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[OS216] Immuno Exam 2 Flo Cluster > Lec 07: Adrenergic Agents > Flashcards

Lec 07: Adrenergic Agents Flashcards

1
Q

Drug of choice for the immediate treatment of anaphylactic shock.

A

Epinephrine

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2
Q

Type I, II, III or IV hypersensitivity reaction?

IgE-mediated acute allergic reactions to stings, pollens, and drugs, including anaphylaxis, urticaria, and angioedema.

A

Type I

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3
Q

Type I, II, III or IV hypersensitivity reaction?

Complement dependent allergic reactions.

A

Type II

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4
Q

Type I, II, III or IV hypersensitivity reaction?

Involve IgG or igM antibodies in which the antibody is fixed to circulating blood cell.

A

Type II

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5
Q

Type I, II, III or IV hypersensitivity reaction?

Serum sickness

A

Type III

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6
Q

Type I, II, III or IV hypersensitivity reaction?

Involves immune complexes containing IgG

A

Type III

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7
Q

Type I, II, III or IV hypersensitivity reaction?

Multisystem complement-dependent vasculitis

A

Type III

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8
Q

Type I, II, III or IV hypersensitivity reaction?

Cell-mediated allergy that is the mechanism involved in allergic contact dermatitis from topically applied drugs.

A

Type IV

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9
Q

Non-IgE-mediated reaction resulting from the direct release of mast cell mediators without stimulation.

A

Anaphylactoid Reaction

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10
Q

Identify the drug:

Immunosuppressive, blocks proliferation of IgE producing clones and inhibits IL-4 production by T-helper cells in the IgE response

A

Prednisone

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11
Q

Identify the drug:

Selective leukotriene receptor antagonist used for asthma

A

Montelukast

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12
Q

What are the effects of histamine on the Cardiovascular System?

A
  • VASODILATION of arterioles and precapillary sphincters
  • TACHYCARDIA
  • EDEMA
  • INCREASED CONTRACTILITY
  • INCREASED PACEMAKER RATE
  • End effect: Decreased systolic and diastolic BP due to peripheral vasodilation and increased heart rate
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13
Q

What are the effects of histamine on the GI Tract Smooth muscle?

A
  • CONTRACTION -> Decreased Transit Time -> Can lead to Diarrhea
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14
Q

What are the effects of histamine on Bronchial Smooth Muscles?

A

BRONCHOCONSTRICTION -> Difficulty breathing

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15
Q

What is the Triple Response of Lewis?

A

FLUSH - (redness) can be due to direct vasodilatory effect of histamine
WHEAL - reflects histamine’s capacity to cause edema
FLARE - histamine-induced stimulation of axon reflexes, indirect vasodilation.

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16
Q

What is the physiologic antidote to histamine?

A

Epinephrine.

*Epinephrine reverses most of the effects of histamine (except for cardiac stimulation). It is a potent vasoconstrictor (B2 receptors in skeletal blood vessels & A1 receptors in vascular beds)

End effect: Increase in systolic blood pressure, decreased systolic blood pressure, increased heart rate.

17
Q

CONTRAINDICATIONS of Epinephrine

A

Cardiac arrythmias

Angle glaucoma

18
Q

Why is Epinephrine added to local anesthetics?

A

Added to local anesthetics (ex. Lidocaine) to

  1. decrease systemic absorptions (such as epinephrine-induced vasoconstriction -> decrease
    transfer/absorption)
  2. increase duration of action
  3. decrease toxicity of local anesthetics
19
Q

TRUE or FALSE: If your patient is already being given dopamine IV, you CAN’T give epinephrine in the same IV line.

A

FALSE.

Yes you can. Other compatible hypotensives: dopamine, dobutamine at diltiazem (basta nagsstart sa ‘D’!)

Epinephrine is incompatible with aminophylline, sodium bicarbonate or other alkaline solutions.

20
Q

After being taken up into adrenergic neuron, Epinephrine is degraded by:

A

Monoamine oxidase (MAO) and Catecholamine-o-methyl-transferase (COMT)

21
Q

Correct dose for Epinephrine taken Intramuscularly (for anaphylaxis)

A

0.1-0.5mL of a 1:1000 solution.

Other dosage forms:
- Subcutaneous: 0.3-0.5 mL of 1:1000 solution
- Sublingual : 0.5mL; 1:1000 solution
- Femoral/IJV: 3-5mL of a 1:10,000 solution
- Endotracheal tube: 3-5mL of a 1:10,000 solution (solution diluted to 10 mL
with normal saline solution
diluted to 10 mL with normal saline through the endotracheal tube)

22
Q

Best route for anaphylaxis treatment when patient has an IV line.

A

IV

23
Q

Administering too much epinephrine may cause:

A

lesion necrosis

24
Q

TRUE or FALSE:

Half doses of adrenaline may be safer for anaphylactic patients who are taking amitriptyline, imipramine or a beta blocker.

A

TRUE.

25
Q

Drug of choice for allergic or vasomotor rhinitis.

A

Alpha-adrenergic agents

26
Q

Agonist for A1 or A2 receptor:

acts on capacitance of venous vessels

A

A1 (ex. nasal tissues that have erectile characteristics)

27
Q

Agonist for A1 or A2 receptor:

acts on contraction of arterioles possibly causing ischemia.

A

A2

  • A2 agonists may cause damage to mucosa -> ischemia
28
Q

Identify the Alpha-Adrenergic Drug: More selective site of action, but
they are apt to be used excessively by patients, leading to rebound congestion (less systemic effects, overuse causes
less effectivity later on)

a. Oral decongestant
b. Topical decongestant
c. Oral ephedrine
d. Phenylpropanolamine
e. NOTA

A

b. Topical decongestant

29
Q

Identify the Alpha Adrenergic Drug: withdrawn in the US due to increased cardiac effects in patients with hypertension.

a. Oral decongestant
b. Topical decongestant
c. Oral ephedrine
d. Phenylpropanolamine
e. NOTA

A

d. Phenylpropanolamine

30
Q

Identify the Alpha Adrenergic Drug:

less likely to cause rebound
congestion but carry a greater risk of inducing adverse systemic effects.

a. Oral decongestant
b. Topical decongestant
c. Oral ephedrine
d. Phenylpropanolamine
e. NOTA

A

a. Oral decongestant

31
Q

Identify the Alpha Adrenergic Drug:

often causes CNS adverse effects.

a. Oral decongestant
b. Topical decongestant
c. Oral ephedrine
d. Phenylpropanolamine
e. NOTA

A

c. Oral ephedrine

32
Q

Identify the Alpha Adrenergic Drug:

mydriatic (dilates pupils), increases BP and resists inactivation by COMT

a. Phenylephrine
b. Ephedrine
c. Xylometazolin
d. Oxymetazolin

A

a. Phenylephrine

33
Q

Identify the Alpha Adrenergic Drug:

Resists oxidation by MAO, mechanism of action involves release of stored catecholamine and excretion is accelerated by urine alkalinization.

a. Phenylephrine
b. Ephedrine
c. Xylometazolin
d. Oxymetazolin

A

b. Ephedrine

* Has mild stimulant effect and high bioavailability

34
Q

Identify the Alpha Adrenergic Drug:

Overdose of this drug can lead to hypotension due to clonidine.

a. Phenylephrine
b. Ephedrine
c. Xylometazolin
d. Oxymetazolin
e. both a&c
f. both c&d

A

f. both c&d

Xylometazoline/Oxymetazoline

- Congeners of clonidine ->
(antihypertensive, works on 
the alpha receptors)
- Direct acting A2 agonists
- Promote constriction of nasal 
mucosa
- Drug class: alpha agonist
- Topical decongestant (spray 
or drops)
- Overdose – hypotension  due to clonidine (A2 agonist against HPN)-like effects

[OS216] Immuno Exam 2 Flo Cluster (3 decks)

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