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Year 2 CV > Exam 3, Adrenergic Agonist Antagonist MArtin > Flashcards

Exam 3, Adrenergic Agonist Antagonist MArtin Flashcards

1
Q

What are the alpha R antagonists

A

prazosin

phentolamine

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2
Q

What are the alpha R agonists

A

phenylephrine

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3
Q

what are the alpha 2 agonists

A

clonidine and methyldopa

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4
Q

what are the D1 agonists

A

dopamine

fenoldopam

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5
Q

what are the nonselective beta R antagonists

A

proparnolol, nadolol, timolol, pindolol, carteolol, sotalol

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6
Q

what are the cardioselective beta R antagonists

A

atenolol, acebutolol, metoprolol

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7
Q

what are the third generation beta R antagonists

A

labetolol, carvedilol, betaxolol, carteolol

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8
Q

what are the pre and post synaptic NT for sympathetic sweat glands

A

Ach and Ach

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9
Q

what are the B1 actions on the heart

A

stimulate HR and force

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10
Q

what are the muscarinic actions on the heart

A

decrease in heart rate

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11
Q

what are the alpha 1 effects on the heart

A

vasoconstriction

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12
Q

what are the beta 2 effects on the heart

A

vasodilation

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13
Q

what are the effects of dopamine on renal arteries

A

dilation of afferent aa increasing blood flow to kidneys

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14
Q

what increases MAP and TPR

epi, norepi or isoproterenol

A

Norepinephrine, decreases pulse rate

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15
Q

what increases pulse rate and decreases TPR

epi norepi or isoproterenol?

A

epi and isoproterenol

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16
Q

which has greater effect on decreasing TPR

norepi, epi or isoproterenol

A

isoproterenol

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17
Q

what are the CV uses for epi

A

during CPR for asystole
hemodynamic support after CABG surgery
anaphylaxis
local or topical hemostatic

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18
Q

what are the CV uses of NE

A

pressor agent of choice for septic shock and may be more appropriate than dopamine as first line Tx for other types shock
can be used to support BP in surgical care setting
decreases renal blood flow

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19
Q

What is phenylephrine used for

A

OTC nasal decongestant

IV vasopressor agent, maintain BP in hypotensive states like spinal anesthesia

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20
Q

what are the effects of phenylephrine

A

vasoconstriciton, increased TPR, increase BP

reflex bradycardia

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21
Q

what can block reflex bradycardia from phenylephrine

A

atropine

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22
Q

does phenylephrine cause atrial or ventricular tachy

A

atrial

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23
Q

what peripheral R does dopamine work on

A

D1>B1>a1

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24
Q

what are the pharmocological effects of dopamine

A

vasodilate renal, coronary and mesenteric vascular beds
increase blood flow to kidney
heart- mild increase in rate and force
high dose causes vasoconstriction of blood vessels

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25
what are the clincal uses for dopamine
shock, unstable CHF icnrease CO and increases renal perfusin somtimes in acute crisis of chronic CHF
26
why must you monitor BP carefully with use of dopamine
higher infusion rate or doses can cause vasoconstriciton and decreased tissue perfusion
27
what are the effects of dobutamine
since B1 selective agonists positive inotropic and some increase in rate CO increases little vascular effect
28
what are the clinical uses of dobutamine
cardiogenic shock, MI CHF
29
what are the adverse effects of dobutamine
potential arrhythmias | increase work and O2 requirement
30
what are the clincal uses of alpha 1 selective R blockers
2nd or 3rd line Tx for essential HTN
31
what are the effecs of alpha 1 selective antagonists
decrease venous return, dec preload does not increase Hr or CO normal NE release dec LDL and TG, inc HDL
32
what are the adverse effects of alpha 1 selective antagonists
caus emarkerd postural hypotension and syncope, orthostatic hypotension usually given at bedtime to minimize hypotensive effects
33
What are the clincal uses for beta blockersq
HTN, decrease CO and slow decrease in TPR ischemic heart disease, angina, MI, acute coronary syndromes CHF arrhythmias
34
how do beta blockers help with MI and post MI prophylaxis
protect against arrhythmias and limits infarction size assess LV function 5-12 days post MI reduces O2 demand and spread of infarct area
35
how are beta blockers helpful in thyrotoxicosis
hyperthyroid patients have increased beta R sensitivity | beta blockers reduce sensitivity of myocardium to adrenergic stimulation in hyperthyroid patients
36
What is the mechanism for propanolol
competitive antagonist at B1 B2 and B3 R
37
hwo do B blockers differ
their bioavailability, biotransofrmation and pharmokinetics
38
what are the pharmacological general effects of beta blockers
block existing sympathetic tone | effects are greater if sympathetic tone is high (druing MI or exercise)
39
what are the effects on heart by beta blockers
``` dec HR and CO dec exercise tolerance dec depolarization extopic pacemakers dec O2 demand dec AV nodal conduction dec infarct size ```
40
how do beta blockers decrease exercise tolerance
blunt increase in HR and contractility that normally occurs with exercise CO less affected because SV increased decrease work capacity increased catecholamines during exercise increase work of heart and oO2 demand
41
what are the effects of beta blockers on myocardial O2 demand
decrease it
42
What are the effects of beta blockers in people with normal BP
does not lower BP, just in HTN patients
43
what are the effects of beta blockers on plasma renin levels
beta blockers block the normal catecholamine driven release of renin therefore decrease renin
44
what beta blockers have non selective vasodilatory effects
carteolol, carvedilol, bucindolol, labetolol
45
what b1 selective antagonisls have vasodilatory effects
betaxolol, celoprolol, nebivolol
46
what are teh peripheral vasodilatory effects of some beta blockers
``` increase NO activate B2 R block alpha 1 block Ca entry open K channels antioxidant activity antiprolfierative effects ```
47
what normal side effects of beta blockers are decreased with the vasodilating beta blockers
bronchospasm, imparied lipid metabolism, impotence, reduced regional blood flow, icnreased TPR, withdrawal Sx
48
which type of angina are beta blockers not helpful in
vasospastic angina
49
what is the main effect of beta blockers that helps in Tx of IHD and agina and MI
decrease in myocardial oxygen demand
50
why should most patients be put on beta blocker after MI
shown to decrease morbidity and mortality from MI by 25%
51
betablockers prevent HF in what percent of people
50%
52
what are relative contraindicaitons for beta blockers
asthma and cOPD because block bronchodilation blocks lipolysis and glycogenolysis cautisouly in DM becausre mask signs of hypoglycemia delays recovery from insulin induced hypoglycemia
53
what are side effects of beta blockers
dizziness, fatigue, diarhhea, constipation, nausea, depression, sexual dysfunction, bizarre dreams severe but rare purpura, rash and fever
54
what tests may beta blockers interfere with
SGOT and BUN tests
55
what are the effects on cholesterol long term use beta blockers
increase VLDL and decrease HDL
56
what occurs with sudden withdrawal of beta blockers
rebound HTN, anginal attack and possibly MI if drug suddenly withdrawn after chronic therapy. beta R up regulation
57
what are major contraindications for beta blockers
acute Tx decompensated HF, 2nd and 3rd degree Heart block, cardiogenic shock
58
what other hypotensive medications do beta blockers have drug interactions with
reserpine, guanethidine, methyldopa
59
what other antiarrhthmic agents do beta blockers have interactions with
CCB and lidocaine
60
beta blockers mask signs of what
hypoglycemia and hyperthyroidism
61
what cardioselective beta blocker has very rapid onset and short duration of action
esmolol
62
when is esmolol used
IV infusion for peri-operative tachycardia and HTn and arrhythmias
63
What type of antagonist is labetolol and what are its clinical uses
selective alpha 1 blocker nonselective B1 B2 blocker HTN and pheochromocytoma
64
which beta blocker has been very useful in CHF clinical trials
carvedilol
65
how do alpha 2 receptor agonists work
at brainstem inhibit sympathetic outglow to periphery decrease sympathetic tone decrease Ne release via feedback
66
what are the side effects of methlydopa
sedation, dry mouth, sexual dysfunction
67
what is the preferred anti HTN drug in pregnancy
methyldopa
68
what is clonidine used for
rarely essential HTN | more for narcotic, alcohol and tobacco withdrawal
69
what are the sideeffects of clonidine
dry mouth, sedation, impotence | sudden withdrawal causes HTN crisis

Year 2 CV (31 decks)

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