Sympathetic Activation & Inhibition Flashcards

1
Q

Adrenergic receptors

A

alpha1
alpha2
beta1
beta2

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2
Q

Alpha1 stimulation

A

Vascular smooth muscle contraction

  • increase peripheral resistance
  • increase BP
  • Mydriasis
  • increase bladder sphincter muscle contraction
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3
Q

Where are alpha2 receptors located?

A
  • beta cells (pancreas)
  • Certain smooth muscle cells
  • Presynaptic nerve
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4
Q

Alpha2 stimulation

A

inhibit NE release (negative feedback mechanism)

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5
Q

Beta1 stimulation

A
  • Increase HR (Tachycardia)
  • Increase lipolysis
  • Increase myocardial contractility
  • Increase release of renin
    (HEART)
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6
Q

Beta2 stimulation

A
  • Vasodilation
  • Slight decreased peripheral resistance
  • Bronchodilation
  • Increased lipolysis
  • Increased insulin release
  • Decreased uterine tone
  • Response to drop in BP 2/2 vasodilation, HR will increase
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7
Q

Skeletal muscles have what type of receptors?

A

alpha1

beta2

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8
Q

Heart has what type of receptors?

A

beta1

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9
Q

Lungs have what type of receptors?

A

beta2

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10
Q

Direct sympathomimetics: mechanism?

A

Bind adrenergic receptors, without interacting with the presynaptic neuron

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11
Q

Direct sympathomimetics:

examples?

A
Epinephrine
Norepinephrine
Isoproterenol
Dopamine
Dobutamine
Phenylephrine
Albuterol / Levalbuteral / Salmeterol
Terbutaline
Clonidine
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12
Q

Epinephrine: which receptors?

A

alpha1
alpha2
beta1
beta2

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13
Q

Epinephrine: uses?

A

Anaphylaxis
Severe croup
Hypotension

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14
Q

Norepinephrine: which receptors?

A

alpha1 (Strong)
alpha2 (Strong)
beta1

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15
Q

Norephinephrine: use?

A

Hypotension
Septic shock
Cardiac shock

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16
Q

Isoproterenol: receptors?

A

beta1
beta2

not used clinical anymore

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17
Q

Dopamine: receptors?

A

Low doses - dopamine receptors
Medium doses - beta1 & beta2
High doses = alpha1 & alpha2

Used in shock, but studies showed that it actually did not help in renal perfusion…

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18
Q

Dobutamine: receptors?

A

beta1 (HEART)

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19
Q

Dobutamine: use?

A

Stress test

HF

20
Q

Phenylephrine: receptors?

A

alpha1

21
Q

Phenylephrine: uses?

A

Pupillary dilation

Nasal decongestant

22
Q

Albuterol, Levalbuterol, Salmeterol: receptors?

A

beta2 (Strong)

beta1

23
Q

Albuterol, Levalbuterol, Salmeterol: uses?

A

Asthma (bronchodilation)

24
Q

Terbutaline: receptors?

A

beta2 (Strong)

beta1

25
Q

Terbutaline: uses?

A

Bronchospam

Tocolysis

26
Q

Clonidine: receptor?

A

alpha2

27
Q

Clonidine: uses?

A

Decrease BP

However, can see significant rebound HTN

28
Q

Indirect sympathomimetics: mechanism?

A

NE release from presynaptic terminal

Inhibit uptake of NE

29
Q

Indirect sympathomimetics: examples?

A

Amphetamines
Ephedrine
Cocaine

30
Q

Amphetamines: mechanism?

A

Release stored catecholamines

31
Q

Amphetamines: uses?

A

Narcolepsy
Obesity
ADHD

32
Q

Ephedrine: mechanism?

A

Release stored catecholamines

33
Q

Ephedrine: uses?

A

Nasal decongestant

Urinary incontinence

34
Q

Cocaine: mechanism?

A

Inhibits reuptake of catecholamines

35
Q

Cocaine: uses?

A

Nasal decongestant

Local anesthetic

36
Q

Selective alpha1-blockers

A

Prazosin
Doxazosin
Terazosin

Tamsulosin (only prostate)

37
Q

Nonselective alpha-blockers

A

Phenoxybenzamine

Phentolamine

38
Q

Nonselevtice Beta-blockers

A

Propranolol
Timolol
Nadolol

39
Q

Selective Beta1-blockers

A

Metoprolol
Atenolol
Esmolol

40
Q

Weak beta1 and beta2 agonists that act as antagonists

A

Acebutolol

Pindolol

41
Q

alpha1/beta1 blockers

A

Carvedilol

Labetalol

42
Q

Indications for Beta-blockers

A
HTN
CAD
CHF
Hyperthyroid
Migraine ppx
Anxiety
SVT
Glaucoma (Timolol, Nadolol)
Aortic Dissection
43
Q

Adverse effects of Beta2 blockers

A

Bronchoconstriction

44
Q

Adverse effects of general beta-blockers

A

Hypoglycemia (also covers sxs of hypoglycemia)

Rebound tachycardia
Rebound HTN
Arrhythmia

45
Q

Dont give Beta-blockers to what type of patients?

A

Cocaine – Unopposed Alpha1
Asthma / COPD – bronchospasm
Diabetic – hypoglycemia or cover sxs

46
Q

Alpha 2 agonist

A

Clonidine - malignant HTN

alpha-methyldopa - HTN in pregnancy