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Pharmacology 3rd Exam > Sympathetic / Adrenergic > Flashcards

Sympathetic / Adrenergic Flashcards

1
Q

Andrenergic transmission steps

A 
Synthesis 
Uptake into vesicles
Release 
Binding to Receptor 
Removal
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2
Q

Rate limiting step in the synthesis

A

Hydroxylation of tyrosine

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3
Q

Inhibitors of synthesis

A

Metyrosine and

Carbidopa

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4
Q

Inhibits transport into vesicle

A

Reserpine

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5
Q

Facilitates release of NE

A

Calcium

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6
Q

Block release of NE

A

Guanethedine

Bertylium

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7
Q

Causes release of NE

A

M - methamphetamine
E - Ephedrine
T - tyramine
A - amphetamine

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8
Q

Removal

Methylaed by

A

COMT

catechol o-methyltransferase

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9
Q

COMT destroys

A

Catecholamines

Epi, NE, dopamine

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10
Q

Removal

Oxidized by

A

MAO

monoamine oxidase

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11
Q

MAO destroys

A

Monoamines

NE, dopamine, serotonin

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12
Q

Inhibits reuptake

A

Cocaine

TCA (tricyclic antidepressants)

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13
Q

Urine metabolites

A

Vanillylmandelic acid
Metanephrine
Normethanephrine

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14
Q

Alpha 1

A 
B - blood vessel - vasoconstriction
P - pili arrector muscle - constriction
S - spinchter
P - constriction
G - glands
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15
Q

Alpha 2

A

Preganglionic - central
Postganglionic - peripheral
Beta islet cells of pancreas

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16
Q

Beta 1

A

Heart

Kidney

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17
Q

Beta 2

A 
B - bronchus
U - uterus
B - blood vessel
S - contraction
P - pancreas; stimulates INSULIN RELEASE
M - metabolism
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18
Q

Beta 3

A

Adipose tissue

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19
Q

Dopamine 1

A 
BV of
Renal
Mesenteric
Coronary
Cerebral
vascular Beds 
VASODILATION
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20
Q

Dopamine 2

A

CNS

STIMULATION

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21
Q

Sub-groups of DIRECT ADRENERGIC AGONISTS

A

Catecholamines

Non-catecholamines

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22
Q

Unique feature of catecholamines

A

3,4-dihydroxybenzene group

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23
Q

Catecholamines

A

Metabolized by COMT and MAO
ineffective orally
Polar
Do not readily penetrate the CNS

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24
Q

Has the HIGHEST potency in activeting the alpha and beta receptors

A

Catecholamines

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25
Q

Non-catecholamines

A

LONGER HALF-LIVES

increased lipid solubility, thus greater access to CNS

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26
Q

[SUBSTITUTION ON THE BENZENE RING]

Absence of ONE OR BOTH -OH GRP IN THE CATECHOL
Without other substitutions

A

Reduce potency
Increase BA after PO
prolongs duration of action
Increase distribution to the CNS

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27
Q

[SUBSTITUTION ON THE ALPHA CARBON]

A

Blocks oxidation by MAO
prolongs action

Ephedrine, amphetamine

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28
Q

Other name for alpha methyl cmpds

A

Phenylisopropylamine

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29
Q

[SUBSTITUTION ON THE BETA CARBON]

Substitution of a hydroxyl group of the beta carbon

A

Decreases activity with the CNS bec of decreased lipid solubility

Enhances agonist activity for both alpha and beta receptors

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30
Q

Directly bind to adrenergic receptors

A

Direct acting sympathomimetics

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31
Q

Alpha 1 blockers

A 
3 PM
Phenylephrine
Phenylpropanolamjne 
Pseudoephedrine
Methoxamine
32
Q

Causes intense vasoconstriction

For hypotensive emergencies

A

PHENYLEPHRINE

Alpha 1 agonist

33
Q

OTC nasal decongestant

A

PHENYLPROPANOLAMINE

alpha 1 agonist

34
Q

Alpha 2 agonist aka

A

Symphatolytics

Symphatoplegics

35
Q

Alpha 2 agonists

A

Sir Charles
C - colonidine
M - methyldopa
G - guanabenz and guanfacine

36
Q

Used for paroxysmal atrial tachycardia

A

Methoxamine

37
Q

Decreases preganglionic sympathetic outflow

Leads to decreased BP

A

Clonidine

Methyldopa

38
Q

Causes ORTHOSTATIC HYPERTENSION

A

All alpha 2 agonist but in methyldopa (mild only)

39
Q

Methyldopa is converted to _________ which is a potent alpha 2 agonist

A

Alpha methyl norepinephrine

40
Q

For gestational hypertension

A

Methyldopa

41
Q

Has a false-positive result in Coomb’s test

A

Methyldopa

42
Q

Clinical use of BETA 2 AGONISTS (-olols)

A

For ASTHMA

43
Q

Reduce uterine contractions in premature labor

A

terbutaline
Ritodrine
Beta 2 agonists

44
Q

The only beta 1 and 2 agonist

A

Isoproterenol

45
Q

Causes intense vasodilation
Reduces mean arterial pressure
Prevent bronchospasm
Stimulates heart more than Epi due to direct effects
Has adverse effects similar to epinephrine

A

Isoproterenol

46
Q

Alpha and beta agonists

A

Epinephrine
Norepinephrine
Dopamine
Dobutamine

47
Q

Drug of choice for ANAPHYLAXIS

Alpha and Beta agonist

A

Epinephrine

48
Q

Epinephrine has _____ onset but ______ duration of action

A

Rapid

Brief

49
Q

Used only when intense vasoconstriction is necessary (septic shock)

A

Norepinephrine

50
Q

Derivative of dopamine but DOES NOT bind to dopamine receptors

A

Dobutamine

51
Q

Increases cardiac output with little change in the heart rate

For congestive heart failure

A

Dobutamine

52
Q

Cause NE release from presynaptic terminals but do not bind to adrenergic receptors

A

Indirect acting

53
Q

Indirect acting adrenergic agonist

A

Tyramine

Amphetamine, methamphetamine

54
Q

Not a clinically useful Drug

Can cause hypertension in depressed patients taking MAOI

55
Q

For NARCOLEPSY,
ADHD
Apetite suppression
Parkinson’s disease

A

Amphetamine

Methamphetamine

56
Q

Displace NE from pre-synaptic terminals and bind to adrenergic receptors

57
Q

Causes narcolepsy

A

Amphetamine & methamphetamine (indirect acting)

Ephedrine (mixed)

58
Q

Mixed adrenergic agonists

A

Ephedrine

Metaraminol

59
Q

Has longer duration of action but less potent than epi

Poor Substrate for COMT and MAO

60
Q

For SHOCK
when Infusion of NE or dopamine is not possible

Acute hypotension

A

Metaraminol

61
Q

Benign prostatic hyperplasia (BPH)

A

Alpha 1 blockers (zosin)

62
Q

First dose phenomenon

A

Alpha 1 blockers (zosin)

63
Q

Treats erectile dysfunction (impotence)

A

Yohimbine

Alpha 2 blocker

64
Q

Alpha 1 and 2 blockers

A

Phenoxybenzamine PO
Irrev
Slow onset, long duration 24 hrs

Phentolamine IV
ReV
Rapid onset, short half-life 4 hrs

65
Q

Hypertension due to

  • PHEOCHROMOCYTOMA
  • inatake of MAOIs or symphatomimetics
A

Alpha 1 and 2 blockers

66
Q

Vasospasm in reynaud’s syndrome

A

Alpha 1 and 2 blockers

67
Q

Lowers BP

Triggers ASTHMA

A

Beta 1 and 2 blockers

68
Q

For hypertensive patients with impaired pulmonary function

A

Beta 1 blockers

69
Q

Beta 1 and 2 blockers

A 
Propanolol
Nadolol
Timolol
Sotalol
Labetalol and carvedilol
70
Q

Causes arrhythmias and fasting hypoglycemia due to decreased glycogenolysis

A

Propanolol

71
Q

For angina pectoris

Requires only one dose per day

72
Q

Only beta-blocker for the eye (open-angle glaucoma)

73
Q

Has action potential prolonging actions

74
Q

Maintenance of sinus rhythm in patients with atrial fibrillation

75
Q

For diabetic hypertensive patients who are receiving insulin or oral hypoglycemic agents

A

Beta 1 blockers

76
Q

Indirect-acting adrenergic antagonists

A

Guanethidine

Reserpine

Pharmacology 3rd Exam (2 decks)

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