamine

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17
Q

Dobutamine uses

A

Failed cardiac pump function

  • Severe Congestive heart failure
  • Cardiogenic shock
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18
Q

Dobutamine MOA

A

increase cardiac output and contractility

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19
Q

Dopamine low dose

A

activation of D1 on kidneys resulting in increases diuresis

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20
Q

Domamine intermediate dose

A

Activation of B1 in the heart to increase contractile force

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21
Q

Dopamine high dose

A

acts on A1 receptors to increase peripheral resistance resulting in increase in HR

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22
Q

Dopamine uses

A

1: Septic Shock
2: Severe Congestive heart failure
3: Cardiogenic shock

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23
Q

Nonselective Beta receptor agonist

A

Isoproterenol

24
Q

Isoproterenol uses

A

AV block (speed up conductance)

Bradycardia

Strokes-Adams attack (loss of cardiac output)

25
Q

Dopamine 1 agonist

A

Fenoldopam

26
Q

Fenoldopam uses

A

Hypertensive crisis (especially in those in renal failure)

27
Q

Fenoldopam MOA

A

bind DA1 receptors on coronary and renal artery to cause vessel relaxation

28
Q

Fenoldopam side effects

A

reflex tachycardia (due to stimulation of baroreflex)

29
Q

Fenoldopam contraindication

A

Glaucoma (open or closed angle) - increases intraoccular pressure

30
Q

Mixed alpha beta antagonists

A

Labetalol

Carvediol

31
Q

Latetalol uses

A

1: Hypertension
2: Hypertensive crisis
3: Ischemic heart disease

32
Q

Labetalol MOA

A

Competitive and reversibel binding to a1, B1, and B2

higher potency for BETA receptors

33
Q

Carvedilol MOA

A

Competive and reversible binding to a1, B1, and B2

higher potency for BETA receptors

34
Q

Carvediol uses

A

Hypertension

Ischemic heart disease

Chronic heart failure (preferred drug)

(other: antioxidant, antiproliferative, NO production)

35
Q

Mixed alpha beta antagonist Adverse effects

A

Bradycardia

Precipitation of acute heart failure

Bronchospasm

Cold extremities

Raynauds disease

CNS- mental depression, insomnia, fatigue

36
Q

Metabolic effects of mixed alpha beta antagonists

A

decreased blood glucose plasma levels

altered plasma lipid levels (worsened profile)

37
Q

Contraindications of Beta receptor antagonists

A

Asthma (nonselective should be avoilded)

AV block (can worsen condition)

38
Q

Nonselective alpha antagonists

A

Phenoxybenzamine

Phentolamine

39
Q

Phenoxybenzamine uses

A

Pheochromocytoma

40
Q

Phenoxybenzamine MOA

A

competitive IRREVERSIBLE

vasodialation
Cardiac stimulation

41
Q

Phenoxybenzamine AE

A

reflex tachycardia

42
Q

Phenoxybenxamine Drug- drug interactions

A

High doses can block seratonin, histamine, and AcH

43
Q

Phentolamine uses

A

1: reversal of anesthesia
2: Hypertensive crisis associated with MOA inhibitor

44
Q

Phentolamine MOA

A

competitive REVERSIBLE, dose dependent

Vasodilation
Cardiac stimulation

45
Q

Alpha 1 selective antagonist

A

Prazosin

46
Q

Prazosin pharmacological effects

A

reduce LDL and TG and increase HDL

suppress release of NE

Dilate arteries and veins (decrease BP)

47
Q

Prazosin clinical uses

A

Pheochromocytoma

Chronic hypertension with benighn prostatic hyperplasia (BPH)

Urinary retention in men with BPH

Chronic hypertension (not commonly used)

48
Q

Prazosin adverse effects

A

First dose syncope (30-90 minutes after first dose)

hypotension, dizziness, fainting, reflex tachycardia

Nasal stuffiness, impotence, polyuria, water retention

49
Q

nonselective beta antagonist

A

Propranolol

50
Q

Propranolol uses

A

Infantile hemangioma

hypertension

ischemic heart disease

Arrhythmia (Supraventricular and ventricular)

Chronic heart failure

51
Q

Beta antagonist MOA (selective and non-selective)

A

decrease cardiac output (target SA and AV nodes to slow rate and O2 requirements of the heart)

52
Q

Beta antagonist AE (selective and non-selective)

A

Bradycardia

53
Q

Beta antagonist discontinuation (selective and non-selective)

A

requires tapering

54
Q

Beta antagonist drug-drug interaction (selective and non-selective)

A

insulin

55
Q

Beta antagonist contraindication (selective and non-selective)

A

Asthma and AV block

Pharmacology II (3 decks)

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