Sympathomimetics

Question 1

What are the direct sympathomimetics

Answer 1

Epi
Norepi
Isoproterenol
Dopamine
Dobutamine
Phenylephrine
Albuterol, Salmeterol, Terbutaline

Question 2

Epinephrine
What receptor
Use

Answer 2

B>a agonist

For anaphylaxis
Open angle glaucoma
asthma
hypOtn

a effects predominate at higher doses

Question 3

Norepi
What receptor
Use

Answer 3

a1 > a2 > B1 agonists
no B2

Treats hypOtn but DECREASES renal perfusion
can cause a reflex brady

Question 4

Isoproterenol
What receptor
Use
SEs

Answer 4

B1=B2 (nonselective) agonists

For tachyarrythmias, can worsen ischemia

Via B2 can treat bronchospasm
Brady & Heart block via B1

SE: flushing, angina, arrythmia

Question 5

Dopamine
Receptors?
Uses

Answer 5

D1=D1 >B > a agonist

Uses: Unstable brady, Heart failure, shock
Inotropic and chronotropic a effects at high doses

Question 6

Dobutamine
Receptors?
Uses

Answer 6

B1 > B2 > a

Uses: HF (ino > chronotropic)
cardiac stress testing

Question 7

Dobutamine
Receptors?
Uses

Answer 7

B1 > B2 > a
agonist

Uses: HF (ino > chronotropic)
cardiac stress testing

Increases CO, and contractility

Question 8

Phenylephrine
Receptors
Uses

Answer 8

a1 > a2
agonist

HypOtn (causes vasoconstrictor)
Ocular procedures (mydriatic w/o cycloplegia)
Rhinitis (decongestant)

no B2 so no epi reversal

usu in cold medicine so beware heart patients bc can cause ischemia

Question 9

Albuterol, Salmeterol, Terbutaline
What receptors
Uses

Answer 9

B2 > B1

Albuterol (acute asthma)
Salmeterol (long term asthma COPD control)
Terbutaline (decrease premature uterine contractions)

Question 10

What are the indirect sympathomimetics?

Answer 10

Amphetamine
Ephedrine
Cocaine

Note they don’t act on a receptor bc they are INDIRECT
this is the case for all indirects

Question 11

Amphetamine
MOA
Use

Answer 11

MOA: Indirect general agonist
Reuptake NE inhibitor
Releases stored catecholamines

Uses:
Narcolepsy
Obesity
ADD

Question 12

Ephedrine
MOA
Use

Answer 12

MOA: Indirect General Agonist
Release stored catecholamines (NE)

Uses:
Nasal decongestant
Urinary Incontinence (closes the sphincter to keep the pee in)
HypOtn

Question 13

Amphetamine
MOA
Use

What shouldn’t you mix with?

Answer 13

MOA: Indirect general agonist
Reuptake NE inhibitor
Releases stored catecholamines

Uses:
Narcolepsy
Obesity
ADD

Don’t mix with MAO Inhibitors

Question 14

Ephedrine
MOA
Use

What shouldn’t you mix with?

Answer 14

MOA: Indirect General Agonist
Release stored catecholamines (NE)

Uses:
Nasal decongestant
Urinary Incontinence (closes the sphincter to keep the pee in)
HypOtn

Don’t mix with MAO Inhibitor

Question 15

Cocaine
MOA
Uses

Answer 15

MOA: Indirect general agonist, reuptake inhibitor

Causes vasoconstriction, local anesthetic

DO NOT GIVE A B BLOCKER!! because can lead to unopposed a1 activation and extreme HTN bc no B2 to cause vasodilation bc the B Blocker blocked it

Question 16

What is methoxamine?

Answer 16

Old drug that Increases BP to trigger a reflex brady during paroxysmal atrial tacky

In this case, the atria are beating too fast–>ventricles start beating too fast–>Decrease in CO. so to avoid this, give methoxamine to trigger reflex brady by first causing incr BP via vasoconstriction