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Pharmacology part 3 > Sympathomimetics > Flashcards

Sympathomimetics Flashcards

1
Q

as bronchodilators

A

beta-2 stimulants used to relieve bronchoconstriction in chronic obstructive pulmonary disease (COPD)

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2
Q

receptors involved in bronchodilators

A

Beta-2
alpha-1
beta-1 action-> side effect

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3
Q

leading cause of death

A

COPD

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4
Q

emphysema

A

WBC proteolytic destruction of alveolar wall

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5
Q

asthma

A

allergic or intrinsic precipitated by cold, gasoline, fresh paint

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6
Q

bronchoeictasis

A

dilated bronchi due to damage by infection

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7
Q

chronic bronchitis

A

due to infection

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8
Q

sympathetic bronchodilators

A

can be used to diagnose cause of airway constriction

  • may be due to inflammation of bronchiolar spasms
  • beta-2 stimulants act in seconds
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9
Q

epinephrine works on

A

alpha-1, beta-1, beta-2

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10
Q

albuterol

A

beta-2

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11
Q

metaproterenol

A

beta-2

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12
Q

salmeterol

A

beta-2

-use with steroids

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13
Q

what else do bronchodilators do?

A

increase ciliary activity, inhibit histamine, leukotriene release

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14
Q

beta-2 agonist drugs of choice

A
  • tolerance

- receptor-down regulation prevented or even partly revered with steroids

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15
Q

precautions for adrenergic bronchodilators

A
  • benign essential tremor (from beta-2 stimulation)
  • feelings of anxiety may limit use
  • increased blood sugar: alpha1/beta2 receptors mobilize liver glycogen
  • dry pharyngeal membranes-> problem with epinephrine (vasoconstriction)
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16
Q

nasal decongestants

A

alpha-1 agonists constrict dilated blood vessels and relieve nasal stiffness and headache

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17
Q

nasal decongestant drugs

A
  • phenylephrine
  • pseuoephedrine
  • oxymetazoline
18
Q

phenylephrine

A

give p.o, nose drops or spray

-p.o dose advantages

19
Q

pseuoephedrine

A

still widely available

CNS stimulant

20
Q

oxymetazoline

A

long duration, 12 hours

21
Q

adverse effects to nasal decongestants

A

transient burning
rebound congestion
chemical rhinitis
CNS depression, hypotension (imidazoline)

22
Q

uses of sympathomimetisc in eye

A

Mydriasis
relieve redness, itching
-in allergic hyperemia of conjunctival membrane

23
Q

uses of sympathomimetisc in eye: Mydriasis

A

phenylephrine

  • duration 3 hours, advantage over atropine
  • mydriasis without cycloplegia
24
Q

uses of sympathomimetisc in eye: to relieve itching and redness

A

oxymetazoline

25
Q

adrenergics in acute hypersensitivity

A

involve foods, pollon, drugs, animals

  • beta-2 stimulants inhibit antigen-induced histamine release
  • epinephrine used
26
Q

sympathomimetics in hypotension

A 
"pressor" effects
-below 40 mmHg diastolic or 50 systolic
-critical decrease in flow to heart, brain, gut, liver, kidney
-clinical situations showing decrease BP
general and spinal anesthesia
drug overdose
acute renal failure
27
Q

what are the two ways to increase blood pressure

A
  1. increased cardiac output (beta-1)

2. increased peripheral resistance (alpha-1)

28
Q

norepinephrine

A

lasts about 2 mins
does nothing to CO
increases PR

29
Q

alpha-1 stimulant: Phenylephrin

A

20 mins
decrease CO
increases PR

30
Q

dopamine

A

lasts about 2 mins
increases CO
decreases PR

31
Q

dobutamine

A

lasts about 2 mins
increases CO
does nothing to PR

32
Q

sympathomimetic pressor agents

A
  • short acting ones are substrates for NET and ENT
  • long acting-> smoother pressure control
  • dopamine-> some beta-1, and dilation of renal, coronary and mesenteric beds (D1 receptors)
  • dobutamine-> beta-1 but little increase in rate
33
Q

precautions in using pressor agents

A
  • hyperthyroidism (excess receptors)

- necrosis on prolonged vasoconstriction: Liver, kidney

34
Q

what are some diseases that show adrenergic deficiency

A

PAF: pure autonomic failure
POTS: postural tachycardia syndrome
MSA: multiple systems atrophy

35
Q

PAF

A

disease of post-ganglionic sympathetic nerves

  • onset middle age
  • more common in men
36
Q

POTS

A

50% antecedent viral illness

-4 times more common in females

37
Q

MSA

A

autoimmune degeneration ANS centrally

-twice as common in men

38
Q

adrenergics in sympathetic deficiency

A
  • correct postural hypotension, urinary incontinence and retrograde ejaculation
    mitodrine: alpha-1 agonist, give early in the day avoid nocturnal hypertension
39
Q

sympathomimetics as cardiac stimulants

A

In A-V block to prevent loss of consciousness
-“Stokes Adams” syndrome
-some patients alternate between 2nd and 3rd degree block (skipped beats or complete block)
-definitive treatment-> pacemaker
After bypass surgery
-iv epinephrine, isoproterenol, dobutamine, dopamine

40
Q

indirect-acting sympathomimetics

A
  • Tyramine in some cheese and sausage
  • Dopamine
  • Pseudoephedrine, ephedrine

Pharmacology part 3 (13 decks)

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