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Basic Pharmacology FA 2020 > Sympathomimetics > Flashcards

Sympathomimetics Flashcards

1
Q

Name the Direct sympathomimetics

A 
Albuterol, salmeterol, terbutaline
Dobutamine
Dopamine
Epinephrine
Fenoldopam
Isoproterenol
Midodrine
Mirabegron
Norepinephrine
Phenylephrine
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2
Q

What receptors are activated by Albuterol, salmeterol, terbutaline?

A

β2 > β1

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3
Q

What HEMODYNAMIC CHANGES have Albuterol, salmeterol, terbutaline?

A

↑ HR (little effect)

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4
Q

What clinical APPLICATIONS Albuterol has?

A

Albuterol for Acute asthma/COPD.

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5
Q

What clinical APPLICATIONS Salmeterol has?

A

Salmeterol for Serial (long-term) asthma/COPD.

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6
Q

What clinical APPLICATIONS Terbutaline has?

A

Terbutaline for acute bronchospasm in asthma and tocolysis.

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7
Q

What RECEPTORS are activated by Dobutamine?

A

β1 > β2, α

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8
Q

What HEMODYNAMIC CHANGES have Dobutamine?

A

↔︎/↓ BP,  ↑HR,  ↑CO

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9
Q

What clinical APPLICATIONS Dobutamine has?

A

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

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10
Q

What RECEPTORS are activated by Dopamine?

A

D1 = D2 > β > α

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11
Q

What HEMODYNAMIC CHANGES have Dopamine?

A

 ↑BP (high dose),  ↑HR,  ↑CO

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12
Q

What clinical APPLICATIONS Dopamine has?

A

Unstable bradycardia, HF, shock; inotropic and chronotropic effects at lower doses due to β effects; vasoconstriction at high doses due to α effects.

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13
Q

What RECEPTORS are activated by Epinephrine?

A

β > α

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14
Q

What HEMODYNAMIC CHANGES have Epinephrine?

A

 ↑BP (high dose),  ↑HR,  ↑CO

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15
Q

What clinical APPLICATIONS Epinephrine has?

A

Anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses.
Significantly stronger effect at β2-receptor than norepinephrine.

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16
Q

What RECEPTORS are activated by Fenoldopam?

A

D1

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17
Q

What HEMODYNAMIC CHANGES have Fenoldopam?

A

 ↓BP (vasodilation),  ↑HR, ↑CO

18
Q

What clinical APPLICATIONS Fenoldopam has?

A

Postoperative hypertension, hypertensive crisis.
Vasodilator (coronary, peripheral, renal, and splanchnic).
Promotes natriuresis.
Can cause hypotension and tachycardia.

19
Q

What RECEPTORS are activated by Isoproterenol?

A

β1 = β2

20
Q

What HEMODYNAMIC CHANGES have Isoproterenol?

A

 ↓BP (vasodilation),  ↑HR, ↑CO

21
Q

What clinical APPLICATIONS Isoproterenol has?

A

Electrophysiologic evaluation of tachyarrhythmias.
Can worsen ischemia.
Has negligible α effect.

22
Q

What RECEPTORS are activated by Midodrine?

A

α1

23
Q

What HEMODYNAMIC CHANGES have Midodrine?

A

 ↑BP (vasoconstriction), ↓HR, ↔︎/↑ CO

24
Q

What clinical APPLICATIONS Midodrine has?

A

Autonomic insufficiency and postural hypotension.

May exacerbate supine hypertension.

25
Q

What RECEPTORS are activated by Mirabegron?

A

β3

26
Q

What HEMODYNAMIC CHANGES have Mirabegron?

A

none

27
Q

What clinical APPLICATIONS Mirabegron has?

A

Urinary urgency or incontinence or overactive bladder.

Think “mirab3gron.”

28
Q

What RECEPTORS are activated by Norepinephrine?

A

α1 > α2 > β1

29
Q

What HEMODYNAMIC CHANGES have Norepinephrine?

A

 ↑BP,  ↑HR, ↔︎/↑ CO

30
Q

What clinical APPLICATIONS Norepinephrine has?

A

Hypotension, septic shock.

31
Q

What RECEPTORS are activated by Phenylephrine?

A

α1 > α2

32
Q

What HEMODYNAMIC CHANGES have Phenylephrine?

A

 ↑BP (vasoconstriction),

 ↓HR, ↔︎/↓ CO

33
Q

What clinical APPLICATIONS Phenylephrine has?

A

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

34
Q

Name the Indirect sympathomimetics

A

Amphetamine
Cocaine
Ephedrine

35
Q

Amphetamine MOA

A

Indirect general agonist, reuptake inhibitor, also releases stored catecholamines

36
Q

What Indirect sympathomimetics is use for Narcolepsy, obesity, ADHD?

A

Amphetamine

37
Q

Cocaine MOA

A

Indirect general agonist, reuptake inhibitor

38
Q

Which Indirect sympathomimetic pharm Causes vasoconstriction and local anesthesia?

A

Cocaine

39
Q

Which pharm should be used with Caution when giving β-blockers if intoxication is suspected?

A

Cocaine

40
Q

What can cocaine lead to when used with β-blockers?

A

can lead to unopposed α1 activation → extreme hypertension, coronary vasospasm.

41
Q

Ephedrine MOA

A

Indirect general agonist, releases stored catecholamines

42
Q

Clinical application of Ephedrine

A

Nasal decongestion (pseudoephedrine), urinary incontinence, hypotension.

Basic Pharmacology FA 2020 (5 decks)

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