Pharm - Autonomic Drugs (Sympathomimetic Basics) Flashcards
Pg. 248 in First Aid 2014 Sections include: -Sympathomimetics
What are 7 examples of Direct sympathomimetics?
(1) Epinephrine (2) Norepinephrine (3) Isoproterenol (4) Dopamine (5) Dobutamine (6) Phenylephrine (7) Albuterol, Salmeterol, Terbutaline
What is the effect of Epinephrine? In other words, on what receptor(s) does it act, and to what degree?
Beta > Alpha
What are 4 clinical applications for Epinephrine?
(1) Anaphylaxis (2) Open angle glaucoma (3) Asthma (4) Hypotension
Again, on what receptor(s) does Epinephrine act, and to what degree? What effects predominate at high doses?
Beta > Alpha; Alpha effects predominate at high doses
What is the effect of Norepinephrine? In other words, on what receptor(s) does it act, and to what degree?
Alpha 1 > Alpha 2 > Beta 1
What is the major clinical application for norepinephrine? What is an important consideration related to its clinical use?
Hypotension (but decreased renal perfusion)
What is the effect of Isoproterenol? In other words, on what receptor(s) does it act, and to what degree?
Beta 1 = Beta 2
What is the major clinical application for isoproterenol? What is an important consideration related to its clinical use?
Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia.
What is the effect of Dopamine? In other words, on what receptor(s) does it act, and to what degree?
D1 = D2 > Beta > Alpha
What are 3 clinical uses for Dopamine?
(1) Unstable bradycardia, (2) Heart failure, (3) Shock
Again, on what receptor(s) does Dopamine act, and to what degree? What effects predominate at high doses?
D1 = D2 > Beta > Alpha; Inotropic and chronotropic Alpha effects predominate at high doses
What is the effect of Dobutamine? In other words, on what receptor(s) does it act, and to what degree?
Beta 1 > Beta 2, Alpha
What are 2 clinical uses for Dobutamine?
(1) Heart failure (inotropic > chronotropic), (2) Cardiac stress testing
What is the effect of Phenylephrine? In other words, on what receptor(s) does it act, and to what degree?
Alpha 1 > Alpha 2
What are 3 clinical uses for Phenylephrine, and what is the mechanism behind each of these uses?
(1) Hypotension (vasoconstrictor), (2) Ocular procedures (Mydriatic), (3) Rhinitis (Decongestant)
What is the effect of Albuterol? In other words, on what receptor(s) does it act, and to what degree? What are 2 other drugs that share the same mechanism?
Beta 2 > Beta 1; Albuterol, Salmeterol, Terbutaline
What is the clinical use for each of the following direct sympathomimetics: (1) Albuterol (2) Salmeterol (3) Terbutaline?
(1) Albuterol for acute asthma; (2) Salmeterol for long-term asthma or COPD control; (3) Terbutaline to reduce premature uterine contractions
What are 3 examples of Indirect sympathomimetics?
(1) Amphetamine (2) Ephedrine (3) Cocaine
What are the classifications/effects of Amphetamine?
Indirect general agonist (sympathomimetic), reuptake inhibitor, also releases stored catecholamines
What are 3 clinical applications for Amphetamine?
(1) Narcolepsy (2) Obesity (3) Attention deficit disorder
What are the classifications/effects of Ephedrine?
Indirect general agonist (sympathomimetic), releases stored catecholamines
What are 3 clinical applications for Ephedrine?
(1) Nasal decongestion (2) Urinary incontinence (3) Hypotension
What are the classifications/effects of Cocaine?
Indirect general agonist (sympathomimetic), reuptake inhibitor
What are 2 clinical applications/notes for Cocaine? What is an important consideration related to its clinical applications?
Causes vasoconstriction and local anesthesia; Never give Beta-blockers if cocaine intoxication is suspected (can lead to unopposed alpha 1 activation and extreme hypertension)
