Pharm REVERSE - adrenergic agonists

Question 1

agonist of a₁, a₂, B₁

Answer 1

Norepinephrine

Question 2

Effects:

1) Peripheral vasoconstriction
- increased peripheral vascular resistence (a₁)

2) Increased blood pressure (a₁)
3) can cause reflex bradycardia (vagally mediated)

Answer 2

Norepinephrine?

Question 3

Therapeutic effects

1) used as a vasoconstrictor under certain intensive care situations (i.e. shock) (a₁)
2) elevate blood pressure during reduced sympathetic tone (neurological injury or during use of spinal anesthesia) (a₁)

Answer 3

Norepinephrine

Question 4

agonist of a₁, a₂, B₁, B₂

Answer 4

Epinephrine

Question 5

Effects:

1) Increased heart rate, contractile force, cardiac output
2) Increased systolic, decreased diastolic blood pressure
3) Constriction of most vascular beds but dilation of skeletal muscle blood vessels - net effect is to decrease peripheral vascular resistence

Answer 5

Epinephrine

Question 6

Effects

Bronchodilation (B₂)

Answer 6

Epinephrine and Isoproterenol

Question 7

1) Hyperglycemia (stimulates gluconeogensis and glycogenolysis; inhibits insulin release)
2) Lipolysis - increase free fatty acids

Answer 7

Epinephrine

Question 8

Therapys

1) rapid relief of hypersensitivity reactions to drugs and other allergens
2) Co-administered with local anesthetics to increase duration of action
3) Bradyarrhythmias - restore rhythm in patients with cardiac arrest
4) opthalmic uses - mydriatic, decrease hemorrhage, conjunctival decongestion

Answer 8

Epinephrine

Question 9

Agonist of B₁, B₂

Answer 9

Isoproterenol

Question 10

Effects

1) Decrease peripheral resistance
2) Increase heart rate, contractile force, cardiac output
3) Decrease mean blood pressure

Answer 10

Isoproterenol

Question 11

Therapeutic use:

In emergencies to stimulate heart rate during bradycardia or heart block

Answer 11

Isoproterenol

Question 12

agonist of DA₁, B₁, a₁

Answer 12

Dopamine

Question 13

Therapeutic use

severe decompensated heart failure, shock (cardiogenic; septic)

Answer 13

Dopamine

Question 14

B₁ agonist

Answer 14

Dobutamine

Question 15

Effects:

1) Increased cardiac rate, contractility and output (B₁)
2) Minimal change in peripheral resistence and blood pressure

Answer 15

Dobutamine

Question 16

Therapys

1) short term treatment of cardiac decompensation (surgery, CHF, MI) (B₁)
2) cardiac stress testing (B₁)

Answer 16

Dobutamine

Question 17

a₂ receptor agonist

Answer 17

Methyldopa and Clonidine

Question 18

Thearpeutic use:

anti-hypertensive (a₂)

Answer 18

Methyldopa + clonidine

Question 19

Side effects:

Sedation

dry mouth

edema

rebound hypertension with sudden discontinuation

Answer 19

Methyldopa + Clinidine (dry mouth in 50% of patients)

Question 20

1) Phenylephrine
2) Clonidine
3) Albuterol
4) Salmeterol

Answer 20

What drugs are direct acting Adrenergic agonists that are non-catecholamines? (4)

Question 21

a₁ adrenergic agonist

Answer 21

Phenylephrine

Question 22

Therapuetic use:

1) opthalmic: mydriatic, decrease hemorrhage, conjuctival decongestion (a₁)
2) nasal decongestant: oral or nasal spray (a₁)
3) used with local anesthetics to increase duration of action (a₁)
4) treatment of hypotension (orthostatic hypotension, shock) i.v. administration (a₁)

Answer 22

Phenylephrine

Question 23

Effects:

1) Prolonged blood pressure lowering (a₂ - CNS)
2) Decreased peripheral resistance, heart rate and cardiac output (a₂ - CNS)

Answer 23

Clonidine

Question 24

B₂ adrenergic receptor agonist

Answer 24

Albuterol and Salmaterol

Question 25

available only for inhalation

Answer 25

Salmeterol

Question 26

duration of action = over 12 hours

Answer 26

Salmeterol

Question 27

They release endogenous norepinephrine from nerve terminals

Answer 27

What is the mechanism of action for indirect acting adrenergic agonists?

Question 28

Indirect acting adrenergic agonist

Answer 28

Tyramine

Question 29

Increases norepinephrine release AND stimulates adrenergic receptors

Answer 29

mixed acting adrenergic agonist drugs

Question 30

What are the Mixed acting adrenergic agonist drugs?

Answer 30

1) Amphetamine
2) Ephedrine
3) Pseudoephedrine

Question 31

Powerful CNS stimulant

Is a weak direct alpha and beta agonist itself

Answer 31

What is the effect of Amphetamine?

Question 32

1) Direct agonist of alpha and beta receptors
2) Releases NE that activates adrenergic receptors

Answer 32

Ephedrine

Question 33

toxic plus weak CNS stimulation

Answer 33

Ephedrine

Question 34

Direct a₁ agonist (little B₂ activity)

Answer 34

Pseudoephedrine

Question 35

CNS stimulation, but less than Ephedrine

Answer 35

What is the effect of Pseudoephedrine?