(L6, L8) Adrenergic Drugs Flashcards
epinephrine uses
- anaphylactic shock
- acute asthmatic atacks
- cardiac arrest
- local anesthetics
explain the differences in function of varying epinephrine doses
Low- mainly β agonist
High (therapeutic doses)- α1 response predominates and β1 effects in heart opposed by baroreceptor reflex
norepinephrine mainly effects (1) receptors and is used for (2)
1- α1, β1 agonist
2- shock (inc vascular resistance –> inc BP)
dopamine mainly effects (1) receptors and is used for (2)
1- D1 > β1 > α1 agonist
2- severe CHF, cardiogenic / septic shock (intermediate to high doses)
Isoproterenol is a (1) type adrenergic agent and is used for (2)
1- direct acting non-selective β agonist
2- emergencies: stimulates HR in patients with bradycardia or heart block
_____ is used for emergencies to stimulate HR in patients with bradycardia or heart block
isoproternol (non-selective β agonist)
Dobutamine is a (1) type adrenergic agent and is used for (2)
1- direct acting selective β1 agonist
2- acute HF, cardiogenic shock, nonexercise stress tests
______ is used for acute heart failure, cardiogenic shock, and nonexercise stress tests
dobutamine (selective β1 agonist)
Albuterol is a (1) type adrenergic agent and is used for (2)
1- direct acting selective β2 agonist, short-acting
2- acute asthma Sxs
(1) is used for acute asthma symptoms
(2) is used for long-term asthma management
1- albuterol (selective β2 agonist, short-acting)
2- salmeterol, formoterol (selective β2 agonist, long-acting)
Salmeterol and Formoterol are (1) type adrenergic agents and are used for (2)
1- direct acting selective β2 agonist, long-acting
2- asthma Sxs (slow onset and long duration of action - albuterol is opposite)
Phenylephrine is a (1) type adrenergic agent and is used for (2)
1- direct acting selective α1 agonists
2- nasal congestion, mydriasis, inc BP in hypotension due to septic shock or anesthesia or to terminate episodes of supraventricular tachycardia
_______ is used for nasal congestion, mydriasis, to increase BP in hypotension due to septic shock or anesthesia, or to increase BP / terminate episodes of supraventricular tachycardia
phenylephrine (selective α1 agonists)
Clonidine is a (1) type adrenergic agent and is used for (2)
1- direct acting selective α2 partial agonists (antagonist effects)
2- HTN
Methyldopa is a (1) type adrenergic agent and is used for (2)
1- direct acting selective α2 agonists
2- HTN in pregnancy
______ is used to treat HTN in pregnancy
methyldopa (selective α2 agonists)
Brimonidine is a (1) type adrenergic agent and is used for (2)
1- direct acting selective α2 agonists
2- glaucoma (reduces aqueous humor –> lowers intraocular pressure)
Amphetamine is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- indirect acting agonist, releasing agent
2- inc NE release (inc BP - α agonist, heart effects - β agonist)
3- ADHD, narcolepsy
Methylphenydate is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- indirect acting agonist, releasing agent
inc NE release (inc BP - α agonist, heart effects - β agonist)
3- ADHD in children
(1) is used for ADHD, (2) is specifically for children
1- amphetamine (inc NE release from SNS), atomoxetine (selective inhibitor of NE reuptake transporter)
2- methylphenydate (inc NE release from SNS)
_____ is used for narcolepsy
- amphetamine (inc NE release)
- modafinil (inhibits NE/DA reuptake)
Tyramine is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- indirect acting agonist, releasing agent
2- inc NE release from SNS in people on MAOIs
3- N/A
Cocaine is a (1) type adrenergic agent with a (2) MOA
1- indirect acting agonist, uptake inhibitor
2- monoamine reuptake inhibitor
Atomoxetine is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- indirect acting agonist, reuptake inhibitor
2- selective inhibitor of NE reuptake transporter
3- ADHD
Modafinil is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- indirect acting agonist, reuptake inhibitor
2- (somewhat unknown psychostimulant) inhibits DA/NE reuptake transporter
3- narcolepsy
Ephedrine is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- mixed acting agonist
2- induces NE release (long duration, penetrates CNS)
3- pressor agent (during spinal anesthesia), myasthenia gravis Tx
_______ is a pressor agent during spinal anesthesia and is used to treat myasthenia gravis
ephedrine (mixed acting agonist, inc NE release)
Pseudoephedrine is a (1) type adrenergic agent with a (2) MOA, and is used for (3)
1- mixed acting agonist
2- induces NE release
3- decongestant
_____ is used as a nasal decongestant
- phenylephrine (selective α1 agonist)
- pseudoephedrine (inc NE release)
Phenoxybenzamine is a (1) type adrenergic agent and is used for (2)
1- irreversible non-selective α antagonist
2- pheochromocytoma (prior to surgery)
Phenotolamine is a (1) type adrenergic agent and is used for (2)
1- reversible non-selective α antagonist
2- prevent HTN crisis in pheochromocytoma surgery and for its Dx + prevents dermal necrosis after NE extravasation
(1) is used prior to pheochromocytoma surgery
(2) is used during pheochromocytoma surgery
1- phenoxybenzamine (irreversible non-selective α antagonist)
2- phenotolamine (reversible non-selective α antagonist - prevent HTN crisis)
Prazosin is a (1) type adrenergic agent and is used for (2)
1- selective α1 antagonist (prototype)
2- HTN (2nd/3rd line), BPH
Terazosin and Doxazosin are a (1) type adrenergic agents and are used for (2)
1- selective α1 antagonist (longer half-life than prazosin)
2- HTN (2nd/3rd line), BPH
Tamsulosin is a (1) type adrenergic agent and is used for (2)
1- selective α-1a antagonist
2- BPH
selective α1 antagonists are used to treat…..
(prazosin, terazosin, doxazosin, tamsulosin)
- HTN (not tamsulosin, selective α-1a antagonist)
- BPH (all)
discuss the difference is using a non-selective β antagonist versus using a selective β1 antagonist
non-selective β (propanolol, nadolol, timolol): HTN in non-impaired pulmonary and non-diabetic patients
selective β (atenolol, metoprolol): HTN in COPD, asthma, DM patients
Propanolol is a (1) type adrenergic agent and is used for (2)
1- non-selective β antagonist (prototype)
2- HTN
Nadolol and Timolol are (1) type adrenergic agents and are used for (2)
1- non-selective β antagonist
2- HTN
Atenolol and Metoprolol are (1) type adrenergic agents and are used for (2)
1- selective β1 antagonist
2- HTN for COPD, asthma, DM patients
Esmolol is a (1) type adrenergic agent and is used for (2)
1- selective β1 antagonist (ultra-short acting, IV for 10 min half-life)
2- AFib, atrial flutter (controls ventricular rate)
Labetalol and Carvedilol are (1) type adrenergic agents and are used for (2)
1- competitive α1, β antagonists (more potent for β receptors)
2- HTN [CHF for carvedilol]
Pindolol is a (1) type adrenergic agent and is used for (2)
1- partial β agonist
2- people with diminished cardiac reserve or that have propensity to bradycardia
______ is used in people with diminished cardiac reserve or that have propensity to bradycardia
pindolol (partial β agonists)
(1) and (2) inhibit NE storage via (3) and (4) mechaisms respectively. (1) is used for (5) and (2) is used for (6).
1/3- Tetrabenazine: reversible inhibitor of VMAT
5- chorea in Huntington’s disease
2/4- Reserpine: irreversible inhibitor of VMAT
6- previously HTN
(1) inhibits NE synthesis via a (2) mechanism and is used for (3)
1- α-methyltyrosine
2- competitive inhibitor for Tyrosine Hydroxylase
3- manages malignant pheochromocytoma or in its preoperative resection
