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Pharmacology 2 > E1- Adrenergic Stimulants > Flashcards

E1- Adrenergic Stimulants Flashcards

1
Q

What type of adrenergic agent acts on presynaptic neuron to increase synthesis, cause release, and inhibit re-uptake?

A

Indirect acting

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2
Q

What type of adrenergic agent acts on adrenergic receptors on target tissues to mimic sympathetic stimulation?

A

Direct acting

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3
Q

What type of adrenergic agent stops indirect acting and may enhance direct acting?

A

Denervation

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4
Q

What is the relative affinity of EPI, NE, and Isoproterenol for both alpha 1 and alpha 2 receptors?

A

EPI and NE > Isoproterenol

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5
Q

Between alpha, beta, and dopamine, what is the only inhibitory receptor?

A

Alpha 2

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6
Q

What is the role of of alpha 1 receptors?

A

Vasoconstriction in skin, kidney, and mucous membranes

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7
Q

What is the role of of alpha 2 receptors?

A

Presynaptic

Inhibit neurotransmitter release

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8
Q

What is the relative affinity of EPI, NE, and Isoproterenol for beta 1 receptors?

A

Isoproterenol > EPI and NE

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9
Q

What is the role of beta 1 receptors?

A

Increase force and rate of contraction of the heart

Increase renin secretion from the kidney

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10
Q

What is the relative affinity of EPI, NE, and Isoproterenol for beta 2 receptors?

A

Isoproterenol > EPI > NE

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11
Q

What is the role of beta 2 receptors?

A

Relax bronchioles and gut smooth muscles
Increase glycogenesis
Vasodilate blood vessels supplying skeletal muscles

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12
Q

What is the relative affinity of EPI, NE, and Isoproterenol for beta 3 receptors?

A

Isoproterenol and NE > EPI

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13
Q

What is the role of beta 3 receptors?

A

Increase lipolysis

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14
Q

What is the role of D1 receptors?

A

Vasodilate renal vasculature

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15
Q

What receptors does NE stimulate? With what affinity?

A

Stimulates alpha and beta receptors

a1 = B1 > B2

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16
Q

What is the affect of NE on a1 and b1 receptors?

A

a1= Vasconstriction, increase BP
B1= Increase HR
Baroreflex responds and decreases HR, therefore CO is either unchanged or decreased

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17
Q

What the the route of administration of NE?

A

IV

Very short acting

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18
Q

What is NE used for?

A

Rarely used to increase BP for severe hypotensive crisis

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19
Q

Are cocaine, tyramine, amphetamine, and MAOIs indirect acting, direct acting, or denervation agents?

A

Indirect acting agents

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20
Q

If atropine is given prior to NE, what will happen?

A

The vagal reflex is inhibited, the baroreceptor effect will not occur, and the HR will increase

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21
Q

What receptors does EPI stimulate? With what affinity?

A

Activates all adrenergic receptors

B1 = B2 > a1

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22
Q

What receptor does low dose EPI stimulate? What affect does this have?

A 
B2 
Vasodilate blood vessels supplying skeletal muscle
- Decreased DBP
- Increased PP
- No change in MAP
- No baroreflex to slow HR
- HR stays increased
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23
Q

What receptor does high dose EPI stimulate? What affect does this have?

A 
a1 overrides B2 
Vasoconstriction
- Increased DBP
- Increased MAP
- Baroreflex responds
- HR slows
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24
Q

What is EPI used for?

A

Anaphylactic shock
Decrease diffusion of anesthetics (vasoconstrictor)
Glaucoma
Emergency tx for cardiac arrest and complete heart block

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25
Q

What are contraindications of NE?

A

Severe vasoconstriction at the infusion site that can lead to necrosis

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26
Q

What are contraindications of EPI?

A

Pts taking beta-blockers (unopposed alpha effects, so it can lead to severe HTN)

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27
Q

What are side effects of EPI?

A 
Tremor 
Throbbing HA
Increased BP
Tachycardia
Angina in pts with CAD
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28
Q

What can be used to reverse the effects of EPI?

A

Alpha blockers

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29
Q

What are the three drugs classified as alpha 1 agonist?

A

Phenylephrine
Pseudeophedrine
Oxymetazoline

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30
Q

What is Phenylephrine used for?

A

Hypotensive emergency
Decongestant (vasoconstrict nasal mucosa)
Mydriasis

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31
Q

What are contraindication of Phenylephrin?

A

Caution in pts with HTN and BPH

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32
Q

What is the main side effect of Phenylephrine?

A

Rebound decongestion

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33
Q

What drug is similar to Phenylephrine, but more effective?

A

Pseudeophedrine

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34
Q

What is Oxymetazoline used for?

A

Decrease redness in the eye

Decongestant

35
Q

What are contraindications of Oxymetazoline?

A

Caution in pts with glaucoma and HTN

36
Q

What are the three drugs classified as alpha 2 agonist?

A

Clonidine
Methyldopa
Tizanidine

37
Q

What is Clonidine used for?

A

Decreases cravings in recovering addicts
Decreases hot flashes
Pre-anesthetic to sedate and dry secretions

38
Q

What are side effects of Clonidine?

A 
Xerostomia
Sedation
Erectile dysfunction
Sudden withdraw can lead to HTN crisis
Avoid getting patch hot, can lead to hypotension
39
Q

What is Methyldopa used for?

A

HTN

40
Q

What are contraindications of Methyldopa?

A

Not recommended for monotherapy b/c of CNS effects (only used fo refractory HTN pts)

41
Q

What are side effects of Methyldopa?

A 
Xerostomia
Sedation
Erectile dysfunction
Hemolytic anemia
Hepatotoxicity
42
Q

What drug is recommended to tx HTN in pregnancy?

A

Methyldopa

43
Q

What is Tizanidine used for?

A

Muscle spasticity in neurological conditions

44
Q

What is the main side effect of Tizanidine?

A

Asthenia (dose-related effect defined as weakness, fatigue, and/or tiredness)

45
Q

What is the one drug classified as a non-specific beta agonist?

A

Isoproterenol

B1 and B2 agonst

46
Q

What is Isoproterenol used for?

A

Emergency tx for cardiac arrest and complete heart block

47
Q

What are side effects of Isoproterenol?

A

Tachycardia
Palpations
Arrhythmias

48
Q

What is the one drug classified as a beta1 agonist?

A

Dobutamine

49
Q

How is Dobutamine administered?

A

IV

50
Q

What is Dobutamine used for?

A

Increase contractility and output in cardiogenic shock and low output heart failure
Cardiac stress tests if pt cannot exercise

51
Q

What should you watch out for when giving Dobutamine to a pt with HTN?

A

BP may increase if given too quickly

52
Q

What is the one drug classified as a beta2 agonist?

A

Albuterol

53
Q

What is Albuterol used for?

A

Athma

54
Q

What are side effects of Albuterol?

A

H/A
Tachycardia
Palpitations
Tremor

55
Q

What is the one drug classified as a beta3 agonist?

A

Mirabegron

56
Q

What is Mirabegron used for?

A

Overactive bladder (relaxes detrusor muscle to increase bladder capacity)

57
Q

What are the side effects of Mirabegron?

A

HTN

Tachycardia

58
Q

What is the two drug classified as dopamine agonist?

A

Dopamine

Fenoldopam

59
Q

What is the effect/use of low dose dopamine?

A

Renal vasodilation via D1 receptors in the kidey

60
Q

What is the effect/use of moderate dose dopamine?

A

Inotropic effect via B1 receptors in the heart

61
Q

What is the effect/use of high dose dopamine?

A

Vasocontriction via alpha receptors in blood vessels

62
Q

What are contraindications of dopamine?

A

Should not be used with a MAOI because they are metabolized by MAO

63
Q

What are the side effects of dopamine?

A

Tachycardia, nausea, vomiting, angina, headache, and peripheral vasoconstriction

64
Q

How are dopamine and fenoldopam administered?

A

IV

65
Q

What is fenoldopam used for?

A

Emergency HTN

66
Q

What are then side effects of fenoldopam?

A

Reflex tachycardia, headache, and flushing

67
Q

What is are the 5 drugs classified as indirect acting sympathoimetics agonist?

A 
Amphetamine
Methylphenidate
Methamphetamine
Cocaine
Tyramine
68
Q

What is the MOA of Amphetamine, Methylphenidate, and Methamphetamine?

A

Increase release of NE from neurons

69
Q

What is the MOA of Cocaine?

A

Inhibits reuptake of DA and NE

70
Q

What is the MOA of Tyramine?

A

Increases release of DA, NE from nerve terminals

Rapidly hydrolyzed by MAO

71
Q

What are Amphetamine and Methylphenidate equal DOCs for?

A

ADHD

72
Q

What are side effects of Amphetamine, Methylphenidate, and Methamphetamine?

A

Tremor
Tachycardia
HTN
Psychosis

73
Q

What is unique about Amphetamine, Methylphenidate, and Methamphetamine?

A

Only work on intact neurons

74
Q

Why is Methamphetamine a major drug of abuse?

A

It has more central actions and fewer peripheral effects

75
Q

What can cocaine be used for?

A

Local anesthetic and powerful vasoconstrictor

Rarely used for nasopharyngeal surgery (too addicting)

76
Q

What are side effects of cocaine?

A 
Severe HTN
Stroke 
Tachycardia
Arrhythmias
MI
Psychosis
77
Q

What are contraindications of Tyramine?

A

Pts tx for depression with MAOI, tyramine can lead to severe HTN crisis

78
Q

What is the specific agonist for alpha 1 receptors?

A

Phenylephrine

79
Q

What is the specific agonist for alpha 2 receptors?

A

Clonidine

80
Q

What is the specific agonist for B1 receptors?

A

Dobutamine

81
Q

What is the specific agonist for B2 receptors?

A

Albuterol

82
Q

What is the specific agonist for B3 receptors?

A

Mirabegron

83
Q

What happens when you give epinephrine after an alpha blocker?

A

The effects of epinephrine are reversed (hypotension)

84
Q

What is dopamine used to treat?

A

Severe refractory heart failure and is useful if an increase in BP is needed

Pharmacology 2 (12 decks)

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