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Pharmacology: Exam 2 > Lecture 2: Adrenergic Pharmacology > Flashcards

Lecture 2: Adrenergic Pharmacology Flashcards

1
Q

Which class of receptors are adrenergic receptors?

A

G protein-coupled (GPCR)

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2
Q

Which catecholamines do adrenergic receptors target?

A

1) Norepinephrine
2) Epinephrine

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3
Q

Do adrenergic receptors stimulate the PNS or SNS?

A

SNS and activates different G-proteins

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4
Q

List the tissues (4) affected by ⍺1 receptors

A
  • Most vascular smooth muscle
  • Heart
  • Prostate
  • Pupillary dilator muscle
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5
Q

How does an α1 receptor affect most vascular smooth muscle?

HIGH yield

A

Vasoconstriction

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6
Q

What is the G protein for an α1 receptor?

A

Gq

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7
Q

How does an α1 receptor affect the heart?

LOW yield

A

Increase force

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8
Q

How does an α1 receptor affect the prostate?

LOW yield

A

Contraction

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9
Q

How does an α1 receptor affect the pupillary dilator muscle?

LOW yield

A

Pupil dilation

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10
Q

List the systems (2) affected by the ⍺2 receptors

A
  • Postsynaptic CNS
  • Presynaptic ANS

⍺2=Decreases sympathetic tone

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11
Q

How does an α2 receptor affect the postsynaptic CNS?

HIGH yield

A

Decreases SNS tone

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12
Q

How does an α2 receptor affect the presynaptic ANS?

HIGH yield

A

Decreases NT release

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13
Q

What is the G protein for an α2 receptor?

A

Gi

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14
Q

List the tissues (2) affected by the β1 receptors

A
  • Heart
  • Juxtaglomerular cells
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15
Q

What are the G proteins for a β1 receptor?

A

Gs, Gi

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16
Q

How does a β1 receptor affect the heart?

HIGH yield

A

Increases force and rate

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17
Q

How does a β1 receptor affect the juxtaglomerular cells?

HIGH yield

A

Increases renin release = retains fluid

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18
Q

List the tissues (4) affected by β2 receptors

A
  • Skeletal muscle blood vessels
  • Bronchial smooth muscle
  • Liver
  • Uterus
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19
Q

What are the G proteins for a β2 receptor?

A

Gs, Gi

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20
Q

How does a β2 receptor affect skeletal muscle blood vessels?

HIGH yield

A

Relaxation

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21
Q

How does a β2 receptor affect the bronchial smooth muscle?

HIGH yield

A

Relaxation

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22
Q

How does a β2 receptor affect the liver?

HIGH yield

A

Glycogenolysis and gluconeogenesis = increases blood glucose

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23
Q

How does β2 receptors affect the uterus?

LOW yield

A

Relaxation

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24
Q

List the tissue affected by the β3 receptors

Low yield

A

Adipose tissue (fat cells)

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25
Q

What are the G protein for β3 receptors?

A

Gs

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26
Q

How does β3 receptor affect adipose tissue?

LOW yield

A

Increases Lipolysis

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27
Q

Which organs (4) receive adrenergic synapses?

A
  • Cardiac muscle
  • Smooth muscle
  • Gland cells
  • Nerve terminals
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28
Q

Adrenergic receptors have sympathetic responses. Explain what occurs to the:

  • Pupils
  • Heart rate and contractility
  • Respiratory rate
  • Digestion
  • Blood flow to muscle
  • Urination
A
  • Dilates pupil
  • Increase heart rate, contractility
  • Increase respiratory rate (dilates bronchi)
  • Inhibits digestion
  • Diverts blood flow to muscles (by vasoconstriction/dilation)
  • Inhibits urination
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29
Q

What are the different agonist drug classes (4) of Adrengeric receptors

A
  1. ⍺1 agonist
  2. ⍺2 agonist
  3. Non-selective agonist (β1+β2)
  4. β2 agonist
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30
Q

Which drug is an α1 agonist?

A

Phenylephrine (vasoconstriction)

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31
Q

Which drugs are α2 agonists?

A
  • Clonidine
  • Methyldopa = decrease SNS tone
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32
Q

Which drugs (2) are non-selective β agonists (β1 + β2)?

A
  • Isoproterenol
  • Dobutamine
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33
Q

Which drug is a β2 agonist?

A
  • Albuterol (dilates bronchial smooth muscle)
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34
Q

List the antagonist drug classes of Adrenergic receptors (5)

Antagonist: opposite effect

A
  1. Non-selective ⍺ antagonist
  2. ⍺1 antagonist
  3. Non-selective β antagonist (β blockers)
  4. β1 antagonist (β blockers)
  5. Mixed ⍺/β antagonists
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35
Q

Which drug is a non-selective α antagonist (blocks α1 and α2)?

A
  • Phentolamine (vasodilation & increases HR)
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36
Q

Which drug is an α1 antagonist?

A

Prazosin

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37
Q

Which drug is a non-selective β antagonist (β blocker)?

β=olol

A

Propranolol

β1 antagonist= decreased HR
β2 antagonist=Bronchoconstriction

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38
Q

Which drugs (2) are β1 antagonists (β blockers)?

β=olol

A
  • Atenolol
  • Metroprolol

β1 antagonist= derease HR

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39
Q

List the drugs that are β blockers

A
  • Propranolol (non-selective)
  • Atenolol (β1)
  • Metroprolol (β1)

all antagonist

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40
Q

Which drugs are mixed α1/β antagonists?

-lol: mixed

A
  • Carvedilol
  • Labetalol
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41
Q

What is the oral usability of epinephrine?

A

completely ineffective

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42
Q

Is the duration of action of epinephrine long or short? And explain why?

A

Short, b/c the structure of epi includes a catechol which gets metabolized quickly by COMT (↑ COMT sensitivity)

COMT: catechol-O-methyltransferase

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43
Q

Does epinephrine have good or poor penetration of the CNS?

A

poor d/t the high polarity of the structure (canNOT cross barrier)

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44
Q

Why is phenylephrine better than epinephrine as a ⍺1 selective agonist?

A
  • More stable and is not broken down as fast (↓COMT sensitivity)
  • Higher ⍺ selectivity compared to epinephrine which has mixed ⍺/β selectivity
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45
Q

Explain the mechanisms of action of ⍺1 agonist.

Drug: Phenylephrine

A
  • Stimulation of ⍺1
  • Induce contraction of smooth muscle
  • Vasoconstriction of most vascular muscle
  • Decrease mucosal edema
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46
Q

What is the primary effect of α1 agonist?

Drug: Phenylephrine

A

vasoconstriction of most vascular smooth muscle

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47
Q

What are the clinical uses of α1 selective agonists? What are the effects?

Drug: Phenylephrine

A

● Nasal congestion = decreases inflammation markers
● Hypotension = vasoconstriction = increases BP
● Hemorrhoids = vasoconstriction = stops inflammation of markers to swollen/inflamed veins
● Dilates pupils

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48
Q

What are the adverse effects of phenylephrine?

⍺1 agonist

A
  • Angina
  • Anxiety
  • Bradycardia
  • Tissue necrosis
  • HTN
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49
Q

What are the contraindications of phenylephrine?

Contraindications- Underlying diseases

⍺1 agonist

A

● Vfib
● Tachycardia
● HTN

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50
Q

What are the interactions of phenylephrine?

Interactions-Substances that affect the drug

⍺1 agonist

A
  • MAO inhibitors
  • MOA breaks down NE, if pt is taking a MOAI w/ the drug phyenyleprine it will increase the level of NE in the body and ↑↑↑ vasoconstriction

MAO-monoamine oxidase

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51
Q

Drug

Pheylephrine:

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): ⍺1 agonist
  • Effect: Vasoconstriction
  • Treatment: Nasal cong., hypotension, hemorrhoids
  • Side Effects: Angia, Bradycardia, HTN, Necrosis
  • Contraindication: Vfib, Tachy, HTN
  • Interactions:MAOI
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52
Q

List the drugs that are ⍺2 selective agonists

A
  • Clonidine
  • Methyldopa
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53
Q

Stimulation of the α2 receptors in the medulla has what type of effects?

A

Sympatholytic

  • No reflex tachycardia
  • Decrease overall NE release through stimulation of pre-synaptic receptors
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54
Q

What are the net effects of α2 agonists?

A

● Decreased BP
● Decreased HR
● Decreased cardiac output

Activate Gi (inhibitory)

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55
Q

What clinical condition are ⍺2 agonists used for?

Clonidine&Methyldopa

A

Hypertension

56
Q

Which ⍺2 agonist is the first line of therapy for hypertension (HTN) during pregnancy?

HIGH yield

A

Methyldopa

57
Q

Why is clonidine used more often than methyldopa?

⍺2 agonist

A

More potent

58
Q

Why is clonidine not used for pregnancy?

⍺2 agonist

A

Catagory C for pregnancy = risk cannot be ruled out

59
Q

Why is methyldopa the first line therapy for HTN during pregnancy?

⍺2 agonist

A

Pro drug = only effective in the brain = safer

60
Q

What does clonidine treat?

⍺2 agonist

A
  • Hypertension
  • Several CNS disorders including ADHD
  • Mitigate drug withdrawal
  • Severe pain
61
Q

Clonidine is effective in both the _____ and the ____.

⍺2 agonist

A

periphery, brain

62
Q

Where is ⍺-methyldopa ONLY effective and why?

⍺2 agonist

A
  • In the brain
  • It easily enters the brain where it is metabolized to the active compund ⍺-methyl-norepinephrine (⍺2 agonist)
63
Q

What are the adverse effects of clonidine?

⍺2 agonist

A
  • Dry mouth
  • Sedation
  • Depression
  • Orthostatic hypotension
64
Q

What drug class is Clonidine and Methyldopa?

A

α2 agonist

65
Q

What is the effect of Clonidine?

⍺2 agonist

A

Decreases SNS tone

66
Q

What are the contraindications for Clonidine?

⍺2 agonist

A
  • Depression
  • Caution: Sudden withdrawal causes hypertensive crisis
67
Q

What are the adverse effects of Methyldopa?

⍺2 agonist

A
  • Sedation
  • Depression
  • Tolerance
68
Q

What are the contraindications for Methyldopa?

⍺2 agonist

A
  • Depression
  • MAO inhibitory therapy = increases NE
69
Q

Drug

Clonidine

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): ⍺2 selective agonist
  • Effect: ↓SNS tone, ↓ NT release ( decreases BP, HR, CO)
  • Treatment: Hypertension, CNS disorders (e.g. ADHD)
  • Side Effects: Dry mouth, sedation, depression, orthostatic hypotension
  • Contraindication: Depression
  • Interactions: MOAI
70
Q

Drug:

Methyldopa

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): ⍺2 selective agonist
  • Effect: ↓SNS tone, ↓ NT release ( decreases BP, HR, CO)
  • Treatment: Hypertension (Used doing pregnancy)
  • Side Effects: Sedation, depression, tolerance
  • Contraindication: Depression
  • Interactions: MOAI
71
Q

List the drugs that are non-selective β agonist

A
  • Isoproternol
  • Dobutamine (racemic mixture)
72
Q

What drug class is Isoproterenol?

A

Non-selective β agonist = agonist at both β1and β2 receptors

73
Q

Explain the mechanism of action (MOA) of Isoproterenol

Non-selective β agonist

A
  • Potent agonist at both β1 and β2 receptors
  • Potent vasodilator and bronchodilator
  • Positive inotropic (contraction) and chronotropic (heart rate) agent
74
Q

What does Isoproterenol treat?

Non-selective β agonist

A
  • Cardiac arrest
  • AV block
  • Bradycardia
  • Torsade de pointes
75
Q

What are the adverse effects of Isoproterenol?

Non-selective β agonist

A

Arrythmias (common)

76
Q

Explain why Isoproterenol causes an increase in pulse rate (HR), and decreased resistance.

Non-selective β agonist

A
  • Increased HR is d/t activation of β1 agonist (which increases force and rate)
  • Dramatic decreased Resistance is d/t activation of β2 agonist (relaxation) and no ⍺ activation
77
Q

Explain the MOA of Dobutamine

Non-selective β agonist

A
  • Stimulates β1 receptors on the heart but produces greater inotropic (contraction) than chronotropic (heart rate) effects
  • There is some β2 and ⍺1 stimulation as well as ⍺1 inhibition resulting in NO net charge in total peripheral resistance
  • Inotrope

Formerly considered β1 selective

78
Q

Drug

Isoproterenol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): Non-selective β agonist
  • Effect: Potent vasodilator, bronchodilator, positive iontropic and chronotropic agent
  • Treatment: Cardiac arrest, AV block, bradycardia, torsade de pointes
  • Side Effects: Arrhythmias
  • Contraindication: N/A
  • Interactions: N/A
79
Q

List the drugs that are β2 selective agonists

A
  • Albuterol- short action acute bronchospasm
  • Salameterol- longer acting maintenance
  • Metaproterenol-short action acute bronchospasm
  • Terbutaline-short action
80
Q

What are the MOA and Pharmacology of β2 selective agonist

Albuterol

A
  • Relaxation of bronchial smooth muscle
  • Relaxation of vascular smooth muscle (particularly in skeletal muscle vasculature)
  • Stimulation of glycogenolysis (may lead to hyperglycema)
  • Relaxation of uterine smooth muscle
81
Q

What are the clinical uses of β2 selective agonist?

Albuterol

A
  • Asthma
  • Acute bronchospasm
  • Brochospasm prophylaxis
  • Premature Labor-Ritodrine (Yutopar®)
82
Q

What are the adverse effects, contraindications and interactions of β2 selective agonist?

Albuterol

A
  • Tremors
  • Stimulation (CNS)
  • Palpitations
  • Tachycardia (direct and reflex)
83
Q

Drug

Albuterol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): β2 selective agonist
  • Effect: Relaxation, Glycogenolysis, Gluconeogenesis
  • Treatment: Asthma, acute bronchospasm, bronchospasm prophylaxis, premature labor
  • Side Effects, Contraindication, Interactions: Tremors, stimulation (CNS), palpitations, tachycardia
84
Q

List the antagonist effects of the adrenergic receptor.

  • ⍺1
  • ⍺2
  • β1
  • β2
  • β3
A
  • ⍺1-Dilation
  • ⍺2-Increase SNS tone, Increase NT release
  • β1-Decrease HR, Decrease fluid retention
  • β2-Contraction of skeletal muscle blood vessels, bronchial constriction, decrease blood glucose
  • β3-Decrease lipolysis
85
Q

List the drugs that are ⍺-adrenoceptor antagonists

A
  • Phentolamine
  • Prazosin
86
Q

List the drug that are Non-selective ⍺ antagonist

A

Phentolamine

87
Q

What are the MOA and pharmacology of non-selective ⍺ antagonists?

Phentolamine

A
  • Block ⍺1 or both ⍺1 & ⍺2 receptors
  • Decrease peripheral vascular resistance
  • Vasodilation triggers increased heart rate
88
Q

Which target of ⍺ antagonist cause pronouced increase in HR? and why?

A

Mixed ⍺1/⍺2 antagonist because ⍺2 antagonist increases SNS→release of NE binds to β receptors (which ↑HR)

89
Q

What are the clinical uses of Phentolamine?

Non-selective ⍺ antagonist

A
  • Anesthesia reversal
  • Extravasation of ⍺ agonist
  • Pheochromocytoma (tumor at adrenal gland, high BP)
90
Q

What are the clinical uses of Prazosin?

⍺1 antagonist

A
  • Hypertension⋆
  • Benign prostatic hyperplasia (BPH)

⋆Not first line. Increased risk of heart failure (2x) compared to diuretics

91
Q

What are the adverse effects of Phentolamine and Prazosin?

A
  • Tolerance
  • Na/H2O retention when used alone for HTN
  • Dizziness
  • Hypotension
  • Postural hypotension
  • Reflex tachycardia
  • Miosis
  • Nasal stuffiness
  • Inhibition of ejaculation
92
Q

What are the precautions/contraindications of Phentolamine and Prazosin?

A
  • Angina (ischemia chest pain)
  • MI (myocardia infraction)
93
Q

What are the interactions that affect Phentolamine and Prazosin?

A

Beta blocker withdrawal

94
Q

Drug:

Phentolamine

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions

HIGH yield

A
  • Type (class): Non-selective ⍺-antagonist
  • Effect: Dilation, ↑SNS, ↑NT
  • Treatment: Anesthesia reversal
  • Side Effects: Tolerance, Reflex tachycardia
  • Contraindication: Angina, MI
  • Interactions: Beta blocker withdrawal
95
Q

Drug:

Prazosin

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions

HIGH yield

A
  • Type (class): ⍺1 selective antagonist
  • Effect: Dilation
  • Treatment: HTN (not first choice) and BPH
  • Side Effects: Tolerance, reflex tachycardia
  • Contraindication: Angina, MI
  • Interactions: Beta-blocker withdrawal
96
Q

List the drugs that are β-adrenoceptor antagonist (β blockers)

A
  • Propranolol
  • Atenolol
  • Metoprolol
  • Carvedilol
  • Labetalol
97
Q

List the drug that is a Non-selective β antagonist (1st gen)

-olol=β

A

Propranolol

98
Q

What are the MOA and pharmacology of non-selective β antagonist?

A

Block β1 or both β1 and β2 receptors

99
Q

What are the effects of non-selective β antagonist on the cardiovascular system?

A
  • Negative inotropic, dromotropic (conduction speed) and chronotropic effects
  • Decrease renin release
  • Block of β2 may increase peripheral resistance (mild)
100
Q

What are the effects of non-selective β antagonists on the CNS?

A
  • Anxiolytic (reduces anxiety)
  • CNS effects may contribute to decreasing HTN
101
Q

What are the effects of non-selective β antagonist on the eye?

A
  • Decreased aqueous humor production
  • Decrease intraocular pressure
102
Q

What are the effects of non-selective β antagonist on the lungs?

A
  • Bronchoconstriction- “spasm”
  • More prominent in β1/β2 than β1-selective
103
Q

What are the effects of non-selective β antagonists on metabolism?

A
  • Lipolysis and glycogenolysis are inhibited
  • Inhibit recovery from hypoglycemia
  • More prominent in β1/β2 than β1-selective
104
Q

List the clinical uses for Propranolol

Non-selective β antagonist

A
  • angina
  • cardiac arrythmias
  • Hypertension
  • migraine prophylaxis
  • myocardial infraction prophylaxis
  • pheochromocytoma
  • Post-myocardial Infraction
  • thyrotoxicosis
  • essential tremor
105
Q

True or False. β blockers are NOT indicated as first line of therapy for HTN for age 60 and above

HTN: Hypertension

106
Q

Which type of drugs are the first line treatment for people UNDER the age of 50 with hypertension?

A
  • ACEI (Angiotensin converting enzyme inhibitor)
  • ARB (Angiotensin receptor blocker)
107
Q

Which type of drug is the first line of treatment for people OVER the age of 50 with hypertension?

A
  • CCB (Calcium channel blocker)
  • Thiazide/thiazide-like
108
Q

When are β-blockers used as the first-line therapy for hypertension?

A
  • Ischemic Heart Disease
  • Recent STEMI or non-STEMI (ST-Elevation Myocardial Infraction)
  • Left Ventricular Systolic Dysfunction
109
Q

What are the adverse effects of Propranolol?

Non-selective β antagonist

A
  • Dizziness
  • Fatigue
  • Lethargy
  • Sinus bradycardia
  • Hypotension
  • Exacerbation of asthma
  • Dyspnea
  • Bronchospasm
  • Diabetes mellitus
  • Hypertriglyceridemia
  • Decrease plasma HDL
110
Q

What are the precautions/contraindications of Propranolol?

Non-selective β antagonist

A
  • Diabetes mellitus
  • Hyperthyroidism
  • Pregnancy category C
  • Asthma
  • AV block
  • Bradycardia
  • Cardiogenic shock
  • Sick sinus syndrome
111
Q

What are interactions that affect Propranolol?

Non-selective β antagonist

A
  • Drugs that depress AV conduction or have negative iontropic actions
  • Clonidine withdrawal
112
Q

What happens with sudden withdrawal of Propranolol?

Non-selective β antagonist

A

Withdrawal syndrome: rebound hypertension, MI, cardiac arrhythmias and panic attacks

113
Q

Drug

Propranolol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): Non-selective β antagonist
  • Effect: ↓HR, ↓Fluid retention, Constriction (Skel BV, Bronchi SM), ↓Blood glucose
  • Treatment: HTN, post-myocardial infraction
  • Side Effects: Dizziness, fatigue, hypotension
  • Contraindication: Asthma, AV block, bradycardia, DM
  • Interactions: Drugs that depress AV conduction
114
Q

List the drugs that are β1 antagonist

A
  • Atenolol
  • Metoprolol
115
Q

What is the MOA and pharmacology of β1 antagonist?

Atenolol & Metoprolol

A
  • Negative inotropic, dromotropic (conduction speed), and chronotropic effects (↓HR)
  • Decrease renin release
116
Q

Why are β1 antagonist preferred against non-selective β antagonist in patients with bronchospasm, diabetes and peripheral vascular disease?

A

NO β2 activity

117
Q

What are the clinical uses of Atenolol?

β1 antagonist

A
  • Acute MI
  • Angina
  • Hypertension
118
Q

What are the clinical uses of Metoprolol?

β1 antagonist

A
  • Acute MI
  • Angina
  • Hypertension
  • Heart failure (1 of 3 recommended) (long acting form: succinate for SUCCESS)
119
Q

Explain β1 antagonist adverse effects, contraindications, and interactions

Antenolol & Metoprolol

A
  • Similar to non-selective β antagonist
  • Less effect on glucose levels
  • Asthma and bronchospasms are no longer absolute contraindication, but used with great caution
  • Atenolol- Pregnancy category D (intrauterine growth restriction)
120
Q

Drug

Atenolol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): β1 antagonist
  • Effect: ↓HR, ↓Fluid rentention
  • Treatment: Acute MI, Angina, HTN
  • Side Effects: Dizziness, fatigue, hypotension
  • Contraindication: Pregnancy (Cat. D), asthma, bronchospasm
  • Interactions: Drugs that depress AV conduction
121
Q

Drug

Metoprolol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): β1 antagonist
  • Effect: ↓HR, ↓Fluid rentention
  • Treatment: Acute MI, Angina, HTN, heart failure
  • Side Effects: Dizziness, fatigue, hypotension
  • Contraindication: asthma, bronchospasm
  • Interactions: Drugs that depress AV conduction
122
Q

List the drugs that are mixed ⍺1/β-adrenoceptor antagonist

lol=both

A
  • Carvedilol
  • Labetalol
123
Q

What are the antagonist effects of mixed ⍺1/β

A
  • ⍺1: Vasodilation
  • β1: Decreases HR
  • β2: Bronchoconstriction
124
Q

What is the MOA and pharmacology of mixed ⍺1/β antagonist

Carvedilol & Labetalol

A
  • Block ⍺1 and both β1 and β2 receptors
  • Cardiovascular: mixture of ⍺1 and β-blockers
125
Q

What are the clinical uses of Carvedilol?

mixed ⍺1/β antagonist

A
  • Angina
  • Cardiomyopathy
  • Heart failure (1 of 3 recommended)
  • Hypertension
  • Myocardial infarction (acute and post-MI)
126
Q

What are the clinical uses of Labetalol?

mixed ⍺1/β antagonist

A
  • Hypertension
  • Hypertensive emergency (IV)
  • HTN emergency in pregnancy
127
Q

Explain mixed ⍺1/β antagonist adverse effects, contraindications, and interactions

Carvedilol & Labetalol

A
  • Similar to non-selective β-blockers (i.e. bronchospasms) and ⍺1antagonist (i.e. postural hypotension)
  • Less tachycardia than ⍺1 antagonist, less peripheral vasoconstriction than β-blockers
128
Q

Drug

Carvedilol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): mixed ⍺1/β antagonist
  • Effect: Vasodilation (⍺1), ↓ HR (β1), Bronchoconstriction (β2)
  • Treatment: Heart failure (1 of 3 recommended), HTN
  • Side Effects: Brochospasm, postural Hypotension
  • Contraindication: N/A
  • Interactions: N/A
129
Q

Labetalol

  • Type (class)
  • Effect
  • Treatment
  • Side Effects
  • Contraindication
  • Interactions
A
  • Type (class): mixed ⍺1/β antagonist
  • Effect: Vasodilation (⍺1), ↓ HR (β1), Bronchoconstriction (β2)
  • Treatment: HTN, HTN emergency in pregnancy
  • Side Effects: Brochospasm, postural Hypotension
  • Contraindication: N/A
  • Interactions: N/A
130
Q

In a patient with which of the following conditions would propranolol be contraindicated?
a. Asthma
b. Constipation
c. Hypertension
d. Migranes
e. Tachycardia

131
Q
  1. A patient goes to his primary care doctor complaining of hemorrhoids. His doctor wants to prescribe him an adrenergic agonist to help alleviate his symptoms. Which of the following would be a contraindication for this medication?
    a. Hypotension
    b. Asthma
    c. MAO inhibitor
    d. Diabetes
A

c. MOA inhibitor

132
Q

In the Emergency room, the nurse hands you an ECG that leads you to a diagnosis of torsades de pointes. Which of the following would be true regarding the treatment of this?
a. A1 agonist that will increase blood pressure.
b. B blocker to decrease blood pressure
c. B agonist with positive inotropic effects
d. Calcium channel blocker

A

c. B agonist with positive inotropic effects

133
Q
  1. Which of the following drugs can be used for anesthesia reversal?
    a. Phentolamine
    b. Prazosin
    c. Labetalol
    d. Isoproterenol
A

a. Phentolamine

134
Q
  1. A pregnant patient walks into the clinical and was diagnosed with hypertension, what would be the first line treatment?
    a. Clonidine
    b. Metoprolol
    c. Methyldopa
    d. Phenylephrine
A

c. Methyldopa

135
Q
  1. Which of the following is NOT a treatment for HTN if there is no cardiac medical history?
    a. Thiazide
    b. Ace inhibitors
    c. Verapamil
    d. Atenolol
A

d. Atenolol

136
Q
  1. Which beta blocker would be safest for patients with a history of asthma or diabetes?
    a. Propranolol
    b. Atenolol
    c. Metoprolol
    d. 2 of the above
    e. None of the above
A

d. 2 of the above (b&c)

Pharmacology: Exam 2 (10 decks)

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