lecture 41

Question 1

What are some examples of disorders that can be treated with adrenergic agonists and antagonists?

Answer 1

1. hypertension
2. angina
3. heart failure
4. arrhythemia
5. asthma
6. migraine
7. anaphylactic reactions

Question 2

what body hormone has little affect on B2 receptors?

Answer 2

Norepinephrine has little effect on beta2 receptors,
therefore it cannot cause bronchodilation, because
receptors in bronchial smooth muscle are beta2

on the other hand, epinephrine is a potent bronchodilator

Question 3

What receptors are abundant in skin blood vessels

Answer 3

alpha 1 receptors

norepinephrine and epinephrine cause constriction of such vessels.

Question 4

what receptors are found in the smooth muscle of blood vessels in skeletal muscle

Answer 4

both alpha 1 and and beta 2

Activation of beta2 receptors causes vasodilation.
Activation of alpha1 receptors causes vasoconstriction

Question 5

What does a low dose of epinephrine do?

Answer 5

vasodilation

Question 6

what does a high dose of epinephrine do?

Answer 6

vasoconstriction

Question 7

what are the three types of adrenergic agonists?

Answer 7

1. direct acting
2. indirect acting
3. mixed

Question 8

What are the three types of direct acting adrenergic agonists?

Answer 8

1. endogenous catecholamines
2. Beta adrenergic
3. alpha adrenergic

Question 9

what are the three endogenous catecholamines?

Answer 9

1. epinephrine
2. norepinephrine
3. dopamine

Question 10

what are the effects of epinephrine?

Answer 10

acts as a hormone

Increases heart rate and contractile force (beta 1 effect).

Cardiac output increases: oxygen demand of the
myocardium increases.

Increases renin release (beta 1 effect).

Constricts arterioles in skin and viscera (alpha 1 effect).

Dilates blood vessels of skeletal muscle (beta 2 effect).

Relaxes bronchial smooth muscle (beta 2 effect).

Increases liver glycogenolysis (beta 2 effect).

Increases lipolysis (alpha 1 and beta 2 effect).

Question 11

How does a large dose of epinephrine have on blood pressure?

Answer 11

blood pressure is increased

1. increased venticular contraction
2. increased heart rate
3. vasoconstriction

Question 12

How does a small dose of epinephrine have on blood pressure?

Answer 12

1. peripheral resistance decreases
2. systolic pressure decreases
3. heart rate increases

no mean increase in bp

Question 13

What are the uses of epinephrine?

Answer 13

1. anaphylactic shock
2. acute asthmatic attack
3. cardiac arrest

Question 14

norepinephrine is an an agonist at what receptors?

Answer 14

alpha 1 +2 and beta 1

little effect on beta 2

Question 15

effects of norepinephrine?

Answer 15

Causes peripheral vasoconstriction (α1 effect).

Increases cardiac contractility (β1 effect).

Systemic administration of norepinephrine
increases peripheral vascular resistance, systolic
blood pressure and diastolic blood pressure.

The increase in blood pressure stimulates
baroreceptors leading to reflex bradycardia.

Question 16

what is use for norepinephrine?

Answer 16

to treat shock

Question 17

what is the baroreceptor response to increased blood pressure?

Answer 17

stimulates the parasympathetic activity and inhibits the sympathetic activity

decrease heart rate and decrease force of contraction

Question 18

what is the baroreceptors response to decreased blood pressure?

Answer 18

inhibits parasympathetic and activates sympathetic

increased heart rate and increased force of contraction

Question 19

isoproterenol

Answer 19

non selective beta 1 and 2 adrenergic agonist

Question 20

the use of isoproterenol?

Answer 20

Isoproterenol may be used in emergencies to
stimulate heart rate in patients with bradycardia
or heart block.

Question 21

Dobutamine

Answer 21

beta 1 selective adrenergic agonist

given by IV

Question 22

uses for dobutamine?

Answer 22

Management of acute heart failure.

Management of cardiogenic shock.

Question 23

albuterol

Answer 23

beta 2 adrenergic agonist

Question 24

uses for albuterol

Answer 24

Causes bronchodilation (beta 2 effect).

Used in asthma.

DOC for acute asthma attacks

Question 25

what is phenylephrine and what is it used for?

Answer 25

alpha 1 selective adrenergic agonist causes vasoconstriction use: Nasal decongestant. Given orally or topically. Mydriatic.

Question 26

What is clonidine and what is it used for?

Answer 26

partial alpha 2 adrenergic selective agonist centrally acting anti-hypertensive

Question 27

What are the two indirect acting adrenergic agonists (releasing agents)?

Answer 27

1. amphetamine | 2. tyramine

Question 28

What is amphetamine and what is it used for?

Answer 28

Has central stimulatory action. Can increase blood pressure by alpha-agonist action on vasculature as well as beta-stimulatory effects on heart. USES • ADHD • Narcolepsy

Question 29

Where is tyramine found?

Answer 29

found in fermented foods such as cheese and wine MAO inhibitor = antidepressant

Question 30

What is an uptake inhibitor (indirect acting adrenergic agonist)

Answer 30

cocaine blocks the reuptake of monoamines leads to monoamine accumulation in the synapse

Question 31

what are the two mixed acting adrenergic agonists?

Answer 31

ephedrine and pseudoephedrine

Question 32

What is ephedrine and what is it used for?

Answer 32

Not a catecholamine poor substrate for COMT and MAO  long duration. Penetrates the CNS. USES Used as a pressor agent, particularly during spinal anesthesia.

Question 33

What is pseudoephedrine used for?

Answer 33

decongestant

Question 34

What are the three types of adrenergic antagonists?

Answer 34

1. alpha 2. beta 3. partial

Question 35

what are the two kinds of alpha adrenergic antagonists?

Answer 35

1. non-selective alpha | 2. alpha 1 selective

Question 36

what are the two kinds of beta adrenergic antagonists?

Answer 36

1. nonselective beta | 2. beta 1 selective

Question 37

What are two non-selective alpha adrenergic blockers?

Answer 37

1. phenoxybenzamine | 2. phentolamine

Question 38

what is phenoxybenzamine and what is it used for?

Answer 38

Irreversible antagonist at alpha 1 and alpha 2 receptors. Unsuccessful for hypertension. USES Used in Pheochromocytoma: Prior to surgical removal of the tumor.

Question 39

what is phentolamine and what is it used for?

Answer 39

Reversibly antagonist at alpha 1 and alpha 2 receptors. USES Pheochromocytoma: control of hypertension during preoperative preparation and surgical excision. Hypertensive crisis due to stimulant drug overdose

Question 40

what is prazosin and what is its uses?

Answer 40

selective blocker of alpha 1 adrenergic receptors lowers blood pressure uses: used for the treatment of hypertension BUT is not the drug of choice BPH: benign prostatic hyperplasia DOC for symptom relief improve urinary flow

Question 41

what are the effects of beta blockers?

Answer 41

Slow heart rate and decrease myocardial contractility (b1 effect). Blockade of b2 receptors in the lungs can cause respiratory crisis in patients with COPD or asthma. lower Glycogenolysis (b2 effect) lower Glucagon secretion (b2 effect)

Question 42

What are the uses of adrenergic beta blockers

Answer 42

``` Hypertension Stable Angina Pectoris Myocardial Infarction Atrial Fibrillation Hyperthyroidism Glaucoma Migraine prophylaxis Performance Anxiety (“Stage Fright”) ```

Question 43

atenolol description and uses?

Answer 43

beta 1 adrenergic blocker Useful in hypertensive patients with impaired pulmonary function. Useful in diabetic hypertensive patients.

Question 44

What are the adverse effects of using adrenergic beta blockers?

Answer 44

bronchoconstriction hypoglycemia ``` CNS: sedation dizziness lethargy fatigue ```

Question 45

what is pindolol and what is it used for?

Answer 45

It is a partial beta agonist (adenergic) May be preferred in individuals with diminished cardiac reserve or a propensity to bradycardia.