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Pharmacology > Sympathomimetics > Flashcards

Sympathomimetics Flashcards

1
Q

Sympathetic organ synapse

A

involves post ganglionic neuron synapsing directly at the target organ; kidneys release dopamine (vasodilation), sweat glands release ACH (thermoregulation)

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2
Q

two major types of sympathetics receptors

A

alpha and beta, different roles at different sites in the body

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3
Q

Mimetics also called

A

adrenergic agonists

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4
Q

lytics also called

A

adrenergic antagonists

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5
Q

Mimetics role

A

increase release of neurotransmitters, block reuptake into the presynaptic neuron, decrease metabolism

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6
Q

Lytics

A

decrease neurotransmitter release, deplete vesicular stores, decrease synthesis of neurotransmitters

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7
Q

3 types of adrenergic neurotransmitters

A

dopamine, epinephrine, norepinephrine; all very different, commercially available and regularly used, have to give continuously

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8
Q

baroreceptor reflex

A

when baroreceptors sense increase in BP, will try to turn off sympathetic and turn on parasympathetic with M2 receptors

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9
Q

Dopamine

A

works as an agonist on dopamine receptors, all have B activity, a vasopressor; dose dependent causes range of responses

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10
Q

Norepinephrine (levophed)

A

agonist at a1, a2, B1, very little B2, a pressor; a1=vasoconstriction and increase in BP; B1 *net effect decreases HR

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11
Q

Norepinephrine (levophed)

A

agonist at a1, a2, B1, very little B2, “best” pressor; a1=vasoconstriction and increase in BP; B1 *net effect decreases HR

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12
Q

longest time any pt is on Norepinephrine

A

12 days, try to take off drug as soon as stabilized

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13
Q

ADRs of norepinephrine

A

arrhthmies, bradycardia, peripheral ischemia, HA

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14
Q

Epinephrine

A

Most non-selective, works on all adrenergic receptors, a1=vasoconstriction, B2=vasodilation in skeletal muscle, a and B cancel out with potential for small increase in BP; B1 increases HR

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15
Q

Uses of epinephrine

A

used with local anesthesia to capitalize on vasoconstriction to keep local; anaphylaxis, bronchodilator, symptomatic bradycardia, asystole, VT

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16
Q

ADRs of epinephrine

A

chest pain, arrythmia, flushing, hypertension, tachycardia, anxiety

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17
Q

Phenylephrine (neo-synephrine)

A

a1 agonist, hypotension, no direct effects on heart; increase BP and peripheral vasoconstriction will trigger baroreceptor reflex and decrease HR; slows tachycardia

18
Q

uses of Phenylephrine (neo-synephrine)

A

nasal decongestant, spray or red eyes, drops; also used as decongestant, sudafed; use 3 days and stop or effects will decrease

19
Q

Rebound congestion

A

repeated topical exposure to a* agonist results in receptor desensitization, increase dose to get effects and increase again

20
Q

Isoproterenol is considered a B agonist because

A

it requires very large doses to activate alpha receptors

21
Q

Pressors should be infused via

A

a central line

22
Q

Practical consideration of pressors

A

receptor site selectivity is dose dependent, limb threatening in severe case of estravasation, continuous monitoring required,often required during surgery to balance anesthesia

23
Q

a2 agonists uses and medication

A

used for HTN and muscle spasticity; clonidine (catapres), Methlydopa (aldomet), Tizanidine (zananex), guantacine (tanex)

24
Q

a2 agonists uses and medication

A

used for HTN and muscle spasticity; clonidine (catapres), Methlydopa (aldomet), Tizanidine (zananex), guantacine (tanex)

25
Q

Clonidine (catapres)

A

most common alpha agonist, PO and transdermal, HTN, also ADHD, narcotic withdrawal, severe pain, migraine; ADR drowsiness, HA, fatigue, constipation, dry mouth, bradycardia

26
Q

Methyldopa (aldomet)

A

HTN, limited to HTN in pregnancy, ADR: dizziness, HA, sedation, impotence, hemolytic anemia

27
Q

Tizanidine (zanaflex)

A

muscle relaxor, avoid with hepatic, ADR: hypotension, sedation, dry mouth: DI cipro, fluvoxamine, works faster on empty stomach; old, cheap

28
Q

Guanfacine (tenax)

A

PO, never for hypertension, ADHD, ADRs: drowsiness, dizziness, HA,, dry mouth, many drug interactions

29
Q

B agonist, non-selective

A

isoprterenol (isuprel)

30
Q

B agonist, B1 selective

A

Dobutamine, dopamine

31
Q

B agonist, B2 selective

A

terbutaline, albuterol, levalbuterol, salmeterol, formoterol, vilanterol

32
Q

Isoproterenol (Isuprel)

A

relax bronchial, GI and uterine, increase HR and contractility, peripheral vasodilation, IV continuous, limited use; ADR angina, tachyarrhythmia

33
Q

Isoproterenol (Isuprel)

A

relax bronchial, GI and uterine, increase HR and contractility, peripheral vasodilation, IV continuous, limited use; ADR angina, tachyarrhythmia

34
Q

Dobutamine (dobutrex)

A

Dopamine derivative, strong B1, weak B2, increase force of contraction, not a pressor, give IV contiuous, most common for CHF; ADR: hypotension, tachycardia

35
Q

Terbutaline (Brethine)

A

B2 agonist, relax bronchial and uterine muscle, asthma, *terminate premature contraction, short term only; ADR: bronchospasm, nervousness, trembling

36
Q

Albuterol (Proventil, Ventolin, Proair)

A

B2 agonist, bronchodilation, tablet, syrup nebulizer, and inhaler; doesn’t cause cardio effect; minimal ADR; only emergent DOC; onset 1-2 min, lasts 3-4 hours

37
Q

Levalbuterol (Xopenex)

A

cleaner version of albuterol (only L-isomer); reduces ADR? better bronchiolar B2 affinity? inhaler and nebulizer, controversial; onset 5-10 min, lasts 3-6 hours

38
Q

Salmeterol (serevent)

A

B2 agonist, long acting, respiratory disease, long duration, chronic management, not for emergency; onset 30-48 min lasts 12 hours

39
Q

Formoterol (Foradil)

A

B2 agonist, long acting, respiratory disease, long duration, chronic management, not for emergency; onset 3 min, lasts 10-14 hours

40
Q

Vilanterol

A

B2 agonist, long acting, respiratory disease, long duration, chronic management, not for emergency

41
Q

Aformoterol (brovana)

A

B2 agonist, long acting, respiratory disease, long duration, chronic management, not for emergency; onset 7-20 min, lasts 26 hours

Pharmacology (61 decks)

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