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Pharm > Sympathomimetics > Flashcards

Sympathomimetics Flashcards

1
Q

Transportvof Dopamine into vesicles is blocked by?

A

Reserpine

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2
Q

Release of vesicles from cell membrane is blocked by?

A

Guanethidine and bretylium

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3
Q

Reputake of NorEpi is inhibited by?

A

Cocaine and TCA

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4
Q

Where is NorEpi metabolized?

A

By COMT in plasma and MAO in synaptic cleft

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5
Q

What is the MOA of M2 receptors in the heart?

A

Inhibition of adenylate cyclase > opening of K channels, slowing rate of Phase 4 depolarization and decrease HR

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6
Q

MOA of M3 receptors in smooth muscles and glands

A

Formation of IP3 and increase intracellular Ca+

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7
Q

Epinephrine (chart)

A

Mechanism: direct general agonist (a1, a2, b1, b2)

App: anaphylaxis, glaucoma (open angle), asthma, hypotension with LA

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8
Q

NorEpinephrine (chart)

A

Mechanism: a1, a2, b1

App: Hypotension (decreases renal perfusion) (organ ischemia)

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9
Q

Isoproterenol (chart)

A

Mechanism: B1=B2

App: AV block (rare)

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10
Q

Dopamine (chart)

A

Mechanism: D1=D2 > B > a

App: Shock (increases renal perfusion & GFR), heart failure

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11
Q

Dobutamine (chart)

A

Mechanism: B1>B2

App: Shock, CHF

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12
Q

Amphetamine (chart)

A

Mechanism: indirect general agonist, releases stored catecholamines

App: narcolepsy, obesity, ADHD

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13
Q

Ephedrine (chart)

A

Mechanism: indirect general agonist, releases stored catecholamines

App: nasal decongestant, urinary incontinence, hypotension, hypotension w/ epidural/spinal A.

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14
Q

Phenylephrine (chart)

A

Mechanism: a1>a2 “pure agonist”

App: pupil dilator, vasoconstrictor, increases SVR & MAP, nasal decongestant

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15
Q

Albuterol, terbutaline (chart)

A

Mechanism: B1> B2

App: asthma, premature labor

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16
Q

Cocaine (chart)

A

Mechanism: indirect general agonist, uptake inhibitor

App: causes vasoconstriction and local anesthesia

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17
Q

Clonidine, a-methyl dopa (chart)

A

Mechanism: centrally acting a2 agonist, decreases central sympathetic outflow

App: HTN, decreases MAC, increases anesthesia/analgesia

18
Q

Prototype of sympathomimetics

A

Epinephrine

19
Q

Where is Epinephrine?

A

Synthesized, stored, and released from adrenal medulla

20
Q

_____ is 2-10 x more potent than ______ as a renal vasoconstrictor

A

Epinephrine; NorEpinephrine

21
Q

___ receptors are more sensitive to lower epi doses while effects on ___ receptors predominate at higher doses

A

B2; a1

22
Q

Where is NorEpi located?

A

Synthesized and stored in postganglionic sympathetic nerve endings

23
Q

Vascular capacitance is = to?

A

Change in volume/ change in pressure

24
Q

Vascular capacitance

A

The measure of a blood vessel’s ability to increase the volume of blood it holds w/o a large increase in BP

25
Q

____ has a more significant chronotropic effect than NorEpinephrine

A

Epi

26
Q

With NorEpi, peripheral vasoconstriction may decrease tissue blood flow to the extent that _____ occurs

A

Metabolic acidosis

27
Q

NorEpi is primarily eliminated by?

A

Reuptake into the adrenergic nerve endings where it is stored for future release

28
Q

First line agent in tx of refractory hypotension during severe sepsis

A

NorEpi

29
Q

Use NorEpi cautiously in patients with ____

A

RV failure

30
Q

Commonly selected sympathomimetic to increase systemic BP in the presence of sympathetic nervous system blockade produced by regional anesthesia OR hypotension d/t inhaled or injected anesthetics

A

Ephedrine

31
Q

Why is Phenylephrine thout to be good for patients with CAD and aortic stenosis?

A

It increases coronary perfusion pressure w/o chronotropic side effects (unlike most sympathomimetics)

32
Q

Reflex vagal effects of ____ can be used to slow HR in the presence of hemodynamics lily significant SVT

A

Phenylephrine

33
Q

Phenylephrine can improve arterial oxygenation when used with ____?

A

Nitrous oxide

34
Q

Rapid administration ___ mcg/kg of ____ to anesthetize patients with CAD causes a transient impairment of LV global function

A

1; Phenylephrine

35
Q

Phenylephrine overdose preferentially distributes blood where?

A

To the pulmonary vascular beds

36
Q

What is the natural protection of pulmonary vascular overload?

A

Maintain CO

37
Q

How do PDE (III) inhibitors in myocardium work?

A

Increased cAMP stimulates protein kinase that phosphorylates the SR increasing the inward Ca current. This increases intracellular Ca and contractility.

38
Q

How do PDE (III) inhibitors in vascular smooth muscles work? (Venous & arterial)

A

Increased cAMP decreases Ca available for contraction by facilitating the reuptake by the SR. Leads to smooth muscle relaxation and vasodilation

39
Q

Inotropic effects of milrinone are reduced by _____ reflecting decreased ____ formation in acid optic muscle

A

Acidosis; cAMP

40
Q

Is Milrinone FDA approved for heart failure?

A

No

41
Q

What dose of NorEpi to tax refractory hypotension

A

2-16mcg/min

42
Q

What solution do you store NorEpi in to prevent oxidation

A

5% glucose solution

Pharm (15 decks)

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