Overview of CV Receptors and Drug Classes

Question 1

all preganglionic neurons?

Answer 1

cholinergic

-ACh release to nAChR

Question 2

parasympathetic postganglionic?

Answer 2

cholinergic

-ACh release mAChR

Question 3

somatic muscle neuron?

Answer 3

ACh release to nAChR

Question 4

sympathetic postganglionic neuron?

Answer 4

NE release to alpha/beta receptors

Question 5

sympathetic postganglionic to renal?

Answer 5

dopamine release to D1 receptor

Question 6

release at adrenal medulla?

Answer 6

ACh release to nAChR

- stimulates release of Epi and NE

Question 7

release at sweat glands?

Answer 7

ACh release to nAChR preganglionic

ACh release to mAChR postganglionic

Question 8

do we have drugs at the nAChR?

Answer 8

yes, but not very often used clinically
-because we would have such widespread affect

-ex/ nerve gas, insecticide

Question 9

adrenergic receptors?

Answer 9

alpha and beta

-GPCRs

Question 10

muscarine on heart?

Answer 10

M2

Question 11

muscarinic receptor?

Answer 11

GPCR

-activation causes contraction

Question 12

atropine

Answer 12

muscarinic cholinergic agonists

Question 13

what controls blood vessels?

Answer 13

sympathetics only

***may still have the receptors

Question 14

catecholamines?

Answer 14

E
NE
isoproterenol
dopamine
dobutamine

Question 15

dobutamine

Answer 15

beta1 selective agonist

Question 16

alpha 1 effects?

Answer 16

vasoconstriction

-in all vascular beds

Question 17

phenylephrine?

Answer 17

alpha-adrenergic agonist

Question 18

albuterol?

Answer 18

beta-2 selective agonist

Question 19

beta 1 effects?

Answer 19

positive ionotropic and chronotropic

Question 20

beta 2 effects?

Answer 20

relaxation of bronchioles
relaxation of vascular smooth muscle
-skeletal muscle

Question 21

epinephrine?

Answer 21

sympathomimetic

• more activity at beta-2 than alpha-1
• low dose = beta-2 effects
• drop BP
• high dose = increases BP

Question 22

bronchial asthma?

Answer 22

albuterol

-beta-2 selective agonist

Question 23

norepinephrine?

Answer 23

agonist at alpha 1, alpha 2, beta 1
weak beta 2 effects***

positive ionotropic and chronotropic effect
-reflex bradycardia occurs
NET: positive ionotropic and negative chronotropic

increases BP (alpha 1 vasoconstriction)

Question 24

isoproterenol

Answer 24

beta-selective agonist

• beta 1, 2, and 3
• no affect on alpha receptors

increased HR and contractile force
vasodilation of blood vessels
relaxes bronchial smooth muscle

Question 25

dopamine

Answer 25

agonist at D1 | -increase blood flow to renal arterioles (kidneys)

Question 26

NE

Answer 26

alpha 1 and 2 beta 1 no beta 2 AGONIST

Question 27

Epi

Answer 27

alpha 1, 2 beta 1, 2 AGONIST

Question 28

Isoproterenol

Answer 28

beta1, 2 no alpha AGONIST

Question 29

dopamine

Answer 29

D1 partial beta 1 weak alpha 1 AGONIST

Question 30

bethanechol

Answer 30

muscarinic cholinergic agonist

Question 31

propranolol

Answer 31

non-selective beta1,2 antagonist

Question 32

phenylephrine?

Answer 32

``` alpha-1 selective agonist -vasoconstriction reflex bradycardia (that can be blocked by atropine) ```

Question 33

albuterol?

Answer 33

proventil, ventolin selective beta-2 agonist used for bronchial asthma

Question 34

phentolamine?

Answer 34

competitive adrenergic blocker decrease in BP - block alpha 1 - reflex tachycardia from vasodilation

Question 35

NE effects at low dose?

Answer 35

vasoconstriction - increase (alpha1) -increase in BP - systolic, diastolic, and MAP -decrease in heart rate - baroreceptor reflex SLOW, FORCEFUL HEARTBEAT

Question 36

Epi effects at low dose?

Answer 36

vasodilation (beta2) -drop in diastolic, increased systolic, no change MAP -increased heart rate (beta1)

Question 37

Isoproterenol effects at low dose?

Answer 37

beta2 vasodilation - drops diastolic and MAP, increase systolic - increased heart rate (reflex and beta1)

Question 38

beta2, alpha1 and Epi?

Answer 38

higher affinity for beta2 at low doses | higher affinity for alpha1 at high doses

Question 39

bethanechol

Answer 39

muscarinic agonist | -messes up your GI and other things

Question 40

prazosin

Answer 40

selective postsynaptic alpha1 blocker

Question 41

propanolol

Answer 41

beta1 beta2 antagonist - decreased HR and CO - slow AV conduction, increased PR interval - decreases rate of depolarization of pacemakers blocks beta2 vasodilation -slow decrease TPR blocks bronchodilation -maybe bronchospasm blocks lipolysis and glycogenolysis -no good for diabetics

Question 42

clinical use of propanolol?

Answer 42

angina pectoris HTN arrhythmias

Question 43

atenolol?

Answer 43

beta-1 selective antagonist

Question 44

acetylcholine?

Answer 44

``` short acting (broken down quickly) -not very useful clinically ```

Question 45

bethanechol?

Answer 45

cholinergic agonist that is muscarinic receptor selective -not broken down by acetylcholinesterase

Question 46

muscarinic effects on cardio?

Answer 46

SA - negative chronotropy AV - negative dromotropy atrial - negative inotropy

Question 47

atropine?

Answer 47

mucarinic antagonist reversal of reflex bradycardia causes tachycardia bronchodilation and relaxation

Question 48

ipratropium?

Answer 48

muscarinic antagonist -permanently charged - poorly absorbed across membrane used for asthma and COPD

Question 49

selective vs. nonselective alpha blockers?

Answer 49

nonselective will cause tachycardia -because blocks alpha1 and alpha2 selective won't affect alpha2, therefore you can inhibit the NE release presynaptically phentolamine - nonselective prazosin - selective

Question 50

contraindications to beta-blockers (propanolol)?

Answer 50

asthma and COPD | diabetics (hypoglycemia)

Question 51

bronchospasm relief in COPD?

Answer 51

albuterol ipratropium bromide COMBIVENT

Question 52

metoprolol?

Answer 52

in patients with CHF because it has been shown to decreases mortality in CHF patient