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Pharmacology - Fall > Lecture 5 - Sympathetic/Adrenergic > Flashcards

Lecture 5 - Sympathetic/Adrenergic Flashcards

1
Q

What effect does the SNS have on the eye and what receptor is involved?

A
  • Contraction of radial muscle of iris causing dilation

- Alpha 1

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2
Q

What effect does the PNS have on the eye and what receptor is involved?

A
  • Contraction of circular muscle of iris by M3 (causing contraction of pupil)
  • Contraction of ciliary muscle by M3 (causing near vision)
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3
Q

What effect does the PNS have on glands and what receptor is involved?

A

M3 stimulation causes watery secretions

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4
Q

What effect does the SNS have on glands and what receptor is involved?

A
  • Beta adrenergic stimulation causes secretion of protein

- Alpha adrenergic stimulation causes vasoconstriction leading to less water & more concentrated secretions

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5
Q

What effect does the SNS have on systemic blood vessels and what receptor is involved?

A
  • Contraction of skin and splanchnic vessels by alpha 1

- Relaxation of skeletal muscle vessels by MUSCARINIC

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6
Q

What effect does the PNS have on systemic blood vessels and what receptor is involved?

A
  • Release of EDRF causing relaxation of vessels by M3
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7
Q

Which receptors does norepinephrine mainly stimulate?

A

Alpha 1 in vessels

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8
Q

Which receptors does epinephrine mainly stimulate?

A

Beta receptors in cardiac muscle

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9
Q

What effect does the PNS have on GI smooth muscle and what receptor is involved?

A

M3 causes smooth muscle contraction and sphincter relaxation

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10
Q

What effect does the SNS have on GI smooth muscle and what receptor is involved?

A
  • Relaxation of smooth muscle by beta 2

- Sphincter contraction by alpha 1

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11
Q

What are the effector organs of adrenergic receptors?

A
  • Cardiac muscle
  • Smooth muscle
  • Glands
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12
Q

Adrenergic receptors respond to ____ and _____

A

Norepinephrine and epinephrine

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13
Q

What are the main functions of the alpha 1 receptor?

A
  • Vasoconstriction
  • Pupil dilation
  • Ejaculation
  • Contraction of bladder and prostate
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14
Q

Where are alpha 2 receptors located?

A

Presynaptic junction

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15
Q

What are the functions of the alpha 2 receptor?

A
  • Inhibit NT release, thus inhibiting sympathetic activation
  • Cardiac vasoconstriction
  • Inhibit insulin release
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16
Q

Are alpha 1 and alpha 2 opposites?

A

Nope

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17
Q

What is the primary medical importance of alpha 2 receptors?

A

CNS (neuronal) and hypertension

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18
Q

What is the function of beta 1 receptors in the kidney?

A

Renin release, causing vasoconstriction

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19
Q

What is the function of beta 1 receptors in the heart?

A
  • Increase heart rate
  • Increase force of contraction
  • Increase velocity of conduction in AV node
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20
Q

What are the functions of beta 2 receptors?

A
  • Bronchial dilation
  • Vasodilation
  • Glycogenolysis
  • Glucagon release
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21
Q

What is the function of dopamine receptors?

A

Dilate renal blood vessels

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22
Q

What is an example of a drug that is an alpha 1 agonist?

A

Pseudophedrine and phenylephrine

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23
Q

What is an example of a drug that is an alpha 2 agonist?

A

Clonidine

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24
Q

What is an example of a drug that is a beta 1 agonist?

A

Isoproterenol and dobutamine

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25
Q

What are examples of drugs that are beta 2 agonists?

A
  • Isoproterenol
  • Terbutaline
  • Albuterol (salbutamol, ventolin)
  • Salmeterol
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26
Q

What is an example of a drug that is an alpha 1 antagonist?

A
  • Prazosin and doxasin

- Tamsulosin

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27
Q

What is an example of a drug that is a beta 1 antagonist?

A

Propanolol

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28
Q

What is an example of a drug that is a beta 2 antagonist?

A

Propanolol

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29
Q

What is the function of adrenergic agonists?

A

Mimic action of norepinephrine, dopamine, and epinephrine

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30
Q

Are adrenergic agonists selective?

A

Can be selective or non-selective, but almost all are at least partially non-selective

31
Q

What are adrenergic agonists used for?

A
  • Hemodynamic compromise (shock, depressed cardiac rhythm)
  • Bronchospasms
  • Nasal and sinus congestion
  • Often used in emergency situations
32
Q

What does epinephrine stimulate?

A

Both alpha and beta receptors

33
Q

Why is epinephrine given parenterally?

A

GI enzymes destroy the drug

34
Q

Is epinephrine specific?

A

No, very non-specific and is metabolized very rapidly

35
Q

What is epinephrine used for?

A
  • Severe, acute bronchospasms
  • Anaphylactic shock
  • Cardiac arrest
  • Adjunct to anesthetic
36
Q

What are the side effects of epinephrine?

A
  • Stimulant effects on brain
  • Hypertension-induced hemorrhage
  • Cardiac arrythmia
  • Hyperglycemia in diabetics
37
Q

What is norepinephrine used for?

A

To treat shock (increase blood pressure)

38
Q

What is pseudophedrine used for?

A

Nasal decongestant

39
Q

What is the function of cocaine?

A

Inhibits the reuptake of serotonin, norepinephrine, and dopamine

40
Q

Is cocaine selective?

A

No

41
Q

Amphetamine has the same function as ____

A

Cocaine

42
Q

What is selegiline (levadopa) used for and what are its side effects?

A
  • Parkinsons treatment

- Dry mouth, constipation, tachycardia

43
Q

What is phenelzine used for and what are its side effects?

A
  • Anti-depressant

- Dry mouth, constipation, urinary retention, mydriasis, hyperthermia, sweating, hypertension

44
Q

What is amytriptyline used for and what are its side effects?

A
  • Tricyclic antidepressant

- Urinary retention, pregnancy, myocardial infarction, congestive heart failure

45
Q

What are side effects to alpha 1 activation?

A
  • Stimulant effects -> sweats, manic behaviour, anxiety, paranoia
  • Weight loss, hyperglycemia, hypertension, bradycardia
46
Q

When is dobutamine used?

A

In congestive heart failure to increase cardiac output (beta 1 agonist)

47
Q

What is albuterol used for?

A

Asthma, COPD

48
Q

What do anti-adrenergic drugs do?

A
  • Inhibit or block the effects of sympathetic nerve stimulation
  • Most block alpha 1, beta 1, or beta 2 receptors
49
Q

What is another name for alpha 2 adrenergic agonists?

A

Adrenergic antagonists

50
Q

What does clonidine do?

A

Lowers blood pressure

51
Q

What do prazosin and doxasin do?

A

Competitive blockers of alpha 1 receptors, so decrease blood pressure

52
Q

What does tamsulosin do?

A

Treats prostatic hypertrophy and vasospastic (urinary) problems

53
Q

What do alpha 1 antagonists do in congestive heart failure?

A

Cause decreased preload and afterload by decreasing peripheral resistance

54
Q

Why are adrenergic agonists AND antagonists used together in treatment for congestive heart failure?

A
  • One drug activates SNS receptors on the heart (beta 1) to increase cardiac output
  • Different drug inhibit SNS receptors on peripheral vessels (alpha 1) to decrease peripheral resistance
55
Q

What are the side effects to blocking alpha 1 receptors?

A
  • Early on causes massive orthostatic hypotension, so start w/ low doses
  • Vertigo
  • Sexual dysfunction
  • Reflex tachycardia
56
Q

What are beta blockers used for?

A

To treat rapid pulse arrhythmias, hypertension, MI, and other heart problems

57
Q

How do beta blockers treat heart conditions?

A
  • Decrease contractility
  • Reduce oxygen demand
  • Slow conduction through AV node
58
Q

What are 1st generation beta blockers?

A

Non-selective (block beta 1 and 2)

59
Q

What are 2nd generation beta blockers?

A

Cardioselective (beta 1)

60
Q

What are 3rd generation beta blockers?

A

Partially selective (with alpha 1 inhibition)

61
Q

What is a side effect to 1st generation beta blockers?

A

Can cause bronchospasms

62
Q

What does propanolol do?

A
  • Decreases cardiac output
  • Bronchoconstriction
  • Reflex peripheral vasoconstriction
  • Decrease glycogenolysis and glucagon secretion (amplifies effect on insulin in hypoglycemia)
63
Q

What is timolol used for?

A

Glaucoma, by decreasing production of aqueous humour and intraocular pressure

64
Q

Why were 2nd generation beta blockers developed?

A

To avoid the bronchoconstriction of beta 2 receptors

65
Q

What are 2nd generation beta blockers used for?

A

To treat hypertension; especially good for diabetic hypertensive patients

66
Q

What is an example of a drug that is a 2nd generation beta blocker?

A

Atenalol

67
Q

What does carvedilol do?

A

Has higher affinity for beta 1 and beta 2, so it reduces heart rate significantly and may exacerbate asthma

68
Q

What does labetalol do?

A

Has a higher affinity for alpha 1, so reduces blood pressure w/o effecting heart rate

69
Q

When is labetalol used?

A

For pre-eclampsia and emergencies

70
Q

Do beta 2 specific antagonists exist?

A

No

71
Q

Beta 1 receptors are ____ selective

A

Heart

72
Q

What is the primary concern for beta 2 receptors?

A

Bronchial dilation

73
Q

Should beta blockers be given to a patient who is taking insulin?

A

No because it will cause them to go into hyperglycemia shock and possibly die

Pharmacology - Fall (15 decks)

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