Sympathomimetics Flashcards

1
Q

mechanism of action

A

DIRECT: direct activation of adrenoreceptors
INDIRECT: indirect activation via increasing catecholamines

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2
Q

non-selective, direct-acting
activates alpha and beta adrenergic recptors
a1: vasoconstriction, increases BP
b1: increase HR, conduction, contractility
b2: bronchodilation
drug of choice for anaphylaxis
used for cardiac arrest, asthma, COPD, hemostasis

A

Epinephrine

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3
Q

side effects of epinephrine

A

hypertension
tachycardia
ischemia
hyperglycemia

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4
Q

epinphrine is added to this to decrease systemic absorption by vasoconstriction

A

lidocaine

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5
Q

term for agent that increases heart rate

A

chronotropic

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6
Q

term for agent that increases conduction

A

dromotropic

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7
Q

term for agent that increases contractility

A

inotropic

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8
Q

non-selective, direct-acting
activates alpha and beta adrenergic receptors
a1: vasoconstriction, increases BP
b1: increases HR, conduction, and contractility
b2: bronchodilation
used for neurogenic shock, cardiogenic shock (last resort)

A

Norepinephrine

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9
Q

side effects of norepinephrine

A
extreme vasospasm
tissue necrosis
excessive BP increase
arrhythmias
infarction
REFLEX BRADYCARDIA: compensatory decrease in HR in response to increase in BP
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10
Q

has high alpha than beta activity

A

norepinephrine

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11
Q

non-selective, direct acting
activates alpha, beta, and D1 adrenergic receptors
a1: vasoconstriction, increases BP
b1: increased HR, conduction, and contractility
d1: vasodilation in splanchnic and renal vessels
used for cardiogenic shock, heart failure
SE: CV disturbance, arrhythmias

A

dopamine

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12
Q

dose-dependent actions of dopamine

A

LOW dose = 1-5 mcg/kg/min; D1 receptors
MEDIUM dose = 5-15 mcg/kg/min; B1 receptors
HIGH dose = > 15mcg/kg/min; Alpha receptors

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13
Q

dopamine dose for cardiogenic shock

A

MEDIUM DOSE

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14
Q

beta-non-selective
non-selectively activates beta adrenergic receptors
b1: increases HR, conduction, and contractility
b2: bronchodilation
used previously for asthma
side effects: CV disturbance, arrhythmias

A

Isoproterenol

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15
Q

selective alpha 1 agonist
a1: vasoconstriction, increases BP
used as nasal decongestant, mydriatic, drug-induced hypotension, orthostatic hypotension, spinal shock
side effects: REBOUND NASAL CONGESTION (rhinitis medicamentosa), supine hypertension, stroke, MI, piloerection, urinary retention

A

Phenylephrine

pseudoephedrine, oxymetazoline, tetrahydrozoline, midodrine, naphazoline, xylometazoline

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16
Q

ocular administration causes mydriasis WITHOUT cycloplegia (vs. atropine, phentolamine)

A

Phenylephrine

pseudoephedrine, oxymetazoline, tetrahydrozoline, midodrine, naphazoline, xylometazoline

17
Q

4 medications that can be used for pregnant hypertensive patients

A
  1. hydralazine (for urgency)
  2. methyldopa (for maintenance)
  3. nifedipine
  4. labetalol
18
Q

selective alpha 2 agonist
a2: decreases central sympathetic outflow (centrally acting vasodilator)
for hypertension, cancer pain, opioid withdrawal
side effect: SEDATION, REBOUND HYPERTENSION (taper use to avoid), dry mouth

19
Q

used to treat rebound hypertension secondary to clonidine

A

Phentolamine

20
Q

selective alpha 2 agonist
a2: decreases central sympathetic outflow
used for pre-eclampsia, gestational hypertension
side effects: sedation, HEMOLYTIC ANEMIA (POSITIVE COOMB’S TEST)

A

Methyldopa

Guanfacine, Guanabenz, Dexmedetomidine, Tizanadine

21
Q

also a muscle relaxant

A

Tizanadine

22
Q

has more sedating effects

A

Dexmedetomidine

23
Q

selective alpha 2 agonist
a2: decreases aqueous humour secretion
used for glaucoma
side effects: blurring of vision, dry mouth, hyperemia and pruritus, eye discomfort

A

Apraclonidine

Brimonidine

24
Q

selective B1 agonist
b1: increases HR and contractility
used for acute heart failure, cardiogenic shock
side effects: tachycardia, arrhythmias, tachyphylaxis

A

Dobutamine

25
selective B2 agonist activates b2 receptors in bronchial smooth muscle causes bronchodilation drug of choice for ACUTE ASTHMA ATTACKS
Albuterol/Salbutamol | Terbutaline, Ritodrine
26
selective B2 agonist used for TOCOLYSIS for preterm labor
Terbutaline and Ritodrine
27
used in cardiac stress testing
dobutamine
28
may precipitate arrhythmias in patients with concurrent COPD and heart disease
Albuterol/Salbutamol | Terbutaline, Ritodrine