Pharm Block 1 (SNS - Drug) Flashcards
Catecholamines
NE (Primary)
Epinephrine (released from the adrenal medulla)
Dopamine (Renal vascular smooth muscle)
Direct-acting Catecholamines
Epinephrine (a & B, B2 - predominant__ vasodilation)
NE (a & B, a - predominant)
Dopamine (a, B, D depending dose)
Isoproterenol (Non-selective, B1 & B2, B1 = B2)
Dobutamine (Synthetic, Selective B1)
Dipivefrin (Prodrug)
Direct-acting Non-Catecholamines (Agonist)
Phenylephrine (Synthetic, a1) Oxymetazoline (a1 & a2) Midodrine (a1) Clonidine (a2 presynaptic receptors in the brain stem) Brimonidine (Ocular a2) Mirabegron (B3) Fenoldopam (D1)
Direct-acting NON-catecholamines (B2 Agonist)
Short-acting
Albuterol (DOC for acute respiratory relief - COPD, asthma)
Levalbuterol
Terbutaline (Suppress premature birth)
MOA - Bronchodilation
Clinical - Asthma, COPD
Direct-acting NON-Catecholamines (B2 Agonist)
Long-acting
Arformoterol (Approved COPD only)
Formoterol (NOT approved for Asthma)
Salmeterol (30 min for Asthma, 2 hrs for COPD)
Indacterol (Approved COPD only)
Indirect-acting Agonist
Methamphetamine
Tyramine (Not marketed)
Cocaine
Mixed Action Agonist
Ephedrine
Ephedra
Pseudoephedrine
Adrenergic Antagonist
a blockers
Phenoxybenzamine (Non-selective, Irreversible, a1 & a2 antagonist) - Management of Pheochromocytoma
Phentolamine (Non-selective, Competitive a1 & a2 antagonist) - Diagnosis of Pheochromocytoma
a1-blockers
(-zosin)
Prazosin (Treatment of PTSD, NOT approved for BPH)
Doxazosin (XL only for BPH)
Terazosin (Approved for BPH and HTN)
Alfuzosin (Approved only for BPH, NOT selective for the a1A receptor)
a1A-blocker
(-Osin)
Tamsulosin (IFIS, Least effect on BP)
Silodosin(Contraindicated in px w/ severe hepatic and renal impairment)
Non-specific B-blockers B1 & B2
(-olol)
Propranolol (lipophlic - Crosses BBB, useful for migraine, prophylaxis)
Nadolol (Long half-life —> Approved for migraine, prophylaxis)
Timolol (PO rarely used)
Selective B1- blocker
Atenolol
Betaxolol (B21 selectivity —> advantageous compared to timiolol ophthalmic)
Bisoprolol (Lipophilic —> Crosses BBB)
Esmolol (Short half-life, Approved for use in thyroid storm)
Metoprolol
Nebbiolo (NO, Vasodilatory effect)
B-blockers w/ ISA
Acebutolol (B1-specific Blockade)
Pindolol (Non-specific B-blockade)
Penbutolol (Non-specific B-blockade)
Mixed a1 and non-specific B-blockers
(Vowel-lol)
Carvedilol
Labetalol
(Clinical)
-Severe Hypertension (IV); Hypertension (PO)-during Pregnancy
Epinephrine
Agonist (a & B) B2 Vasodilation (Lower Dose) A1 Vasoconstriction (Higher) Increase in BP (Net Effect) Reduces P in open-angle Glaucoma (Dilates pupil)