Drug List 2: adrenergic agonists Flashcards
Dopamine
Class: adrenergic agonist
Mech: D1-5 R agonist, beta > alpha agonist
Ind: shock
Effects: increase kidney perfusion (vasodilate renal/mesenteric vasc.), cardiac stimulant
SE: –
Dobutamine
Class: adrenergic agonist Mech: beta1 > beta2 > alpha1 agonist Ind: congestive heart failure (acutely), chemical cardiac stress test Effects: inotropic, little change to HR Admin: injection SE: arrhythmias, angina, MI
Epinephrine
Class: adrenergic agonist
Mech: alpha & beta agonist
Ind: advanced cardiac life support, asthma/COPD, anaphylaxis (drug of choice); prolong local anesthetic (local vasoconstrict, a1)
Effects: cardiac stimulant (B1 –> CO & HR), bronchodilator (B2), vasoconstriction (a1, B2)
Admin: inject, inhale
SE: arrhythmia, angina, MI, CNS effects (anxiety/fear, tremor, headache/tension), HTN headache, pulmonary edema, cerebral hemorrhage
Isoproterenol
Class: adrenergic agonist (Catecholamine)
Mech: beta 1/2 agonist
Ind: emergency cardiac stimulant, asthma (occasionally)
Effects: 1a) reduced PVR (skeletal mm vasodilation) –> decrease diastolic BP, 1b) direct & reflex cardiac stim. = increase HR and contractility, 2. bronchodilation
Admin: injection
SE: arrhythmia, angina, MI, CNS effects
Norepinephrine
Class: adrenergic agonist (Catecholamine)
Mech: alpha > beta agonist
Ind: acute hypotension/shock
Effects: increase PVR (a1 Rs) –> increase dBP/sBP –> reflex ~decrease HR
SE: kidney failure during shock! (also headache, nausea, pulm. edema, etc)
Albuterol
Class: adrenergic agonist (non-catecholamine)
Mech: beta2 agonist
Ind: acute bronchospasm – asthma, COPD
Effects: bronchodilation by sm. mm. relaxation (lower resp. tract)
Admin: aerosol inhalation
SE: CNS effects (anxiety, fear, tremor, headache, tension), tachycardia/arrhythmia (rare)
Chlonidine
Class: adrenergic agonist (non-catecholamine)
Mech: alpha2 agonist
Ind: HTN, ease opiate withdrawal, & more
Effects: decrease BP via CNS, many others
Admin: oral, transdermal, injection
SE: bradycardia, …
Methoxamine
Class: adrenergic agonist (non-catecholamine)
Mech: alpha1 agonist
Ind: reverse HTN during spinal anesthesia or surgery/trauma, evoke reflex brachycardia during tachycardia
Effects: increase PVR –> reflex brachycardia
Admin: injectable
SE: hypertensive headache, nausea/vomiting, pulmonary edema, cerebral hemorrhage
Phenylephrine
Class: adrenergic agonist (non-catecholamine)
Mech: alpha1 > alpha2 agonist
Ind: Mydriasis w/o cycloplegia (eye exam for older pts), decongestant, evoke reflex bradycardia during tachycardia
Effects: increase PVR –> reflex bradycardia, decongestion, mydriasis
Administration: oral, topical, opthalmic
SE: hypertensive headache
Salmeterol
Class: adrenergic agonist (non-catecholamine)
Mech: beta 2 agonist (long-lasting!)
Ind: chronic use – asthma, COPD
Effects: bronchodilation
Admin: aerosol inhalation
SE: CNS effects (anxiety, fear, tension, headache, tremor)
Terbutaline
Class: adrenergic agonist (non- catecholamine)
Mech: beta2 agonist
Ind: delay premature labor* (*off-label), asthma/COPD
Effects: bronchodilation, relax sm muscle of bladder wall/uterus
SE: CNS effects (anxiety, fear, tremor, headache, tension), tachycardia/arrhythmia
Ephedrine
Class: adrenergic agonist (non-catecholamine)
Mech: (mixed) AP ind.-NE release, direct beta and alpha agonist
Ind: Nasal decongestion (asthma, allergies)
Effects: decongestion, bronchodilation, cardiac stimulation, increase BP/metabolism, mild CNS stim.
Admin: oral
SE: death! (FDA prohibits in dietary supplements)
Amphetamine
Class: adrenergic agonist (non-catecholamine), psychostimulant
Mech: (indirect) AP-indep. NE release
Ind: ADHD, narcolepsy
Effects: strong CNS effects (elation, alertness, increased self-confidence, aggression, loss of appetite)
Admin: oral
SE: addiction!, physical dependence, withdrawal
Tyramine
Class: tyrosine metabolism byproduct (enriched in wine, cheese)
Mech: (indirect) AP-indep. NE release
Ind: - none -
Effects: dangerous increase in BP, nausea, fever, sweating, headaches (in presence of MAOI)
SE: = a food-drug interaction for MAOIs
Cocaine
Class: psychostimulant
Mech: (indirect) blocks NE re-uptake
Ind: epistaxis (nose bleeds), (& local anesthetic)
Effects: vasoconstriction, amphetamine-like (strong CNS –> aggression, alertness, etc)
SE: addiction, dependence, withdrawal
