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Pharm > Sympathomimetics > Flashcards

Sympathomimetics Flashcards

1
Q

What sets the pace of the SA node and is responsible for the phase 4 depolarization?

A

I-f “the funny current”

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2
Q

What is the resting membrane potential of nodal tissue?

A

-60

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3
Q

What is the resting membrane potential of nodal tissue?

A

-60

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4
Q

Which phases make up the nodal action potential?

A

Phase 0, 3, 4

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5
Q

All Alpha 1 receptors ______ levels of _____.

A

Increase, Calcium

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6
Q

All Alpha 2 receptors ______ levels of _____.

A

Decrease, cAMP

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7
Q

Alpha 2 receptors decrease cAMP by _____.

A

Inhibiting adenylate cyclase

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8
Q

Stimulation of Beta receptors causes a(n) _______ in _____.

A

increase, cAMP

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9
Q

Which beta receptors has an equal affinity for norepi and epi?

A

Beta 1

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10
Q

Which beta receptor has a greater affinity for epi than norepi?

A

Beta 2

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11
Q

What do dopamine 1 receptors do?

A

relaxation of peripheral smooth muscle

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12
Q

Dopamine 1 receptors _____ adenylate cyclase causing ______ cAMP levels.

A

Stimulate, increased.

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13
Q

Where are dopamine 2 receptors primarily located?

A

Brain

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14
Q

Dopamine 2 receptors _____ adenylate cyclase and decrease ______.

A

inhibit, ???

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15
Q

Where is Dopamine synthesized?

A

CNS Neurons

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16
Q

Where is Epi synthesized?

A

Second-order neurons and the adrenal medulla (80%)

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17
Q

Where is norepi synthesized?

A

Second-order neurons, adrenal medulla (20%), and CNS neurons

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18
Q

What are examples of alpha 1 agonists?

A

Norepi, Epi, Phenylephrine

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19
Q

What are examples of alpha 1 antagonists?

A

Phenoxybenzamine, Phentolamine, Prazosin

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20
Q

What are examples of alpha 2 agonists?

A

Dex, Clonidine

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21
Q

What are examples of alpha 2 antagonists?

A

Yohimbine (OTC for alertness)

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22
Q

What are examples of beta 1 agonists?

A

Epi, Norepi, Dobutamine/Dopamine

23
Q

What are examples of beta 1 antagonists?

A

Atenolol, Metoprolol

24
Q

What are examples of beta 2 agonists?

A

Albuterol, Terbutaline

25
Q

What is an example of a beta 2 antagonist?

A

Propranolol

26
Q

Is it an alpha or beta receptor in the eye? What does it do?

A

Alpha, mydriasis (dilation)

27
Q

What is the limiting factor in the synthesis of catecholamines?

A

Tyrosine Hydroxylase

28
Q

What percent of norepi goes back to the presynaptic nerve for reuptake?

A

80%

29
Q

What is the byproduct of the breakdown of Norepi?

A

Vanillylmandelic acid (VMA)

30
Q

What do you test to test for VMA?

A

the urine

31
Q

What is the following for Epi:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A 
Dose: 0.01-.2
Onset: 30-60 sec
Duration: 5-10 min
Receptor/action: Alpha and beta agonist
Effect: increase SBP, decrease DBP (wider pulse pressure) positive chronotrope and inotrope, vasoconstriction from alpha activation
32
Q

What is the following for norepi:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A

Dose: 0.01-0.4
Onset: <1min
Duration: 2-10 min
Receptor/action: more alpha than beta agonism
Effect: Increase SBP AND DBP, increased coronary blood flow, potent vasoconstrictor

33
Q

What is the following for Dopamine:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A 
Dose: Renal dose: 1-3mcg/kg/min
Cardiac: 4-6 mcg/kg/min
Vasopressor: >10mcg/kg/min
Onset: 2-4 min
Duration:<10min
Receptor/action: Renal: D1 agonist, Cardiac: Beta 1 agonist, Vasopressor: Alpha 1 agonist
Effect: D1: vasodilation, increased flow to organs
B1: Increased SVR, CO, contractility
A1: vasoconstriction
34
Q

What is the following for Isuprel:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A 
Dose: 0.02-.15mcg/kg/min
Onset: Immediate
Duration: 1-5 min
Receptor/action: Beta 1 and 2 agonist
Effect: Positive chronotrope and inotrope. Potent vasodilator=decreased systemic and pulmonary vascular resistance.
35
Q

What is the following for Dobutamine:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A

Dose: 0.5-30mcg/kg/min
Onset: 1-2
Duration: <10min
Receptor/action: Beta 1 selective agonist
Effect: Positive chronotrope (AV conduction) and inotrope

36
Q

What is the following for Phenylephrine:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A 
Dose: 50-100mcg
Onset: <1min
Duration: 15-20min
Receptor/action: Pure Alpha 1 agonist
Effect: peripheral vasocontriction, increased SBP & DBP, reflex bradycardia, can also be a decongestant
37
Q

What is the following for Ephedrine:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A

Dose: 5-10mg
Onset: immediate
Duration: 10-60min
Receptor/action: Mixed direct and indirect actions, both alpha and beta agonist.
Effect: increased CO, BP, HR, indirectly causes release of stored catecholamines.

Caution with MAOI’s, sensitize pt and can cause hypertensive emergency.

38
Q

What is the following for Vasopressin:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A

Dose: Bolus 2-4units, Infusion 0.02-0.04 units/min
Onset:
Duration:
Receptor/action: smooth muscle vasoconstrictor.
Effect:

39
Q

What type of med is Terbutaline and what is it used for?

A

B2 agonist

40
Q

What is an example of a phosphodiesterase inhibitor?

A

Milrinone

41
Q

What do phosphodiesterase inhibitors do to cAMP?

A

Decreased hydrolysis (metabolism) of cAMP), resulting in increased concentrations in the myocardium and smooth muscle. Causes positive inotropic effects and smooth muscle dilation.

42
Q

hat is the following for Milrinone:

Dose:
Onset:
Duration:
Receptor/action:
Effect:
A

Dose: 0.25-0.5mcg/kg/min
Onset: 5min
Duration: ??
Receptor/action: increases concentration fo cAMP
Effect: positive inotrope (increased contractility) and decreased pulm pressures.

43
Q

Catecholamines are metabolized by what?

A

COMT

44
Q

Noncatecholamines are metabolized by what?

A

MAO

45
Q

Stimulation of alpha 1 causes:

A 
vasoconstriction
mydriasis
urinary retention
glycogenolysis
inhibition of renin
46
Q

Stimulation of alpha 2 causes:

A

decrease in cAMP which causes a decrease in NE production

decreased insulin

47
Q

Stimulation of Beta 1 causes:

A

increased heart rate
increased contractility
increased renin

48
Q

Stimulation of Beta 2 causes:

A 
bronchodilation
vasodilation
inhibition of uterine contractions
decreased GI motility
decreased insulin secretion
49
Q

What is the substance that turns tyrosine to LDOPA?

A

tyrosine hydroxylase

50
Q

What is the substance that turns Dopamine to norepi within the venticle?

A

Dopamine beta hydroxylase

51
Q

What breaks down NE in the synaptic cleft?

A

COMT

52
Q

What breaks down NE after it re-enters the presynaptic nerve?

A

MAO

53
Q

What 2 things block the reuptake of catecholamines?

A

Tricyclic antidepressants and cocaine

Pharm (12 decks)

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