Sympathomimetics

Question 1

Albuterol, salmeterol effect what receptors?

Answer 1

β2 > β1

Question 2

Albuterol, salmeterol clinical use

Answer 2

Albuterol for acute asthma; salmeterol for long- term asthma or COPD control.

Question 3

Dobutamine effects what receptors?

Answer 3

β1 > β2, α

Question 4

Dobutamine clinical use

Answer 4

Heart failure (HF) (inotropic > chronotropic), cardiac stress testing.

Question 5

Dopamine effects what receptors?

Answer 5

D1 = D2 > β > α

Question 6

Dopamine clinical use

Answer 6

Unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at high doses.

Question 7

Epinephrine effects what receptors?

Answer 7

β > α

Question 8

Epinephrine clinical use

Answer 8

Anaphylaxis, asthma, open-angle glaucoma;

α effects predominate at high doses. Signi cantly stronger effect at β2-receptor than norepinephrine.

Question 9

Isoproterenol effects what receptors?

Answer 9

β1 = β2

Question 10

Isoproterenol clinical use

Answer 10

Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia

Question 11

Norepinephrine effects what receptors?

Answer 11

α1 > α2 > β1

Question 12

Norepinephrine clinical use

Answer 12

Hypotension (but decreases renal perfusion). Significantly weaker effect at β2-receptor than epinephrine.

Question 13

Phenylephrine effects what receptors?

Answer 13

α1 > α2

Question 14

Phenylephrine clinical use?

Answer 14

Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant).

Question 15

Amphetamine MoA

Answer 15

Indirect general agonist, reuptake inhibitor, also releases stored catecholamines

Question 16

Amphetamine clinical use

Answer 16

Narcolepsy, obesity, ADHD.

Question 17

Cocaine MoA

Answer 17

Indirect general agonist, reuptake inhibitor

Question 18

Cocaine clinical significance

Answer 18

Causes vasoconstriction and local anesthesia. Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension).

Question 19

Ephedrine MoA

Answer 19

Indirect general agonist, releases stored catecholamines

Question 20

Ephedrine clinical use

Answer 20

Nasal decongestion, urinary incontinence, hypotension.

Question 21

Clonidine and α-methyldopa MoA

Answer 21

Sympatholytics (α2-agonists)

Question 22

Clonidine clinical use

Answer 22

Hypertensive urgency (limited situations); does not decrease renal blood flow
ADHD, Tourette syndrome

Question 23

Clonidine toxicity

Answer 23

CNS depression, bradycardia, hypotension, respiratory depression, miosis

Question 24

α-methyldopa clinical use

Answer 24

Hypertension in pregnancy

Question 25

α-methyldopa toxicity

Answer 25

Direct Coombs ⊕ hemolysis, SLE-like syndrome