Drugs

Question 1

Isoproterenol Receptor selectivity

Answer 1

β1, β2

Question 2

Isoproterenol Cardiovascular effects

Answer 2

Decrease PVR (B2)
– Increase HR, contractile force, cardiac output (B1)
– Decrease mean blood pressure (B2)

Question 3

Isoproterenol• Respiratory effects

Answer 3

– Bronchodilation

Question 4

Isoproterenol Absorption, fate, excretion

Answer 4

– Metabolized by COMT

– brief duration of action

Question 5

Isoproterenol • Therapeutic uses

Answer 5

– Emergency use to stimulate heart

rate during bradycardia or heart block

Question 6

Dobutamine Receptor

Answer 6

B1

Question 7

Dobutamine Cardiovascular Effects

Answer 7

-Increased HR, contractility, and CO

– Minimal change in peripheral vascular resistance & BP

Question 8

Dobutamine • Absorption, fate, excretion

Answer 8

– Metabolized rapidly

– Brief duration of action

Question 9

Dobutamine Therapeutic Uses

Answer 9

-Short-term treatment of cardiac decompensation (cardiac surgery, CHF, infarction)
– Cardiac stress testing

Question 10

Albuterol Receptor

Answer 10

B2 agonist

Question 11

Albuterol Administration

Answer 11

Inhalation or orally

Question 12

Albuterol Metabolism/ Rate of action

Answer 12

Short acting and rapid onset

Question 13

Albuterol Therapeutic Use

Answer 13

relief of bronchoconstriction. (asthma)

Question 14

Albuterol Adverse effects:

Answer 14

tremor, anxiety, tachycardia (Bc even though it is a selective B2 agonist there s a little bit of action on B1 )

Question 15

Is Albuterol short acting or long acting? aka can it be used for asthma emergency

Answer 15

Short acting, yes bc rapid onset

Question 16

Salmeterol receptor

Answer 16

• β2 adrenergic agonist

Question 17

Salmeterol administration

Answer 17

inhalation

Question 18

Salmeterol duration of action

Answer 18

Long, more than 12 hours

Question 19

Salmeterol therapeutic use

Answer 19

• Chronic obstructive pulmonary disease, moderate to severe persistent asthma
• Slow onset of action so not suitable as monotherapy for acute bronchospasm

Question 20

Is Salmeterol good for asthma emergency?

Answer 20

No it is long acting and slow onset

Question 21

Phenylephrine receptor

Answer 21

α1 adrenergic receptors agonist

Question 22

Phenylephrine effects

Answer 22

-Increases systolic and diastolic blood pressure
– Reflex decrease in heart rate
– Decrease blood flow in most vascular beds

Question 23

Phenylephrine• Therapeutic Uses:

Answer 23

-Ophthalmic
• mydriatic, decrease hemorrhage & congestion
-Nasal decongestant
• oral or nasal spray
-Used with local anesthetics to increase duration of action
– Treatment of hypotension

Question 24

Clonidine Receptor and effect of the receptor

Answer 24

α2 adrenergic receptor
agonist that directly stimulates central α2
receptors to reduce sympathetic outflow

Question 25

What does Clonidine do to the CV System

Answer 25

Decrease PVR, HR, CO (SO it decreases BP) These effects occur bc it reduces sympathetic outflow, which reduces sympathetic influence on the CV system. so everything is more relaxed/decreases.

Question 26

Clonidine Therapeutic Use:

Answer 26

Anti-Hypertensive Agent

Question 27

Clonidine Major Adverse Effect

Answer 27

dry mouth and sedation (50% of patients)

Bc you are inhibiting the CNS outflow so you get drowsy

Question 28

Methyldopa metabolism

Answer 28

Orally active pro-drug
– Metabolized in nerve terminals to α-methyldopamine
and α-methylnorepinephrine, which are stored and
released with nerve stimulation

Question 29

Methyldopa Receptor and receptor effect

Answer 29

Both ( α methyldopamine, and α-methylnorepinephrine) are potent α2 receptor agonists
– Stimulate central α2 receptors to reduce sympathetic
outflow

Question 30

Methyldopa • Major therapeutic use:

Answer 30

Anti-hypertensive

Question 31

Methyldopa side effect

Answer 31

similar to Clonidine (drowsy and dry mouth in 50% of patients)

Question 32

Unique fact about Methyldopa

Answer 32

safe in pregnant women

Question 33

Tyramine

Answer 33

Indirect accting sympathomimetic, that releases norepinephrine from sympathetic nerves causing sympathomimetic actions

Question 34

What metabolizes Tyramine

Answer 34

MAO

Question 35

Danger of eating a diet high in Tyramine while taking an antidepressant

Answer 35

• Tyramine is found at high levels in some foods and is broken down by MAO
• Several antidepressants are MAO inhibitors.
• When people are taking an MAOI and ingest a lot of tyramine (ex in alcohol) they won’t break down the Tyramine (bc MAO is blocked) they will develop toooo much Tyramine and this can cause a hypertensive crisis (bc sympathetics increase BP)

Question 36

Amphetamine

Answer 36

• Powerful CNS Stimulant (miscellaneous Sympathomimetic)

- Releases norepinephrine and other biogenic amines (dopamine) from granules

Question 37

Amphetamine administration

Answer 37

effective orally

Question 38

Amphetamine CNS actions

Answer 38

CNS actions:
– CNS stimulation
– Depresses appetite
– Stimulates respiratory center – increases respiration

Question 39

Amphetamine Therapeutic uses

Answer 39

– Narcolepsy

– Attention deficit/hyperactivity disorder

Question 40

Pseudoephedrine receptor

Answer 40

Direct α1 agonist with some β2 agonist activity

Question 41

Compare Pseudophedrine to amphetamine

Answer 41

Orally effective but less CNS stimulation

compared to amphetamine

Question 42

Major therapeutic use of Pseudophedrine

Answer 42

Nasal decongestant (a1)