Section 2b Adrenergic Drugs Flashcards
Epinephrine (adrenaline)
potent vasoconstrictor and cardiac stimulant; increase systolic & decrease diastolic; bronchodilation
Causes decreased blood flow to skin, increased blood flow to skeletal muscle and increased force/rate of cardiac contraction
Norepinephrine (noradrenaline)
increase BP (systolic and diastolic)
Dopamine
- vasodilator (low dose D1; D2)
- vasoconstrictor (high dose a)
Isoproterenol (isoprenaline)
cardiac stimulant, potent vasodilator, lowers BP (diastolic and mean, systolic not changed or increased); bronchodilator
Phenylephrine
a1 adrenergic agonist
hypotension; nasal decongestant; glaucoma; and symptomatic relief of eye irritation
what are the general therapeutic effects and adverse effects of a1-adrenergic agonists?
Therapeutic = arterial vasoconstriction (local/general) = increase in BP Adverse = hypertension, headache, bradycardia, cardiac arrhythmia
Midodrine
a1 adrenergic agonist orthostatic hypotension (increases arteriolar and venous tone)
Methoxamine
hypotension, shock (systemic admin)
Oxymetazoline, Tetrahydrozoline, Naphazoline
mydriatic (opthalmic dilation) and decongestant (nasal, ophthalmic)
Clonidine
a2 adrenergic agonist
decrease BP through CNS (decrease sympathetic outflow)
Adverse: drowsiness, dizziness, bradycardia, dry mouth, sedation, fatigue
Guanfacine
a2 agonist
decrease BP through CNS
Adverse: drowsiness, dizziness, hypotension, fatigue, dry mouth
What drug is used for hypertension in pregnancy?
alpha-Methyldopa (a2 agonist)
Brimonidine
a2 agonist
glaucoma; facial erythema (rosacea)
Dobutamine
B1 agonist
used to increase cardiac output with less reflex tachycardia (needed with heart failure)
Albuterol, Terbutaline, Metaproterenol, Salmeterol (Salmerterol is 12h/long lasting)
B2 agonist
causes bronchodilation and uterine relaxation (Terbutaline)
Adverse: hypertension, tachycardia, dizziness, muscle cramps/tremor, headache, nervousness
What are indirect-acting sympathomimetics that inhibit catecholamine storage used for?
ADHD and narcolepsy
Examples of indirect-acting sympathomimetics that inhibit catecholamine storage
Methampethamine, Amphetamine, Modafinil, Reserpine, Guanethidine, Tyramine
What foods have Tyramine, and what metabolizes Tyramine?
- cheese, red wine, smoked or pickled fish, sausage
2. MAO in GI tract and liver
What is a mixed-acting adrenergic agonist?
ephedrine
What drugs inhibit catecholamine reuptake?
amphetamines, atomoxetine (selective NET inhibitor), cocaine, tricyclic antidepressants
What drugs inhibit the metabolism of cateholamines? (5)
MAOI = antidepressants
Non-selective MAOIs: Phenelzine, Iproniazid, Tranylcyproine
Selective MAO-A inhib: Moclobemide
Selective MAO-B inhib: Selegiline (anti-Parkinson’s disease)
What would you give for acute (emergency) hypotension?
norepinephrine or phenylephrine
What would you give for chronic orthostatic hypotension?
midodrine or ephedrine
What would you give for cardiogenic shock?
dopamine or dobutamine
What would you give for HTN?
clonidine
What would you give for heart block?
isoproterenol or epinephrine
What does epinephrine do when given with local anesthetics?
produces vasoconstriction and prolongs the action of local anesthetics
What are potential ADR when too much stimulation occurs due to a1, B1, and B2 agonists?
a1: hypertensino
B1: tachycardia, arrhythmias
B2: skeletal muscle tremor
