Pharm - Autonomic Sympathetic drugs 1 Flashcards
Albuterol, Salmeterol, Formoterol
Sketchy: “Roll” call sheet in hands of beta-2 tuba player
MOA:
Direct sympathomimetic
B2 > B1 agonist
Effects:
Bronchodilation (B2)
Uses:
Acute asthma or COPD
Dobutamine
Sketchy: “Just DO BUgling” shirt
MOA:
Direct sympathomimetic
B1 > B2 agonist
Effects:
Increased HR, contractility, and cardiac output (B1)
Decreased SVR due to vasodilation (B2)
Uses:
Heart failure
Cardiac stress testing
Epinephrine
Sketchy: epic kiss between alpha and beta campers
MOA:
Direct sympathomimetic
B > a agonist
Effects:
- At low doses - beta effects predominate (bronchidilation, vasodilation/decreased SVR, elevated HR and contractility)
- At high doses - alpha effects predominate (vasoconstriction)
Uses:
Anaphylaxis (a1 counteracts vasodilation, B1 increased blood flow to tissues, B2 opens airways)
Asthma (B2)
Open angle glaucoma
Isoproterenol
Sketchy: iso-pro-tunnel between beta-1 and beta-2 tents
MOA:
Direct sympathomimetic
B1 = B2 agonist
Effects:
Elevated HR and contractility (B1)
Vasodilation and decreased SVR (B2)
Uses:
Electrophysiologic evaluation of tachyarrhythmias (may worsen ischemia)
Midodrine
Sketchy: NONE
MOA:
Direct sympathomimetic
a1 agonist
Uses:
Autonomic insufficiency and postural hypotension
Norepinephrine
Sketchy: north compass on alpha camp side by blowing B1 bugle
MOA:
Direct sympathomimetic
a1 > a2 > B1
Effects: Increased SVR (a1) Increased HR (B1)
Uses:
Hypotension (a1 vasoconstriction)
Septic shock
Phenylephrine
Sketchy: flannel friends
MOA:
Direct sympathomimetic
a1 > a2 agonist
Effects:
Vasoconstriction
Mydriasis
Uses:
Hypotension
Ocular procedures (mydriasis)
Rhinitis (nasal decongestant due to a1 vasoconstriction)
Terbutaline
Sketchy: “do not disTURB” sign near pregnant lady
MOA:
Direct sympathomimetic
B2 agonist
Effects:
Relaxation of uterine contractions
Uses:
Decrease contractions during preterm labor
Ritodrine
Sketchy: “I DREAM of band camp” shirt on pregnant lady
MOA:
Direct sympathomimetic
B2 agonist
Effects:
Relaxation of uterine contractions
Uses:
Decrease contractions during preterm labor
Amphetamine
Sketchy: “A fried of mine” shirt releasing catfish from vesicle
MOA:
Indirect sympathomimetic
Catecholamine reuptake inhibitor, releases stored catecholamines
Uses:
Narcolepsy
Obesity
ADHD
Cocaine
Sketchy: hot cocoa
MOA:
Indirect sympathomimetic
Inhibits NET and DAT, allowing catecholamines to remain in synapse
Effects:
- Peripheral NET inhibition leads to sympathetic stimulation (HTN, tachycardia, mydriasis)
- Central DAT inhibition leads to increased dopamine in the CNS (arousal, addiction, seizures)
Uses:
Vasoconstriction and local anesthesia
Adverse effects:
Never give beta blockers for acute cocaine intoxication - will lead to unopposed alpha activation and extreme HTN
Ephedrine
Sketchy: NONE
MOA:
Indirect sympathomimetic
Releases stored catecholamines
Uses:
Nasal decongestion
Urinary incontinence
Hypotension
Metyrosine
Sketchy: “My tire!”
MOA:
Indirect sympathomimetic
Prevents conversion of tyrosine to L-DOPA within the presynaptic nerve terminal
Atomoxetine
Sketchy: distracting HD TV with atom on it
MOA:
Indirect sympathomimetic
NET inhibitor
Uses:
ADHD
Reserpine
Sketchy: serpents blocking “V” mat
MOA: Inhibits VMAT (vesicular monamine transporter) so that catecholamines cannot be transported into secretory vesicles
Uses:
Huntington’s (degeneration of GABAergic neurons)
