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Pharmacology > Sympathetic Drugs (Adrenergic) > Flashcards

Sympathetic Drugs (Adrenergic) Flashcards

1
Q

Neurotransmitter in Sympathetic

A

Preganglionic - Ach
Postganglionic - NE

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2
Q

Catecholamines Synthesis

A

Phenylalanine → L-tyrosine → L-Dopa → Dopamine → Norepinephrine → Epinephrine

Enzymes:
Phenylalanine hydroxylase
Tyrosine Hydroxylase
Dopa decarbocylase
Dopamine b-hydroxylase
Phenylethanolamine N-Methyltransferase

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3
Q

Neurotransmitter Synthesis

A

Tyrosine Uptake → DOPA → Dopamine → NE Synthesis → NE release → NE Binding → Metabolism (MAO, COMT), → Reuptake

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4
Q

Metyrosine

A

Inhibits Tyrosine Hydroxylase

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5
Q

Reserpine

A

Inh. reuptake of NE to vesicles

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6
Q

Bretylium

A

Inh. release of NE

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7
Q

TCA, Cocaine

A

Inh. reuptake of NE, Binds to NET

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8
Q

Non-Selective Direct-Acting

A

Epinephrine
Norepinephrine
Dopamine

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9
Q

Natural Catecholamines Pharmacodynamics

A

Higher affinity to Beta than alpha
Epinephrine: B1 = B2 > A1
Norepinephrine: B1 > A1
Dopamine: D1 > B1 > A1

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10
Q

Natural Catecholamines Pharmacokinetics

A

Undergo extensive first pass effect
(decreased oral BA)

  • Routes: IV, SQ, inhalation
  • Metabolism by MAO & COMT
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11
Q

DOC for Anaphylactic Shock & Cardiac stimulant

A

Epinephrine

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12
Q

Treating patients with bleeding conditions and ventricular fibrillation

A

Epinephrine

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13
Q

DOC for Septic Shock

A

Norepinephrine/Noradrenaline/Levaterenol - Inotropic Agent

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14
Q

Treatment of shock with Hypertension (Cardiogenic Shock, Septic Shock, Hypovolemic Shock)

A

Dopamine

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15
Q

Dopamine Doses

A

1-3 mcg/kg/min: D1 activation
2-5 mcg/kg/min: B1 activation
> 5 mcg/kg/min: A1 activation

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16
Q

Alpha1 Overstimulation

A

Digital necrosis

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17
Q

Beta 1 Overstimulation

A

Tachyarrhythmias

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18
Q

Non-selective Beta Agonist

A

Isoproterenol
B1 = B2 > A

19
Q

Beta 1 Selective Agonist

A

Dobutamine

20
Q

Dobutamine

A

Cardioselective
Shock with NO Hypertension

21
Q

First line for Cardiogenic Shock & Acute Heart Failure

A

Dobutamine

22
Q

Beta 2-selective Agonist

A

SABA (short-acting beta agonists)
* Albuterol/Salbutamol
* Terbutaline

LABA (long-acting)
* Salmeterol - slow onset of action
* Formoterol - fast onset of action
* Bambuterol
* Indacaterol

Tocolytics
* Ritodrine
* Isoxsuprine - most common
* Terbutaline (SQ) - off-label

23
Q

Alpha1-selective Agonists

A

Phenylephrine (decongestant)
Methoxamine
Propyhexedrine
Tetrahydrozoline
Oxymetazoline
Nafazoline

24
Q

Alpha 2-selective Agonists

A

Clonidine
Methyldopa
Guanfacine
Guanabenz
Dexmedetomidine
Aparaclonidine
Brimonidine

25
Q

Management of Hypertension in pregnant

A

Methyldopa

26
Q

Alpha-2 agonist, false neurotransmitter

A

Methyldopa

Converted to alpha-methylnorepinephrine
(Coomb’s Test – test for hemolytic anemia)

27
Q

Phenylephrine

A

Nasal decongestant
Orthostatic hypotension
Mydriasis

28
Q

Treatment of orthostatic hypotension caused by infections in infants or induced by psychotropic agents

A

Midodrine - Alpha 1 agonist

29
Q

Topical decongestant

A

Oxymetazoline

30
Q

Activates ocular alpha-2; Antiglaucoma

A

Apraclonidine, Brimonidine

31
Q

Clonidine uses

A

Treatment of ADHD
Anti-hypertension
Treatment of opioid Dependence

32
Q

Dexmedetomidine

A

Analgesic + Sedative effect

33
Q

D1-selective Agonist

A

Fenoldepam - Hypertension crisis

34
Q

Mirabegron

A

Selective β3 agonist

35
Q

Relaxes detrusor smooth muscle, increases urinary bladder capacity, promotes urinary retention

A

Mirabegron

36
Q

Indirect-Acting

A

a. NE Displacers
* Amphetamine, Methylphenidate, Modafinil

b. Reuptake Inhibitors
* TCAs, Cocaine, SNRIs, Reboxetine

37
Q

Treatment of narcolepsy

A

Amphetamines

38
Q

DOC for ADHD

A

Methylphenidate

39
Q

Psychostimulant

A

Modafinil

40
Q

First natural local anesthetic

A

Cocaine

41
Q

Ephedrine

A

Obtained from Ma Huang
Nasal decongestant
Anti-asthma
Management of Hypotension

42
Q

Pseudoephedrine

A

Nasal decongestant

43
Q

Phenylpropanolamine/Norephedrine

A

Nasal decongestant
Risk of cerebral hemorrhage

Pharmacology (26 decks)

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