Pharm Block 1 (SNS - Drug)

Question 1

Catecholamines

Answer 1

NE (Primary)
Epinephrine (released from the adrenal medulla)
Dopamine (Renal vascular smooth muscle)

Question 2

Direct-acting Catecholamines

Answer 2

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)

Question 3

Direct-acting Non-Catecholamines (Agonist)

Answer 3

Phenylephrine (Synthetic, a1)
Oxymetazoline (a1 & a2)
Midodrine (a1)
Clonidine (a2 presynaptic receptors in the brain stem)
Brimonidine (Ocular a2)
Mirabegron (B3)
Fenoldopam (D1)

Question 4

Direct-acting NON-catecholamines (B2 Agonist)

Short-acting

Answer 4

Albuterol (DOC for acute respiratory relief - COPD, asthma)

Levalbuterol

Terbutaline (Suppress premature birth)

MOA - Bronchodilation
Clinical - Asthma, COPD

Question 5

Direct-acting NON-Catecholamines (B2 Agonist)

Long-acting

Answer 5

Arformoterol (Approved COPD only)

Formoterol (NOT approved for Asthma)

Salmeterol (30 min for Asthma, 2 hrs for COPD)

Indacterol (Approved COPD only)

Question 6

Indirect-acting Agonist

Answer 6

Methamphetamine
Tyramine (Not marketed)
Cocaine

Question 7

Mixed Action Agonist

Answer 7

Ephedrine
Ephedra
Pseudoephedrine

Question 8

Adrenergic Antagonist

a blockers

Answer 8

Phenoxybenzamine (Non-selective, Irreversible, a1 & a2 antagonist) - Management of Pheochromocytoma

Phentolamine (Non-selective, Competitive a1 & a2 antagonist) - Diagnosis of Pheochromocytoma

Question 9

a1-blockers

Answer 9

(-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)

Question 10

a1A-blocker

Answer 10

(-Osin)

Tamsulosin (IFIS, Least effect on BP)

Silodosin(Contraindicated in px w/ severe hepatic and renal impairment)

Question 11

Non-specific B-blockers B1 & B2

Answer 11

(-olol)

Propranolol (lipophlic - Crosses BBB, useful for migraine, prophylaxis)

Nadolol (Long half-life —> Approved for migraine, prophylaxis)

Timolol (PO rarely used)

Question 12

Selective B1- blocker

Answer 12

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)

Question 13

B-blockers w/ ISA

Answer 13

Acebutolol (B1-specific Blockade)

Pindolol (Non-specific B-blockade)

Penbutolol (Non-specific B-blockade)

Question 14

Mixed a1 and non-specific B-blockers

Answer 14

(Vowel-lol)

Carvedilol

Labetalol
(Clinical)
-Severe Hypertension (IV); Hypertension (PO)-during Pregnancy

Question 15

Epinephrine

Answer 15

Agonist (a & B)
B2 Vasodilation (Lower Dose)
A1 Vasoconstriction (Higher)
Increase in BP (Net Effect)
Reduces P in open-angle Glaucoma (Dilates pupil)

Question 16

NE

Answer 16

DIrect-acting Catecholamines
A & B receptors (a - predominates)
Short-term treatment of shock (hypotension)
Arrhythmia (Dopamine&raquo_space; NE)

Question 17

Dopamine

Answer 17

Direct-acting Catecholamines
A, B, D receptors depending on dose
Alternative to NE

Question 18

Isoproterenol

Answer 18

Direct-acting Catecholamines

Non-Selective B1 and B2
Temporary use in 3rd degree AV block until pacemaker insertion

Question 19

Dobutamine

Answer 19

Synthetic, Selective B1

Increase CO in ADHF (Heart Failure)

Question 20

Dipivefrin

Answer 20

Prodrug metabolized to epinephrine
Contract the radial muscle
Clinical (Open-angle Glaucoma)

Question 21

Clonidine

Answer 21

A2 presynaptic receptors (Brain stem)
ADHD (Pediatric)
Do NOT discontinue long-term clonidine use suddenly

Question 22

Fenoldopam

Answer 22

D1 agonist

Treatment in hospital, short-term management of SEVERE Hypertension

Question 23

Albuterol

Answer 23

Direct-acting NON-Catecholamines

DOC for acute respiratory relief (COPD, asthma)

Question 24

Terbutaline

Answer 24

Short-acting

Suppress premature birth

Question 25

Methamphetamine

Answer 25

Indirect-acting agonists C-II Contraindicated in px w/ hypertension, CV disease, Hyperthyroidism, and Glaucoma

Question 26

Tyramine (Not Marketed)

Answer 26

Indirect-acting agonists Found in fermented foods Px w/ MAOI and eat tyramine —>. Hypertensive crisis —> Medical Emergency

Question 27

Cocaine

Answer 27

Indirect-acting Agonists Fatal dose: 1.2g Severe toxic: as low as 20 mg Topical anesthesia to accessible mucous membranes of oral, laryngeal, and nasal cavities

Question 28

Ephedra

Answer 28

1) Weight loss 2) Energy booster 3) Enhance athletic performance Mixed Action Agonists Direct acting a and B agonist