drug main uses (Sympathomimetics)

Question 1

Epinephrine (Adrenalin, EpiPen, Auvi-Q, Primatene Mist)

Answer 1

Mixed or Nonselective agonists

Treat bronchospasm and vasodilation in anaphylaxis, reverse asthmatic bronchoconstriction, assist resuscitation in CPR, bradycardia from AV block, prolong action of local anesthetics

Mean pressure stays the same
Low IV rate: decrease diastolic and increase systolic, pulse pressure, HR
High IV rate: increase both diastolic and systolic, as well as pulse pressure and HR

Question 2

Norepinephrine (Levophed)

Answer 2

Mixed or Nonselective agonists

Cardiogenic and neurogenic shock, BP support during spinal anesthesia

Increase all pressure measures and reflexively decrease HR (mainly from a receptors)

Question 3

Isoproterenol (Isuprel)

Answer 3

Mixed or Nonselective agonists

Pharmacologic provocator for tilt-table tests

Decrease diastolic and mean pressure, increase pulse pressure and HR

Question 4

Dopamine (Intropin)

Answer 4

Mixed or Nonselective agonists

Cardiogenic and neurogenic shock, CHF pts who are refractory to other therapies, treat bradycardia in pts not in cardiac arrest and unresponsive to other tx

Increases GI and renal blood flow at low doses. Intermediate dose increases cardiac contractility (B1). High doses increases mean arterial BP from increased peripheral vascular resistance.

Question 5

Dobutamine (Dobutrex)

Answer 5

Selective B1 agonist

Used in CHF and cardiogenic shock and occasionally to stimulate the heart during emergence from surgery

Sometimes mixed with an a1 agonist or with an a1 antagonist to greatly increase cardiac contractility. Increased cardiac output and pulse pressure without much increase in diastolic and mean BP.

Question 6

Albuterol (Proventil)
Metaproterenol
Pirbuterol (Maxair)
Salmeterol (Serevent)

Answer 6

Selective B2 agonists

Bronchodilation; rescue inhalers

Relax bronchial smooth muscle

Question 7

Terbutaline

Answer 7

Selective B2 agonists

Manage premature labor

Uterine muscle relaxation

Question 8

Mirabegron (Myrbetriq)

Answer 8

Selective B3 agonist

Treatment of overactive bladder

Relaxes detrusor muscle

Question 9

Phenylephrine

Answer 9

Selective a1 agonists

IV Phenylephrine to maintain diastolic and mean BP in neurogenic shock; hemorrhoids and nasal congestion; mydriasis; treat SVT through reflex bradycardia

Stimulation of vascular a1 receptors

Question 10

Pseudoephedrine (Sudafed)

Answer 10

Indirect

Treat nasal and bronchial congestions

Promote nasal and sinus drainage

Question 11

Midodrine (ProAmatine)

Answer 11

Selective a1 agonists

Treat orthostatic hypotension and urinary incontinence

Question 12

Cocaine

Answer 12

Indirect

Local anesthetic, local vasoconstrictor at site of local injection