Ch. 18 and Ch. 19- Adrenergic/Adrenergic blocking

Question 1

What are adrenergic drugs?

Answer 1

Drugs that stimulate the Sympathetic Nervous System

Question 2

What are adrenergic receptors?

Answer 2

Receptors for the sympathetic neurotransmitters

Question 3

What are the types of adrenergic receptors?

Answer 3

Alpha-adrenergic, beta-adrenergic, and dopaminergic receptors

Question 4

What are dopaminergic receptors?

Answer 4

Receptors for that respond only to dopamine

Question 5

Where are Alpha1 Receptors located?

Answer 5

On the postsynaptic effector cells of the tissue, muscle, or organ that the nerve stimulates

Question 6

Where are Alpha2 Receptors located?

Answer 6

On the presynaptic nerve terminals (the nerve that stimulates the effector cell). Alpha2 Receptors control the release of neurotransmitters.

Question 7

What is the predominant response you’re going to get from an alpha-adrenergic agonist?

Answer 7

Vasoconstriction and CNS stimulation

Question 8

Where are Beta 1 receptors located?

Answer 8

Primarily in the heart

Question 9

Where are Beta 2 receptors located?

Answer 9

In the smooth muscle of the bronchioles, arterioles, and visceral organs

Question 10

What is the beta-adrenergic agonist response?

Answer 10

Smooth muscle relaxation in bronchioles, GI, and uterine.
Glycogenolysis- muscles and tissues using glucose.
Cardiac stimulation

Question 11

What does dopamine cause?

Answer 11

Dilation in the blood vessels, especially kidneys, mesentary, coronary, cerebral blood flow. Results in increased blood flow. Increases perfusion to brain, kidneys, and heart.

Question 12

How are catecholamines made?

Answer 12

They can be produced by your body (endogenous), or they can be produced synthetically by a drug company.

Question 13

What are catecholamines?

Answer 13

Substances that can produce a sympathetic response, such as epinephrine, norepinephrine, dopamine (endogenous) and dobutamine, phenylephrine (synthetic)

Question 14

What are examples of endogenous catecholamines?

Answer 14

Epinephrine, norepinephrine, dopamine

Question 15

What are examples of synthetic catecholamines?

Answer 15

Dobutamine, phenylephrine

Question 16

What does endogenous mean?

Answer 16

Made by the human body

Question 17

What does a direct-acting sympathomimetic do?

Answer 17

Bind directly to the receptor and cause a physiologic response

Question 18

What are some other terms for adrenergic drugs?

Answer 18

Sympathomimetics, adrenergic agonists

Question 19

What does an indirect-acting sympathomimetic do?

Answer 19

Causes the release of catecholamines (from storage sites in nerve endings aka vesicles). Catecholamines then bind to receptors and cause a physiologic response.

Question 20

What does a mixed-acting sympathomimetic do?

Answer 20

It uses both indirect and direct acting. Some may cause release of catecholamines, which will bind to receptors. And some will bind directly to the receptor.

Question 21

Stimulation of alpha adrenergic receptors causes what response?

Answer 21

Vasoconstriction. Ex: Contraction of pupillary muscles of the eye, dilated pupils=better vision

Question 22

What are cardioselective sympathomimetics?

Answer 22

Vasoactive adrenergic drugs which effect both alpha and beta adrenergic receptors. Used during cardiac failure or cardiac shock.

Question 23

What are some examples of cardioselective sympathomimetics?

Answer 23

Dopamine, epinephrine, norepinephrine (all prototypes)

Dobutamine, ephedrine, fenoldapam

Question 24

What is epinephrine?

Answer 24

Secreted by adrenal medulla. AKA adrenaline. It’s a vasopressor.

Question 25

What is dopamine?

Answer 25

Causes pleasure symptoms of brain (sexual, mostly). Huge connection between dopamine and addiction. Primary for preservation of the species (this tastes good, I need more so I don't starve, etc).

Question 26

What are the adverse effects of the alpha adrenergic drugs?

Answer 26

CNS: Headache, restlessness, excitement Cardiovascular: Increased heartrate, palpitation (disrhythmias), HTN GI: N/V, Loss of appetite

Question 27

What are the adverse effects of the beta adrenergic drugs?

Answer 27

Mainly the same as alpha adrenergic. Just bad stuff, could go any way.

Question 28

What are some of the interactions of adrenergic drugs?

Answer 28

With anesthetic drugs: increased risk of cardiac disrythmias With tricyclic antidepressants: Increased vasopressor effects, respiratory depression With MAOIs: Life-threatening hypertensive crisis With antihistamines: Increased effect of adrenergic drugs

Question 29

Why can't patients use nasal decongestants with adrenergic drugs?

Answer 29

Can cause rebound nasal congestion or ulcerations

Question 30

What is another name for adrenergic blockers?

Answer 30

Adrenergic antagonists Sympatholytics Alpha-blockers, beta-blockers, or alpha-beta blockers

Question 31

What are the alpha adrenergic blockers used for?

Answer 31

Their effects on the vascular smooth muscle and small arteries. Cause vasodilation. They decrease BP. They treat benign prostatic hypertrophy (dilate ute

Question 32

What are the beta adrenergic blockers used for?

Answer 32

To block beta adrenergic drugs. Slow the heart down. Many used to treat HTN.

Question 33

What do adrenergic blockers mainly do?

Answer 33

Have the opposite effect of adrenergic drugs. Inhibit, or lyse, sympathetic stimulation.

Question 34

How does the competitive blockade work?

Answer 34

The adrenergic blockers physically block the receptor, so the neurotransmitter can't get in.

Question 35

How does the noncompetitive blockade work?

Answer 35

The adrenergic blocker makes a covalent bond at the receptor site, so it won't respond to the neurotransmitter at all because its already bonded to the blocker.

Question 36

What is the primary response of the alpha blockers?

Answer 36

Vasodilation. Reduces peripheral vascular resistance. So primarily used to treat HTN.

Question 37

What is phentolamine?

Answer 37

An alpha-blocker. Reverses the effect of a vasoconstrictor like epinephrine. Restores blood flow and prevents tissue necrosis.

Question 38

What are some common alpha-blockers?

Answer 38

Phentolamine (regitine), and tamsulosin (flomax)

Question 39

What do beta-blockers do?

Answer 39

Block stimulation of beta receptors in sympathetic nervous system by competing with norepinephrine and epinephrine.

Question 40

What beta-blockers target the beta1 receptors?

Answer 40

Cardioselective beta-blockers

Question 41

What effect do nonselective beta-blockers have?

Answer 41

Same as cardioselective beta-blockers

Question 42

What's an example of a beta-blocker?

Answer 42

Metoprolol (Lopressor)