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Pharmacology > Neurpharm Adrenergics > Flashcards

Neurpharm Adrenergics Flashcards

1
Q

Alpha agonist examples and what is their suffix

A

Norepinephrine, phenylephrine, ephedrine, and epinephrine

Rinse

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2
Q

Norepinephrine

A

Catecholamine used to treat hypotension, which also has effects in treating attention disorders and depression

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3
Q

Phenylephrine

A

Drug used to treat hypotension without chronological or inotropic effects, which can also be used for rhinitis

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4
Q

Ephedrine

A

Drug which can treat urinary incontinence, and has use as a decongestant and vasopressor

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5
Q

Epinephrine

A

Catecholamine which is helpful in anaphylaxis and asthma, which is also used to increase blood pressure

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6
Q

How know alpha antagonists

A

Rine suffix

Epinephrine, norepinephrine, ephedrine, pseudoephedrine, and phenylphrine

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7
Q

Norepinephrine

A

Catecholamine a1 and a2 agonist and acts on b1

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8
Q

Indication for norepinephrine

A

Hypotension and also roles in depression and ADHD

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9
Q

Issue with treating hypotension with norepinephrine

A

Decreased renal perfusion

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10
Q

Phenylephrine

A

Selective a1 agonist that is indicated for use as a decongestant, vasopressor and mydriatic

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11
Q

Indication for phenylephrine

A

Hypotension (septic shock) and congestion

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12
Q

How does phenylephrine treat hypotension

A

Not chronological or inotropic

It increases blood pressure without effecting heart rate or contractility

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13
Q

How does phenylephrine treat congestion

A

Oral drug or ontranasal spray to treat congestion

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14
Q

Ephedrine

A

An indirect agonist which releases stored catecholamine and is categorized as a sympathomimetic.

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15
Q

Indications for ephedrine

A

Congestion (rhinitis)
Urinary incontinence
Hypotension

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16
Q

How does ephedrine treat congestion

A

Decongestant

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17
Q

How does ephedrine treat urinary incontinence

A

Vasoconstriction of the renal arteries

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18
Q

How does ephedrine treat hypotension

A

Used in surgical or obstetric procedures

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19
Q

Epinephrine

A

Catecholamine a agonist (a1 and a2) which has b1 and b2 Adrenergic activity as well

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20
Q

Indications for epinephrine

A

Anaphylaxis, asthma and hypotension

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21
Q

How does epinephrine treat anaphylaxis and asthma

A

Vasoconstriction

Asthma-b2 agonist medications are unavailable or unhelpful

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22
Q

How does epinephrine treat hypotension

A

Acts on numerous Adrenergic receptors
Increase bp in 2 ways
-increases peripheral resistance bc a receptors
-CO increased due to b Adrenergic activity

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23
Q

Alpha 2 agonist (sympathoplegics)

A

A2 agonists decreases sympathetic outflow centrally

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24
Q

How do a2 decrease sympathetic outflow

A

Treat hypertensive symptoms

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25
Q

Examples of a2 agonists

A

Condine

Alpha methyldopa

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26
Q

Indications for a2 agonists

A

Hypertension when people have

Renal disease

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27
Q

How do a2 agonists treat hypertension

A

Reduce peripheral resistance by stimulating postsynaptic a2 adrenoreceptors in CNS

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28
Q

Why can you use a2 agonists in hypertension in people with renal disease

A

Do not cause a decrease in blood flow to the kidney

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29
Q

Centrally acting a2 agonist

A

Centrally acting and decrease sympathetic outflow as they activate medullary presynaptic a2 adrenoceptors.

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30
Q

A2 activation __ sympathetic outflow

A

Decreases

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31
Q

Condine

A

Activates a receptors , which cause inhibition of norepinephrine release from synaptic vesicles.

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32
Q

Clondine is frequently administered with a __ and may produce side effects of __,__, and ___

A

Diuretic

Lethargy, dry mouth, and constipation

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33
Q

Adverse effect of clonidine

A

Severe rebound hypertension in the case of abrupt withdrawal

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34
Q

Alpha methyldopa

A

Methyldopa decreases total peripheral resistance by reducing sympathetic outflow fromt he CNS.

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35
Q

Indications for alpha-methyldopa

A

Mild hypertension and can be used together with a diuretic for increased effect.

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36
Q

Can alpha methyldopa be used to treat hypertension in pregnant women

A

Yup

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37
Q

Methyldopa Umayyad lead to what, causing a positive ___ test

A

Drug induced immune mediated hemolysis, leading to a positive direct Coombs test

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38
Q

Alpha methyldopa may cause SLE like syndrome with symptoms like what

A

Fever, pericarditis, arthralgias and malaise with positive anti nuclear antibodies

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39
Q

Nonselective alpha blockers

A

Vasodilator to Lower blood pressure by inhibiting vasoconstriction through their action at a1 while also having action at a2 receptors

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40
Q

Two examples of nonselective alpha blockers

A

Phentolamine and phenoxybenzamine

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41
Q

Phentolamine

A

Reversible drug which is useful in treating hypertensive crisis and is indicated for diagnosing pheochromocytomas

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42
Q

Phenoxybenzamine

A

Indicated for treating pheochromocytomas due to its slow onset and long duration of effects

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43
Q

Side effects nonselective alpha blockers

A

Orthostatic hypotension

Reflex tachycardia -bc leads to increased sympathetic tone

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44
Q

Why is phentolamine reversible

A

Dissociates from adrenergic receptors

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45
Q

Why is phentolamine ideal for the diagnosis of pheochromocytoma

A

Bc reversible

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46
Q

What crisis may we use phentolamine for

A

patients on MAO inhibitors who eat tyramine-containing food, in order to treat hypertensive crisis

Concaine-induced hypertensive crisis

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47
Q

Why is phentolamine useful for treating cocaine induced hypertensive crisis

A

Helpful in avoiding the unopposed alpha effects of other drugs that may be used to treat cocaine intoxication

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48
Q

Phenoxybenzamine

A

Non reversible

Used to treat pheochromocytomas and has a slower onset and longer effect than other a blockers

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49
Q

How does phenoxybenzamine treat pheochromocytoma better than beta blockers

A

Pheochromocytomas-adrenal gland

Has longer effect than other a blockers

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50
Q

Side effects of nonselective alpha blockers

A

Orthostatic hypotension

Reflex tachycardia

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51
Q

How do nonselective alpha blockers cause orthostatic hypotension

A

Inhibit a1 and a2 adrenergic receptors , they decrease vasoconstriction and vessel tone.

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52
Q

Why do non selective alpha blockers cause reflex tachycardia

A

Hypotension and added a2 inhibition are countered physiologically by increased sympathetic tone

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53
Q

Selective alpha 1 blockers and suffix

A

Osin

Block a1 in smooth muscle, arteolar and central nervous tissues

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54
Q

What are selective a1 blockers used to treat

A

Hypertension

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55
Q

What is tamsulsoin (a1 blocker) used to treat selectively

A

Urinary retention in BPH

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56
Q

Symptoms of selective a1 blockers

A

Limit ability to maintain bp
Syncope and orthostatic hypotension
Espicially in their first dose

Tamsulosin-priapism

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57
Q

Examples of selective a1 blockers

A

Osin suffix

Tamsulosin, prazosin, terazosin, doxazosin

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58
Q

How do selective a1 blockers work

A

Selectively block a1 adrenergic receptors in smooth muscle , arteriolar and CNS. Leading to vasodilation

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59
Q

What does tamsulosin block

A

A1a receptors

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60
Q

Where are a1a receptors

A

Prostate, as indicated for BPH while having little activity on hypertension

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61
Q

Indications for selective a1 blockers

A

Hypertension and BPH

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62
Q

Why tamsulosin good for treating BPH

A

Selective a1a receptors, which exist in prostate. It is helpful in treating urinary retention in BPH but has little effect on blood pressure

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63
Q

Treat hypertension with tamsulosin

A

No

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64
Q

Why does selective a1 blockers cause syncope

A

Esp prazosin

Body cant maintain cerebral blood pressure without a1 activity and this leads to syncope and dizziness

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65
Q

How does selective a1 blocker cause orthostatic hypotension

A

Body poorly controlling bp without a1 input

Patients told to stand up slowly

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66
Q

1st dose phenomenon

A

First time a patient is introduced to an a1 blocker where a sudden and severe fall in bp occurs with body position changes

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67
Q

Side effects of tamsulosin

A

Priapism

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68
Q

Example of selective a2 blocker

A

Mirtazapine

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69
Q

What is selective alpha 2 blocker indicated for

A

Depression treatment

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70
Q

How do selective a2 blockers work

A

Selectively blocking a2 receptors, and having antagonist activity at 5-HT receptors as well as other receptors

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71
Q

Mirtazapine

A

Atypical antidepressant that blocks presynaptc a2 receptors and also has serotonin 5-ht2 and 5-ht3 receptor antagonist activity

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72
Q

What does mirtazapine treat

A

Depression and other mood disorders

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73
Q

How does mirtazapine treat depression

A

Blocking a2 agonists, which in turn leads to enhanced adrenergic and serotonergic transmission

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74
Q

Although selective a2 adrenergic receptor is what we call mertazapine, what does it block that is clinically significant

A

5-HT

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75
Q

Side effects of mirtazapine

A

Sedation, weight gain, increased serum cholesterol

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76
Q

Why does mirtazapine cause sedation

A

Block of 5-HT2 and 5-HT3 receptors

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77
Q

How does mirtazapine cause weight gain

A

Potent stimulator of appetite and may cause weight gain espicially in younger patients

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78
Q

Why does mirtazapine cause increased serum cholesterol

A

Idk

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79
Q

What is prazosin (mini press)

A

Alpha blocker that selectively inhibits a1 receptors

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80
Q

Effects of prazosin

A

Relaxation and widening of blood vessels for increased blood flow and relaxes the smooth muscles in the bladder neck and prostatic capsule

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81
Q

Indication for prazosin

A

Treat hypertension and BHP and nightmares

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82
Q

Side effects of prazosin

A

Orthostatic hypertension , reflex tachycardia, inhibition of ejaculation, nasal congestion

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83
Q

Why should tell patient to take first does of prazosin (minipress) at night

A

Minimize the risk of the medications first dose effect which is severe orthostatic hypotension

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84
Q

How does prazosin work

A

Selectively block a1 receptors causing blood vessel dilation and smooth muscle relaxation of the bladder neck and prostatic capsule. Relaxing blood vessels and allows blood to flow more easily

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85
Q

Why does prazosin treat hypertension

A

A1 antagonist in walls of blood vessels, allowing the vessels to relax and widen while decreasing peripheral vascular resistance

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86
Q

How does prazosin treat BPH

A

BPH causes urinary issues
Block a1 receptors and relaxing the muscles surrounding the bladder neck (trigone and sphincter) and prostate capsule. This actions allows urine to flow more easily in patients with BPH

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87
Q

How does prazosin treat nightmares

A

Decreasing amounts of systemic adrenaline while sleeping

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88
Q

How does prazosin cause orthostatic hypotension

A

Effect ability to vasoconstriction and maintain blood pressure. Instruct patient to stand slowly and sit down if dizzy

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89
Q

Why does prazosin cause tachycardia

A

Adrenergic receptors widen blood vessels, decrease vascular resistance and lowers the hearts effort to effectively pump blood throughout the body. The decrease in blood pressure triggers the body to overcompensate by increasing the heart rate

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90
Q

Why does prazosin cause priapism/inhibition of ejaculation

A

Blocks adrenergic receptors in the prostate causing relaxed blood vessels and increased blood flow. This med affects the body ability to vasoconstrict and maintain an erection

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91
Q

Why does prazosin cause nasal congestion

A

Effects adrenergic receptors in the nasal mucosa and causes vasodilation of the nasal arterioles. Inform the patient that this drug may cause nasal congestion

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92
Q

First does effect of prazosin

A

May lose consciousness within 60 minutes so take at bedtime to minimize orthostatic hypotension and syncope

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93
Q

B1 agonist

A

Medications used because of their sympathomimetic activity

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94
Q

Examples of beta 1 agonists

A

Dobutamine

Isoproterenol

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95
Q

What is dobutamine used to treat

A

Heart failure and cardiogenic shock as it increases heart rate and contractility

96
Q

What can dobutamine diagnose

A

Ischemic heart disease by being a pharmacological stress test agent

97
Q

Why should dobutamine not be used in ischemic heart disease

A

It increases myocardial oxygen demand

98
Q

Isoproterenol

A

B1 agonist which also has b2 adrenergic activity

99
Q

Effects of isoproterenol

A

Increases cardiac inotropy, chronotropy, and dromotropy (conduction speed through AV node), which allows it to be helpful in treating bradyarrhythmias

100
Q

Indication for isoproterenol

A

Bradyarrhythmias

Torsades de pointes (with Mg and cardiac pacing)

101
Q

Isoproterenol only treat torsades de pointes which stems from ____ _ _ __

A

Acquired long QT syndrome

102
Q

Bc of its combined b activity, isoproterenol will __ systolic bp, but _ diastolic pressure (___ ___)

A

Increase

Decrease (B2 vasodilation)

103
Q

The b2 activity of isoproterenol allows it to be used for __ but rarely

A

Asthma

104
Q

Dobutamine is a pure b1 agonist, and thus, acts more selectively on the __

A

Heart

105
Q

What is dobutamine used for

A

Heart failure and cardiogenic shock to increase cardiac inotropy and chronotropy

106
Q

Why cant dobutamine be used for ischemic heart disease

A

Increases myocardial oxygen demand

107
Q

How can dobutamine be used in CHF

A

Increase contractility

108
Q

Dobutamine and cardiac stress test

A

Help identify coronary artery disease by acting as a pharmacological stress testing agent

109
Q

Isoproterenol

A

B1 agonist which also has action on b2 receptors

110
Q

Isoproterenol increases _____ and ____ and ___

A

Inotropy
Chronotropy
Dromotropy

111
Q

What does isoproterenol treat

A

Bradycardia and torsades de pointes (only when from acquired long qt syndrome)

112
Q

Why can isoproterenol be used for asthma (but rarely)

A

B2 activity on dilation of bronchial airways

113
Q

Why not use isoproterenol on ischemia

A

Increases myocardial oxygen demand and can worsen ischemia

114
Q

How treat torsades de pointes

A

Isoproterenol and overdrive pacing and Mg

KEEP IN MIND that isoproterenol is only used in acquired cases of long QT syndrome which leads to torsades de pointes

115
Q

What do b2 agonist do

A

Induce smooth muscle relaxation, bronchial dilation, vasodilation, uterine relaxation, along with insulin release

116
Q

Indications for b2 agonists

A

Asthma, pulmonary disorders, and tocolysis

117
Q

What are the short acting b 2 agonists SABA

A

TERBUTALINE AND ALBUTEROL

118
Q

Terbutaline

A

Tocolytic agent and to treat asthma attacks

119
Q

ALBUTEROL

A

Asthma attacks (and COPD exacerbations)

120
Q

Long acting beta 2 agonist LABA

A

Salmeterol

121
Q

What is salmeterol used for

A

Prevent the number of monthly asthma and COPD exacerbations in patients and is usually co-administered with an inhaled corticosteroid

122
Q

Terbutaline

A

Fast acting short term treatment used for acute asthma exacerbations, and to delay premature uterine contractions (replaced ritodrine)

123
Q

How does terbutaline treat asthma

A

Fast acting bronchodilator that works within 15 minutes with effects lasting up to 6 hours

124
Q

How does terbutaline treat tocolysis

A

Class b not fda approved

125
Q

Terbutaline and the uterus

A

Relaxes the uterus prior to the obstetric maneuvers used to correct uterine inversion

126
Q

An important note about terbutaline is that in it __ form, it should not be used for prolonged treatment for tocolysis in preterm labor.why

A

Injectable

Can lead to serious maternal health problems and death

127
Q

ALBUTEROL

A

SABA used to relieve bronchospasm in conditions such as asthma and COPD

128
Q

Asthma and albuterol

A

Most commonly used for acute asthma attacks bc of its quick acting mechanism but can also be administered for copD.

129
Q

How is albuterol administered

A

Inhaler or nebulized solution

130
Q

What are LABA used for

A

Chronic conditions

131
Q

Salmeterol

A

LAB with therapeutic effects of 12 hours

132
Q

What is salmeterol used for

A

Severe persistent asthma (combined with corticosteroid) and used everyday to prevent the number of monthly attacks in patients

133
Q

Salmeterol and asthma

A

Used for severe persistent asthma bc uncontrolled with SABA

134
Q

COPD and salmeterol

A

Induces bronchial dilation. Used daily to prevent acute COPD exacerbations in patients with this condition

135
Q

Selective b1 blockers

A

Act to block b1 receptors to treat CVD

136
Q

How do selective beta blockers work

A

Block actions of norepinephrine and epinephrine on cardiovascular contractility, chronotropy and the body’s release of renin

137
Q

Suffix of selective beta blockers

A

lol

138
Q

Examples of selective beta blockers

A

Atenolol
Esmolol
Metoprolol

139
Q

Some b1 blacking drugs also work as partial b agonists at high doses such as ___

A

Acebutolol

140
Q

In general. Selective beta blockers begin with letter - and nonselective betea blockers begin with letters -. Nam two exceptions

A

A-m
N-z

Nonselective b blockers carvedilol and labetalol

141
Q

Effects of selective b1 blockers

A

Decrease heart rate, contractility and renin release

142
Q

Atenolol

A

B1 blocker

Does not cross bbb

143
Q

Indications for atenolol

A

Arrhythmia, angina, MI and hypertension (though not first line for hypertension)

144
Q

Esmolol

A

Very short acting drug with rapid onset. Given IV in OR

145
Q

Indications for esmolol

A

Tachycardia and supraventricular tachycardia in OR

Also fo aortic dissection

146
Q

Metoprolol

A

B1 blocker crosses bbb

147
Q

What is metoprolol used for (selective b1 )

A

Control angina, MI, CHF
Migraine prophylaxis
Anxiety disorders

148
Q

Partial beta agonist

A

B1 selective blocker also act as partial b agonist at high doses. So have some intrinsic sympathomimetic activity along with their b blocking activities

149
Q

Example of partial b agonist

A

Acebutolol

150
Q

Acebutolol

A

B1 blocker with partial b agonist activity at high doses

151
Q

Indications for acebutolol

A

Arrhythmia and hypertension

152
Q

Non selective beta blockers

A

Olol
First generation
Antagonistic effects at b1 (heart kidney) and b2 (lung peripheral blood vessels and skeletal muscle) preventing direct sympathomimetic such as norepinephrine and epinephrine from binding to these receptors

153
Q

How do nonselective beta blockers work

A

Prevent the release of cAMP, a secondary messenger in the Gs protein signal transduction pathway. Without cAMP, PKA remains inactivated and thus Ca2+ currents are reduced

154
Q

Example of nonselective b blocker

A

Propranolol, timolol, nadolol

155
Q

Propranolol

A

First b blocker
Initially for angina pectoris then antihypertensive but bc of b2 blocking effects like bronchospasm and exacerbations of COPD and asthma.

156
Q

Side effects propranolol

A

Bronchospasm, depression, exacerbation of peripheral arterial disease, masking symptoms of hypoglycemia in diabetics

157
Q

What is propranolol used for now

A

Treatment of thyroid storm, thryotoxicosis, essential tremor, prevention of bleeding esophageal varies, akathisia and chronic migraine prophylaxis

158
Q

Timolol

A

First line therapy for reduction of intraocular pressure in open angle glaucoma and part of empiric therapy for acute angle closure glaucoma

159
Q

Timolol was initially shown to not be effective systemic hypotensive agent, however when formulated into a __ drug it was demonstrated to be extremely effective in reduction of IOP

A

Topical

160
Q

Preferred treatment for open angle glaucoma

A

Topical prostaglandins

161
Q

Side effects timolol

A

Severe bronchospasm

162
Q

Nadolol

A

Prevention of bleeding esophageal varies. Can be used in trea,ent of migraines, ADHD, essential tremor in parkinsons

163
Q

Side effects nadolol

A

Bradycardia, fatigue and bronchospasm

164
Q

Partial B agonist

A

Block b receptor but also have intrinsic sympathomimetic activity and partially activate the receptor.

165
Q

High doses of partial b agonist

A

Effects like epinephrine (increased pulse , bp, and bronchodilator)

166
Q

Example of partial b agonist

A

Pindolol

167
Q

Pindolol

A

B blocker that is also a partial b agonist.

168
Q

Indications for pindolol

A

Treatment of angina pexctoris and hypertension. However, rarely done so due to its intrinsic sympathomimetic activity

169
Q

Nonselective b with a blocking

A

Nonselectively block both b and a receptors.

170
Q

A blocking effects of nonselective b blocking with a blocking

A

Vasodilator which potentialities the b blocking effect to reduce bp

171
Q

Examples of nonselective b with a blocking

A

Carvedilol

Labetalol

172
Q

Carvedilol

A

Treats CHF with ACE inhibitors and diuretics)

173
Q

Labetalol

A

Treats pregnant induced hypertension and 2nd line in hypertensive emergencies

174
Q

What CVD issues can beta blockers be used for

A

CHF, arrhythmia, angina, MI, hypertension and other

175
Q

How do betea blockers work for CVD

A

Preventing normal ligands (E and NE) from binding to their adrenoceptor binding site

176
Q

Heart effects of beta blockers

A

Decreased contractility by halting CA2+ influx by decreasing cAMP and decreasing SA and AV node conduction velocity, which also slows chronotropy.
O2 consumption is lowered as chronotropy and inotropy are decreased

177
Q

By decreasing CO, bp is __

A

Lowered

178
Q

Beta blockers have been shown to __ mortality and morbidity post MI

A

Decrease

179
Q

Cardiac myocyte and peripheral vasculature contain _ and _ adrenoceptors which are activated by _ and _ leading to what

A

B1 B2
NE E
Increased inotropy, chronotropy, dromotropy (electrical conduction) and increasing bp and CO

180
Q

B blockers bind to _ proteins and inhibit formation of _ to _

A

Gs

ATP to cAMP

181
Q

What does decreased cAMP in heart cause

A

Decreased CA2+ currents by the sarcoplasmic reticulum of the heart …decreased heart contractility

182
Q

Beta blockers _ SA and AV node conduction velocity which means they decrease dromotropy

A

Decrease

183
Q

What are beta blockers indicated for supraventricular and ventricular tachycardia and atrial fibrillation and flutter

A

Bc decrease dromotropy

184
Q

Why are beta blockers contraindicated in patients with heart block or AV conduction delta regardless of 1 2 or 3 degree

A

Decrease dromotropy

185
Q

How do beta blockers decrease bp(although not first line treatment for hypertension)

A
  • decrease chronotropy and inotropy, so heart has lower CO, contributing to lower bp andrequiring less oxygen in the process
  • decrease renin secretion which reduced extracellular volume, further lowering bp and decreasing myocardial oxygen demand
186
Q

Why do beta blockers decrease o2 consumption

A

Inhibit chronotropy and inotropic sympathetic effects
Decrease workload of heart
Decreased o2 consumption by decreasing myocardial oxygen demand
-CAN TREAT ANGINA

187
Q

Why do beta blockers decrease mortality post MI

A

Beta blockers such as metoporlol and atenolol and bisoprolol are used after MI to decrease death and illness

188
Q

What beta blockers are used in eye

A

Timolol and betaxolol

Reduce intraocular pressure by decreasing aqueous humor reduction

189
Q

Systemic side effects of beta blockers

A

Respiratory-bronchoconstriction

Metabolic-decreased insulin , decrease glycolysis and lipolysis, reducing blood glucose

190
Q

Diabetics and beta blockers

A

Aware of their blood sugar as beta blockers may mask usual signs of hypoglycemia

191
Q

Why do beta blockers cause bronchocontriction

A

B2 receptors bronchodilator

When blocked get bronchoconstriction

192
Q

B3 receptors beta blockers

A

Normally increase lipolysis

Beta block-decrease lipolysis

193
Q

B2 beta blockers

A

Normally increase insulin release block if blocked

194
Q

Beta blockers glycolysis

A

Block it

Glycogenolysis decreased

195
Q

Beta blockers and eye

A

Ciliary epithelium contains beta adrenergic receptors and ligand binding (e and NE) stimulated the formation of aqueous humor. Thus beta blockers decrease queues humor formation

196
Q

How do timolol and betaxolol decrease aqueous humor formation

A

Block beta receptors on ciliary bodies

197
Q

Epinephrine

A

Direct sympathomimetic that is used for treatment of hypotension , anaphylaxis and open angle glaucoma.

198
Q

Administration of epinephrine

A

IV

199
Q

Epinephrine is metabolized by the ___ prior to excretion

A

Liver

200
Q

Effects of epinephrine

A

Increase heart rate and systolic bp and acute on a and b receptors

201
Q

Epinephrine is an a and b __

A

Agonist

202
Q

Epinephrine effect on a1

A

Constrict smooth muscle of resistance blood vessels, such as those in the skin and splanchnic needs, causing increased peripheral resistance and venous return

203
Q

Epinephrine on b1 and b2

A

Increase heart rate and contractility

Increases lipolysis and renin release while causing vasodilation also increase uterine tone

204
Q

Indications for epinephrine treatment

A

Hypotension
Anaphylaxis
Allergy
Glaucoma

205
Q

How does epinephrine treat hypotension

A

Increases systolic pressure as a result of positive inotropic and chronotropy effects on the heart.

206
Q

High doses of epinephrine

A

Vasoconstriction within skeletal muscle vasculature

207
Q

How does epinephrine treat anaphylaxis (asthma attack and anaphylactic shock)

A

Vasoconstrict I’ve and reversing angioedema and hypotension
Stimulation of b2 causes bronchodilator as well as increasing intracellular cyclic adenosine and monophosphate production in mast cells and basophils, reducing release of inflammatory mediators

208
Q

How does epinephrine treat allergy

A

Patients with allergies undergoing immunotherapy may be administered epinephrine to reduce possible immune response to the allergen

209
Q

How does epinephrine treat glaucoma

A

Act on eye is less selective alpha agonist and decreases aqueous humor production through vasoconstriction of ciliary body blood vessels. This decreases ocular pressure in open angle glaucoma

210
Q

What should we not use epinephrine for

A

Cloaked angle glaucoma

211
Q

Ephedrine

A

Indirect sympathomimetic that works to release stored catecholamine such as NE from sympathetic neurons

212
Q

Ephedrine is a _ and _ agonist

A

A and b

213
Q

Indication for ephedrine

A

Rhinitis
Hypotension
Urinary incontinence

214
Q

Ephedrine as an a agonist

A

Release stored catecholamine as an indirect agonist
Constrict smooth muscle of resistance bv such as those in the skin and splanchnic beds causing increased peripheral resistance and venous return

215
Q

Ephedrine as a b agonist

A

B1 and b2 and increases Herat rate and contractility
Increases lipolysis and renin release while causing vasodilation
Decrease uterine tone
Ciliary muscle relaxation and increase aqueous humor production

216
Q

Ephedrine and rhinitis

A

Yup

217
Q

Ephedrine and hypotension

A

A1 agonist effect of increased bp

218
Q

Ephedrine and urinary incontinence

A

Constrict urinary sphincters and vasoconstrict renal arteries

219
Q

Norepinephrine

A

Catecholamine and direct sympathomimetic

220
Q

Indications for NE

A

Hypotension

Depression and attention disorders

221
Q

Side effects NE

A

Decreased renal perfusion

222
Q

NE is an a and b __

A

Agonist

223
Q

NE as an a agonist

A

A1 and a2

224
Q

NE as a b agonist

A

B1 agonist increased heart rate , contractility , and renin release
Little activity on B2

225
Q

NE and hypotension (emergencies such as neurogenic or septic shock)

A

Raise diastolic bp and total peripheral resistance more so than E due to its vasoconstrictor activity and lack of effect on B2 receptors in skeletal muscle vascular bed.

226
Q

Why does NE decrease renal blood flow

A

Idk but get impaired kidney function

227
Q

Phenylephrine

A

Direct sympathomimetic drug which acts as an a1 agonist

228
Q

Indications for phenylephrine

A

Rhinitis and emergency hypotension

Ocular procedures 9mydrasis)

229
Q

Who should we not use phenylephrine in

A

Patients with narrow angle glaucoma

230
Q

Phenylephrine as an a1 agonist

A

Constrict smooth muscle of resistance blood vessels such as those in the skin and splanchnic beds causing increased peripheral resistance and venous return

231
Q

Phenylephrine and a2

A

Agonist

232
Q

Phenylephrine and mydratic

A

Dilates pupil (in conjunction with anticholinergic) and should be avoided in patients with narrow angle glaucoma

233
Q

Phenylephrine and rhinitis and hay fever

A

Most commonly prescribed OTC decongestant

Also open obstructed eustsachian tubes

234
Q

Phenylephrine and hypotension

A

Short term emergencies increasing mean blood pressure with no effect on pulse pressure. 9severe hemorrhage where there is inadequate perfusion of the heart and Brian)

235
Q

Phenylephrine caused __ chronotropy and __ inotropy

A

Decreased increased

236
Q

Why does phenylephrine cause increas chronotropy but increased inotropy

A

Increases systemic vascular resistance, it can induce a barre pet or mediated vagal response against the heart, resulting in a slower heart rate(aka bradycardia). It also directly stimulates alpha receptors on cardiacmyocytes causing them to contract harder or increasing inotropy

Pharmacology (52 decks)

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