Study questions

Question 1

Recall the basic structure of catecholamines, and how substitutions affect degradation.

Answer 1

Benzine ring with adjacent hydroxyl groups and an amine group on the side chain

Substitutions greatly reduces potency and other factors like where it’s broken down and prolonged action
i.e. catecholamines are inactivated by Catechol-O-MethylTransferase in the gut, non-catecholamines are not inactivated in the gut.
i.e. substitutions at alpha carbon block oxidation by MonoAmine Oxidase

Question 2

Describe the MOA of direct and indirect acting catecholamines

Question 3

List the major types and subtypes of adrenergic receptors, including their downstream signaling.

Question 4

Define a pressor agent.

Answer 4

something that is going to increase blood pressure

Question 5

Describe what happens in the cardiovascular system after the administration of an alpha-agonist.

Question 6

Describe what happens in the cardiovascular system after the administration of a beta-agonist.

Question 7

Describe what happens in the cardiovascular system after the administration of a mixed agonist.

Question 8

Name a typical nonselective α agonist, a selective α2 agonist, a nonselective β agonist, a selective β1 agonist, selective β2 agonists

Question 9

List tissues that contain significant numbers of α1 or α2 receptors.

Question 10

List tissues that contain significant numbers of β1 or β2 receptors.

Question 11

List the major clinical applications of the adrenoceptor agonists.

Question 12

Define the triphasic effects of dopamine.

Question 13

Delineate the decision in selecting a specific adrenergic agonist.

Question 14

List the most common toxicities associated with sympathomimetics.

Question 15

Describe and compare the effects of an α blocker on the blood pressure and heart rate.

Question 16

Differentiate the effects of a blocker in the presence or absence of an agonist.

Question 17

List the alpha and beta blockers described in class, and their clinical uses.

Question 18

Explain the following sentence: Phentolamine converts a pressor (epinephrine) into a depressor.

Question 19

Define the difference between selective and non-selective beta-blockers.

Question 20

Describe the clinical indications and toxicities of typical α and β blockers.

Question 21

1. Evaluate blood pressure including procedure, MAP, and category.

Answer 21

Use of a sphygmomanometer uses rise and fall of mercury to measure BP

Map= diastolic + 1/3(SBP-DBP)

Normal: <120/80
prehtn: 120-135/80-89
HTN: >140/90

Question 22

2. Describe the regulators of blood pressure including cardiac output and PVR.

Answer 22

PVR- how much tone is on our arteries at a given time

Average is 5L of blood/person

CO=SVXHR

Hydraulic equation
(BP)= CO X PVR

Question 23

3. Define anatomic control sites for blood pressure.

Answer 23

resistance arterioles
capacitance venules
pump output in the heart
volume kidneys RAAS system

Question 24

4. Recall non-pharmacologic intervention for elevated blood pressure.

Answer 24

Diet
weight
stress
smoking

Question 25

5. List 4 major groups of antihypertensive drugs and give examples of drugs in each group. (Renin inhibitors are not considered an independent major group; can you name the one available drug that acts by this mechanism?)

Answer 25

Diuretics
sympathoplegic
direct vasodilators
anti-angiotensin

betablockers block the release of renin

Question 26

6. Describe the targets (receptor and location) for the centrally acting sympathoplegics clonidine and methyldopa, overall effects, indications for use, and major side effect.

Answer 26

alpha 2 receptors in the periphery
block sympathetic response. Clonidine is not as specific for alpha 2 so you have a brief rise in BP before decrease

Overall effects: Decreases cardiac output

Indications: htn- methyldopa doesn’t cross Placenta barrier
ADHD, Tourette’s, withdrawal symptoms

side effects: sedation

Question 27

7. List the major sites of action of peripheral sympathoplegic drugs in clinical use and give examples of drugs that act at each site.

Question 28

8. List dose for metoprolol, atenolol, and esmolol.

Question 29

9. List the mechanisms of action of vasodilator drugs, and 4 classifications.

Question 30

10. Describe the compensatory responses to vasodilators.

Question 31

11. List the major antihypertensive vasodilator drugs and describe their effects.