direct sympathomimetics

Question 1

what are the subtypes of the adrenergic receptors ?
what type of receptor are they ?

Answer 1

α1/α2/β1/β2
Q I S S

G-coupled receptors

Question 2

α1 activation

(“single lit candle”)

Answer 2

-G(q) coupled receptor →IP3/DAG cascade
(“scouts holding 3 DAGS Infront of α1 cabin “)

-increases T.P.R and venous return by vasocontriction
(“scouts pulling the DAGS red and blue leashes )

-increase M.A.P
(“Scout infront of α1 cabin holding a MAP”

-Mydriasis -α1 receptors are found of dilator pupillae muscle
(“3rd scout infront of α1 cabin holding binoculars wtih dilated pupills”

-Urinary retention due to Urethral sphincter/Prostatic Smooth muscle contraction

(“3rd scout pulling on drawstring and carrying a full bladder canteen”)

Question 3

α2 activation

(“2 lit candles”)

Answer 3

-G(i) couples receptor that decreases [cAMP]
(“Dissassembling cAMP Tent infront of α2 cabin”)

-leads to inhibition of neurotransmitter release
(“α2 blacky scout rolling up presynaptic wire”)

-activation of α2 receptors leads to sympathoLYTIC effects (“no sympathy” graffiti on α2 cabin)

-decreases insulin release
(“welcome inside” mat rolled up infront of α2 dissassembled tent)

-inhibits lipolysis and release of fatty acids

(“α2 scout pouring water on roasting pig and turning off fire below him”)

-activation of α2 receptors on Cilliary body decreases AQ.H production

(“α2 scout holding eyeball pot and pouring the water out of it”)

Question 4

β Adrenegic receptors are ..

Answer 4

G(s) coupled and therefor increase [cAMP] levels

(“Band cAMP”)

Question 5

β1 activation

(“Bugle”)

Answer 5

-found on cardiac myocytes , SA, AV nodes thus increases Contractility and HR

(β1 milf wearing “i <3 Band cAMP” , holding up the heart watch {HR} and flexing her sexy Bicep {Contrc.} )

-increases cardiac output
(“red fire hydrant infront of β1 cabin squirting water”)

-increases Renin levels from JGA
(“open {incr.} yellow umbrella because Rainin from fire hydrant”)

Question 6

β2 activation

(“Tuba”)

Answer 6

-Vasodilation and thus decrease in T.P.R
(“β2 milf wearing shirt with dilated sleeves”)

-Decrease Diastolic pressure
(β2 milf with Dangling Earings”)

-bronchoDILATION
(“β2 milf inhales extensivly before playing Le Tuba “)

-increase Lipolysis and release of FFA’s
(“roasting pig infront of β2 cabin”)

-increase Gluconeogenesis in the liver
(“β2 girl pulling marshmallows from liver shaped marshmallow bag)

-increase insulin release
(“welcome inside” mat infront of β2 tent)

-causes Hypokalemia
(“Banana peels on ground infront of β2 cabin”)

-activation of β2 receptors on ciliary body increases AQ.H production

(“β2 kid filling eye-shaped balloons with water”)

Question 7

name the direct acting sympathomimetic drugs

Answer 7

α1 agonist

Phenylephrine
(“Flannel wearing Friends”)

α2 agonist

Brimonidine
(“brim of eyeball hat” infront of α2 cabin)

α>β1 agonist

Norepinephrine
(“scout leader with North compass holding a bugle”)

β > α agonist
Epinephrine

(“EPIC Qiss between α and β camps” raft low towards β means β agonist in low doses )

β1>β2 agonist

Dobutamine
(girl wearing “ just _do bu_gle” shirt infront of _β1 cabin )

β1=β2 agonist_

Isoproterenol
(“iso-pro-tunnel” between β1 and β2 camp tents )

β2 agonists

Terbutaline
(“pregnant β2 camp counsler sleeping on hammock with “DO NOT DIS_TURB”_ sign”)

Ritodrine
(pregnant β2 camp counsler sleeping on hammock wearing “I dream of Band camp” shirt”)

Question 8

inhaled β2 agonists

(“ROL call sheet”)

Answer 8

• all have “ROL”- suffix (“β2 milf holding ROL call sheet”)
• Used as bronchoDILATION agents

SABA

• Albute-ROL
• ​Pirbute-ROL

LABA

• ​Formote-ROL
• ​Salmete-ROL

Question 9

Phenylephrine

(“Flannel wearing Friends”)

Answer 9

-α1 agonist (“red flannel guy holding 1 lit candle)

-for treatment of nasal congestion and reduction of edema of nasal mucosa mediated by vasoconstriction
(“red flannel guy holding nasal spray”)

-increases M.A.P ,SysP, DiaP
(“blue flannel guy holding map with elevating figures”)

-causes reflex Bradycardia mediated by baroreceptor mechanism
(“flannel friends holding low dangling heart watches”

-causes mydriasis by activation of Dilator pupillae muscle
(“blue flannel guy holding binoculars with dilated pupills”)

Question 10

Brimonidine

(“Brim of eyeball hat”)

Answer 10

-α2 agonist
(“scout holding eyeball hat infront of α2 cabin”)

-useful for treatment of chronic open angle glaucoma since activation of α2 receptor on cilliary body decreases AQ.H production

(“α2 scout emptys eyeball hat from water”)

Question 11

Norepinephrine

(“camp leader with North complass and Bugle”)

Answer 11

-α>β1 agonist
(“found on α scout camp side but also holding a bugle”)

-increases T.P.R and therefore M.A.P , Psys , Pdia (“leader scout holding MAP with elevating figures” α1 )

-increase contractility of the heart
(“scout leader flexin dem Biceps” β1)

-increases Pulse Pressure between Psys and Pdia

-causes reflex Bradycardia
(“scout leader holding low dangling heart watch”)

-Useful in treatment (α1 agonists) of Distributive shock /Hypovolemic shock since it increases T.P.R and venous return *also Phenylephrine*

(“septic shock sign” infront of scout leader and flannel wearing friends” )

Question 12

Epinephrine

(“EPIC qiss between scout camp and band camp”)

Answer 12

-β1>α agonist

-effective ,dose dependent vasoconstrictor and cardiac stimulator

-at LOW doses β effects predominate
(“low side of epic raft towards band camp”)

• Bronchodilation
  (“β tuba girl holding inhaler” β2)
• ​decrease Diastolic pressure via vasodilation and reduced T.P.R
  (“epic DIAmond falls off low side of raft”β2)
• ​Increased HR
  (“ β tuba girl elevating heart watch”β1)
• ​Increase Contractility
  (“β tuba girl flexin dem Biceps”β1)

-at HIGH doses α effects predominate
(“high side of raft elevated towards α scout camp)

• vasoconstriction
• ​Increased T.P.R

• Epinephrine increases Psys , decreases Pdia , increases M.A.P , Increases PP

(“map infront of EPIC QISS shows elevated figures except Pdia which is decreased”)

• Epinephrine is preffered treatment for Anaphylactic shock since it :
• α1 activation counteracts β2 vasodilation (via α1)
• ​increases contractility and improves blood flow (via β1)
• ​bronchoDILATION (via β2)

​

Question 13

Dobutamine

(girl wearing “just do Bugle” shirt )

Answer 13

-β1>​β2 agonist
(girl wearing “just do bugle” shirt next to friend with Tuba)

-useful for treatment of refractory heart failure since it increases HR , Contractility , and cardiac output

(“just do bugle “ girl holding heart flashlight”)

-useful for treatment of Cardiogenic Shock
(“fallen batteries from heart flashlight”

-increases Psys (β1 increase CO) decreases Pdia (β2 vasodilation) increases PP

(“Tuba girl holding map with elevated Psys . unchanged M.A.P and decreased Pdia”)

**Dobutamine can be used to induce a heart stress test in order to identify area of ischemia**

Question 14

Isoproterenol

(“iso-pro-tunnel”)

Answer 14

-β1=β2 agonist
(“iso-pro-tunnel” between β1 and β2 tents”)

-increases HR and contractility

(“iso-pro-tunnel yellow camper elevating heart watch as well as flexin dem Biceps”- via β1)

-causes vasoDILATION and decreases T.P.R thus decrease Pdia

(“iso-pro-tunnel blue camper has dilated sleeves as well as dangling DIAmond earings”- via β2)

• since it has vasodilation effect → T.P.R decrease → Pdia+M.A.P Decrease →PP Increase

Question 15

Terbutaline
(pregnant camp counsler sleeping on hammock with sign saying “do not disTURB”)

Ritodrine
(pregnant camp counsler sleeping on hammock with shirt saying “i DREAM of band camp”)

Answer 15

-β2 agonists
(“pregnant camp counsler sleeping on hammock infront of β2 cabin”)

-both drugs can prevent premature labor by relaxation of the uterine smooth muscles tone- tocolytic agents

(“pregnant camp counsler sleeping on hammock and seems to be very relaxed”)

*not shown in sketchy but can also act as fast-acting bronchodilators*