Pharmacology: Katzung symphathomimetics

Question 1

What are the two classes of symphathomimetics?

Answer 1

(1) direct acting

(2) indirect acting

Question 2

What are the two classes of direct acting symphathomimetics?

Answer 2

(1) Alpha agonists

(2) Beta agonists

Question 3

What are the two classes of indirect acting symphathomimetis?

Answer 3

(1) releasers

(2) re-uptake inhibitors

Question 4

What are the three subclasses of direct acting sympathomimetics?

Answer 4

(1) catecholamines
(2) Non-catecholamines
(3) Non-catecholamine beta selective.

Question 5

To what drug class do epinephrine, norepinephrine, Dopamine, isoproterenol, and dobutamine belong to?

Answer 5

They are catecholamines.

Question 6

What is the mechanism of action for Epinephrine?

Answer 6

Epinephrine is an alpha 1 & 2, Beta 1,2, & 3 agonist.

Question 7

What is the clinical use for epinephrine?

Answer 7

Epinephrine is used for anaphylaxis and hemostasis.

Question 8

What are the major toxicities of epinephrine?

Answer 8

(1) hypertension
(2) arrythmia
(3) stroke
(4) MI
(5) pulmonary edema

Question 9

What is the mechanism of action for Norepinephrine?

Answer 9

Alpha 1 & 2. Beta 1 agonist.

Question 10

What are the clinical uses for Norepinephrine?

Answer 10

Neurogenic shock, last resort therapy in shock.

Question 11

What are the adverse effects associated with norepinephrine?

Answer 11

(1) vasospasm
(2) tissue necrosis
(3) excessive blood pressure increase
(4) arrythmias
(5) infarction

Question 12

What is the mechanism of action for dopamine?

Answer 12

D1, Alpha1, Alpha 2, beta 1, beta 2, beta 3 agonist

Question 13

What are the clinical uses for dopamine?

Answer 13

(1) Shock
(2) renal shutdown
(3) occasionally heart failure

Question 14

What are the adverse affects of dopamine?

Answer 14

(1) cardiovascular disturbances

(2) arrythmias

Question 15

What is the mechanism of action for isoproterenol?

Answer 15

Isoproterenol is a Beta 1, 2, & 3 agonist

Question 16

What is the clinical use for isoproterenol?

Answer 16

isoproterenol is used for acute asthma by nebulizer.

Question 17

What is the mechanism of action for dobutamine?

Answer 17

Dobutamine is a beta 1 agonist

Question 18

What is the primary clinical use for dobutamine?

Answer 18

Dobutamine is a beta 1 agonist used in acute heart failure to increase cardiac output.

Question 19

What is the mechanism of action for phenylephrine?

Answer 19

Phenylephrine is an alpha 1 alpha 2 agonist

Question 20

What is the primary clinical use for phenylephrine?

Answer 20

(1) decongestant
(2) Mydriatic
(3) neurogenic hyotension.

Question 21

What are the adverse affects associated with phenylephrine?

Answer 21

(1) hypertension
(2) stroke
(3) MI

Question 22

What is the mechanism of action for albuterol, metaproterenol, terbutaline, Salmeterol, and formoterol?

Answer 22

They are all Beta 2 agonists.

Question 23

What is the primary clinical use for albuterol, metaproterenol, and terbutaline?

Answer 23

They are used for prompt onset for acute bronchospasm.

Question 24

What are the adverse effects of the selective beta 2 agonists?

Answer 24

(1) tachycardia

(2) tremor.

Question 25

What are clinical uses for salmeterol, and formoterol?

Answer 25

Salmeterol, and formoterol are not useful in acute bronchospasm. They are used only with corticosteroids for prophylaxis. Slow onset, long action.

Question 26

What are the three classes of indirect acting symphathomimetics?

Answer 26

(1) Phenylisopropylamines (2) cocaine (3) Tyramine

Question 27

What class of drugs do amphetamine, methamphetamine, and ephedrine belong to and what is their mechanism of action?

Answer 27

They are phenylisopropylamines. The MOA is that they displace stored catecholamines.

Question 28

What are the clinical uses for Amphetamine and methamphetamine?

Answer 28

(1) narcolepsy (2) anorexiant (3) ADHD

Question 29

What are the adverse effects associated with Amphetamine and methamphetamine?

Answer 29

(1) High addiction liability (2) Paranoia (3) aggression (4) insomnia (5) Hypertension

Question 30

What are the clinical uses for ephedrine?

Answer 30

(1) narcolepsy (2) idiopathic postural hypotension (3) enuresis Lower addiction liability than amphetamines

Question 31

What is the mechanism of action for Cocaine?

Answer 31

Cocaine blocks norepinephrine and dopamine re-uptake

Question 32

What are the clinical uses for cocaine?

Answer 32

(1) local anesthetic | (2) intrinsic hemostatic action

Question 33

What are the adverse effects associated with cocaine?

Answer 33

(1) very high addiction liability (2) Hypertension (3) arrythmias (4) siezures. (common with overdose)

Question 34

What is the mechanism of action for tyramine?

Answer 34

Tyramine displaces stored catecholamines

Question 35

What are the clinical uses for tyramine?

Answer 35

No clinical uses but found in fermented foods

Question 36

How is tyramine metabolized?

Answer 36

Usually has a high first pass effect however in those taking MAO inhibitors it is absrobed.

Question 37

What are the adverse effects associated with tyramine?

Answer 37

(1) hypertension (2) arrythmias (3) stroke (4) MI

Question 38

What effect can MAO and COMT inhibitors have on symphathomimetics?

Answer 38

They will increase the intracellular stores of catecholamines and may therefore potentiate the action of catecholamine releasers.

Question 39

Amphetamines have what unique pharmacokinetic property?

Answer 39

amphetamines are resistant to MAO.

Question 40

Where are alpha 1 receptors found?

Answer 40

(1) vascular smooth muscle (contraction) (2) eye (contraction of pupillary dilator and pilomotor smooth muscle) (3) Liver (stimulate glycogenolysis)

Question 41

Where are alpha 2 receptors found?

Answer 41

(1) Nerve terminals (inhibits transmitters) (2) Platelets (stimulate aggregation) (3) Some vascular smooth muscle (contraction) (4) fat cells (inhibits lipolysis) (5) pancreatic beta cells (inhibits insulin release)

Question 42

Where are Beta 1 receptors found?

Answer 42

(1) heart ( increases HR and contractility) | 2) Juxtaglomerular cells (stimulates renin

Question 43

Where are beta 2 receptors found?

Answer 43

(1) Airway, uterine, and vascular smooth muscle (relaxes) (2) Liver (stimulates glycogenolysis) (3) pancreatic beta cells (stimulates insulin release (4) somatic motor neuron terminals (causes tremor) (5) Heart (stimulates rate and force)

Question 44

Where are beta 3 receptors found?

Answer 44

(1) fat cells (stimulates lipolysis)

Question 45

Where are D1 receptors found?

Answer 45

renal and splanchnic blood vessels (dilates)

Question 46

Where are D2 receptors found?

Answer 46

Nerve terminals (inhibits adenylyl cyclase.)

Question 47

What kind of drug is clonidine?

Answer 47

Clonidine is an alpha 2 agonist

Question 48

What are the effects of the alpha 2 agonists like clonidine?

Answer 48

(1) vasoconstriction when taken IV | (2) reduced sympathetic outflow and blood pressure when given orally.

Question 49

What are the effects of beta agonists on the heart?

Answer 49

They increase rate and contractility. The direct effect overcomes the baroreceptor reflex from the increased pressure.

Question 50

What are the effects on the heart of the pure alpha agonists?

Answer 50

They usually slow the heart rate because of the baroreceptor reflex.

Question 51

What class of drug is tetrahydrozoline?

Answer 51

Tetrahydrozoline is an alpha agonist use to produce mydriasis.

Question 52

What class of drugs do apraclonidine and brimonidine belong to?

Answer 52

They are alpha 2 agonists that are used for glaucoma

Question 53

What is midrodine?

Answer 53

Midrodine is an alpha 1 agonist that is used for orthostatic hypertension.