Sympathomimetics Flashcards
EPI
a1 a2 b1 b2
Use: anaphylaxis, gluacoma (open angle), asthma, hypotension
NE
a1, a2, some b1
Use: hypotension but reduce renal perfusion
Isoproterenol
B1 and B2
USE: torsade de pointes, as tachycardia decreases QT interval, bradhyarrhythmias (but can worsen ischemia)
Dopamine
Low dose: D1
Medium dose: b1 b2
High dose: a2 a2
USE: shock (renal perfusion), cardiac failure: inotropic and chronotropinc
Dobutamine
B1 only
USE: heart failure, cardiac stress testing, inotropic and chronotropic
Phenylephrine
A1»A2
USE: hypotension, ocular procedure (mydriatic), rhinitis (decongestion)
Albuterol, slaboterol, terbutaline
B2»_space;B1
Metaproterenol and albuterol for acute asthma;
salmeterol for long term asthma or COPD
Terbutaline to reduce premature uterine contraction
Ritodrine
B2 only
Reduces premature uterine contraction
Amphetamine
indirect sympathomimetics
release stored catecholamines
USE: narcolepsy, obesity, ADD
Ephedrine
indirect sympathomimetics
release stored catecholamines
Nasal decongestion, urinary incontinence, hypotension
Cocaine
indirect sympathomimetics
blocks reuptake
Causes vasoconstriction, and local anesthesia
NEVER NEVER give beta blockers if cocaine intoxication is suspected => this will lead to unopposed alpha activation and extreme hypertension.
NE vs. isoproterenol
NE causes increase in systolic and diastolic pressure as a result of alpha mediated vaso constriction => increase mean arterial pressure => bradycardia.
However, isoproterenol has little alpha effect and cause beta2 mediated vasodilation, resulting in decreased mean arterial pressure and increasing heart rate via B1 and reflex activity
Clonidine and alpha methyldopa
Centrally acting alpha 2 agonists, decreases central sympathetic outflow
Application: HTN, especially with renal disease (no decrease in blood flow with kidney)
