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NURG 5710- Pharmacology Test Two > sympathomimetics and sympatholytics > Flashcards

sympathomimetics and sympatholytics Flashcards

1
Q

____ is the neurotransmitter that is released at the postganglionic nerve endings of the sympathetic nervous systme.

A

norepinephrine

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2
Q

Neurons that release norepinephrine are referred to as ____.

A

adrenergic

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3
Q

Adrenergic receptors where norepinephrine acts are located on _____ and _____ muscle membranes.

A

cardiac and smooth muscle membranes.

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4
Q

adrenergic drugs can be further broken down into what two classes

A

Sympathometics (agonists)

Sympatholytic (antagonists)

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5
Q

the adrenergic receptors subdivided into two types which are?

A

alpha and beta receptors

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6
Q

alpha receptors are subdivided into what?

A

alpha 1 receptors

Alpha 2 receptors

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7
Q

individual organs generally possess 1 main type of receptor and this allows the utilization of specific drugs that can ______ bind to and stimulate or block the individual adrenergic receptor.

A

selectively

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8
Q

_________ are adrenergic blocking drugs that antagonize/decrease sympathetic activity

A

Sympatholytics (agonists for alpha and beta)

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9
Q

________ are adrenergic blocking drugs that antagonize decrease sympathetic activity

A

Sympatholytics (antagonists for alph and beta)

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10
Q

sympatholytic drugs are also called two other names which are?

A

antagonists

blockers

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11
Q

sympatholytics = ________

sympathomimetics = _______

A

antagonists

agonists

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12
Q

the activation of alpha 1 adrenergic receptors stimulate what four systems?

A

blood vessels

eye

bladder

prostate

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13
Q

Sympathomimetic drugs of the alpha adrenergic class conistst of which 2 drugs

A

Norepinepherine and Epinephrine

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14
Q

alpha 1 receptor activation causes what signs and symptoms?

A

vasoconstriction of blood vessels = increased blood pressure and increased contractibility of the heart

pupil dilation

bladder relaxation

contraction of the prostate

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15
Q

what are the disadvantages of norepinepherine administration

A

must be used Intraveneously/injected and it has a very short duration of action

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16
Q

mydriasis means?

A

pupil dilation

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17
Q

what is the more important clinical effect that is generated by alpha 1 receptors causing

A

contraction of smooth muscle

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18
Q

alpha drugs are administered _____(route) in hypotensive states such as after surgery to increase blood pressure and maintain circulation. With the exception for which medication?

A

intravenously

midodrine (proamatine)

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19
Q

what are the non therapeutic effects of alpha 1 agonists

A

Contraction of sphincter and GI/GU track

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20
Q

what are the main 2 target organs that alpha 1 act on

A

cardiovascular and eyes

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21
Q

what alpha adrenergic drugs are used to treat hypotension using.

A

A LNP

Aramine, Pro Amatine, levophed, neo-synepherine

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22
Q

what type of alpha adrenergic drugs are included in the over the counter cold and allergy preparations for relief of nasal decongestion?

A

alpha 1 adrenergic agonist

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23
Q

a few of the alpha 1 adrenergic agonist drugs are used in opthalmology for what?

A

dilate the pupils and ocular decongestant

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24
Q

what is the main effect of the alpha adrenergic drugs used to treat hypotension

A

increase BP due to vasoconstriction of smooth muscle (A LNP)

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25
Q

alpha 1 adrenergic agonist drug end in what? except for which drug?

A

“ine”

metarminol (aramine)

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26
Q

what are the major adverse effects of administering alpha adrenergic drugs

A

excessive vasoconstriction

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27
Q

name the two alpha 1 adrenergic agonist that are used for occular decongestant?

A

Naphazoline (Naphcon)

Tetrahydrozoline (Visine)

Remember No Tears when putting in eye drops! and that alpha 1 adrenergic agonist end in ine.

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28
Q

Name the alpha adrenergic agonist used fro nasal decongestant?

A

naphazoline (Privine)

phenylephrine

pseudoephedrine

tetrahydrozoline (Tyzine)

xylometazoline

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29
Q

Alpha adrenergics must be carefully administered to patients with HTN or cardiovascular concerns d/t

A

increased hemorrage, cardiac arythmias and and cerebral concerns

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30
Q

for patients recieiving alpha adrenergic medications, what need to be frequenly obtained

A

BP measurements at frequent intervals

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31
Q

The most common side effects from alpha adrenergic medications when used for nasal decongestion include

A

excessive dryness (d/t vasoconstriction and decreased blood flow)

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32
Q

why can alpha adrenergic medications be administered over the counter

A

because adminsitration of the drug does not cause as severe of side effects such as death when compared to the IV form

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33
Q

what is the function of alpha adrenergic blocking drugs

A

the alpha blockers compete with Epi and norepi for the binding to the alpha adrenergic receptors. This prevents norepi and epi from producing an Alpha SYMPATHETIC response

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34
Q

what is the main pharmacological effect that alpha blockers produce

A

relaxation of smooth muscles

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35
Q

In BPH patients, there is an enlargement of the prostate gland, which interferes with urine flow through the urethra. Alpha blocking drugs help with BPH how?

A

relax the smooth muscle of the urethra, which improves urinary flow

causes prostate to constrict as well

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36
Q

for pateints with pheochromocytoma, the treatment of which drug can lower and control BP until the tumor is removed

A

Phenoxybenzamine

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37
Q

what are the drug names for the class of alpha adrenergic “blocking”

A

“SIN”

Alfuzosin, Doxazosin, Prazosin, Silodosin, Tamsulosin, Terazosin

Phenoxybenzamine (remember this is used for pheochromocytoma)

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38
Q

What is the name of the medication that helps control blood pressure for pheochromocytomas until surgery, what class do they below to? What is the route of administration?

A

Phenoxybenzamine (Dibenzyline)

Alpha-Adrenergic Blocking Drugs

PO

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39
Q

what are the three drugs used to spetreat BPH with alpha adrenergic drugs

A

“TSA”

  • Tamsulosin (FLOmax)
  • Silodosin (RamoFLOW)
  • Alfuzosin (UROatral)
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40
Q

blocking one division of the autonomic nervous system usually produces some effects that are similar to stimulating what?

give an example

A

the other division of the autonomic nervous system

so if you give an alpha blockade, the side effects are simular to an increase in parasympathetic activity in the organs that are blocked.

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41
Q

what is the function of Beta 1 adrenergic receptors

A

increase HR and force of contraction

42
Q

The side effects for alpha 1 blockers are?

A

constriction of pupils

nasal congestion

increase in gastrointestinal activity

increased salivation

bladder contraction

blood vessels dilate

heart rate decrease

lungs- bronchioles constrict and increase in secretions.

Remember these are the same a parasympathetic stimulation

43
Q

Describe the organs and effects that beta 1 receptors have

A

HEART and KIDNEY

Heart: increase contractility and HR

Kidney: increase Renin secretion, angiotensin, increase BP

44
Q

Describe the organs and effects that beta 2 receptors have on the body

A

SMOOTH MUSCLE, Lungs, Uterus, Liver

Smooth muscle: Gastrointestinal track (decrease GI motility)

Lungs: Bronchodialation

Uterus: relaxation of urerine smooth muscle

Liver: increase blood sugar

45
Q

what medications are just with Beta 2 receptor agonists

A

I-SMART

  • I: Isoetharine
  • S: salmeterol
  • M: metaproterenol
  • A: Albuterol
  • R: NONE
  • T: Terbutaline
46
Q

Beta 2 receptors are important in OB cases why?

A

because beta 2 receptors are found in the uterine smooth muscle stimulation of the beta 2 receptors within the uterus relaxes the smooth muscle and inhibits urterine contractions which can occur during premature labor

47
Q

list the beta adrenergic drugs that also stimulate alpha?

A

dopamine

ephedrine

epinephrine

48
Q

what are the beta1 drugs

A

“IDE”

  • Isoproterenol
  • Dopamine & Dobutamine
  • Epinepherine & Ephederine
49
Q

What receptors does the beta adrenergic drug Isoproterenol work on

A

Beta 1 & Beta 2

50
Q

what is the main use for Dopamine and Dobutamine

A

circulatory shock and acute heart failure

51
Q

out of the beta 2 agonist what medications can also be give other ways than aersolized? and how?

A

albuterol- aerolsol inhalant, tablets, syrups

terbutaline -IV, tablets

52
Q

what is one main disadvantage of using Isoproternol

A

it has a dual action causing both dialation and increase contraction of heart leading to overstimulation of the heart

53
Q

list the administration routes for epinephrine?

A

IV (acute anaphlyaxis profound hypotension and bradycardia)

SC (around a central line insertion site that is bleed)

IM (epipen anaphlyaxis)

Aerosol inhalant (rescue for asthma attack bronchodilator)

54
Q

what is the use for terabutaline

A

arrest premature labor

55
Q

Dopamine functions as a neurotransmiter in the brain forming a precursor for _____

A

norepinepherine

56
Q

list the administration routes for ephedrine and the main use for it?

A

route: capsules and parenteral
use: bronchodilator

57
Q

out of dopamine or dobutamine, which drug produces a greater beta 1 effect

A

dobutamine (treats acute HF)

(pumps the heart more compared to dopamine which has alpha and beta efffects used to circulatory shock)

58
Q

list the uses for terbutaline? list the route of administration?

A

bronchodilator/preterm labor

systemic route (tablet or IV)

59
Q

list the indication for dobutamine and the route?

A

acute heart failure, IV infusion

60
Q

list the indication for dopamine and route?

A

circulatory shock, IV infusion

61
Q

list the indicaition for isoproternol and route?

A

cardiac stimulant

IV injection not INFUSION

62
Q

Beta drugs may produce ______ nervous system stimulation, causing what three symptoms.

A

central nervous system stimulation

restlessness

tremors

anxiety

63
Q

the main adverse effect of epinephrine is?

A

overstimulation of the heart causing palpitations or cardiac arrhythmias

64
Q

use extreme caution given epinephrine in what patient population?

A

patients with existing heart disease

65
Q

The use of beta 2 drugs to arrest preterm labor can cause a variety of _______ effects and complications.

A

cardiovascular

66
Q

because the use of beta 2 drugs to stop preterm labor can cause cardiovascular complications, what should be implemented?

A

fetal heart rate and maternal pulse rate and blood pressures should be monitored in patients that have to be administered beta 2 drugs for the cause of preterm labor

67
Q

Beta blocking drugs bind to _______ adrenergic receptors and antagonize the effects of ______ and _____.

A

beta

epinephrine and norepinephrine

68
Q

what is the most important beta organ?

69
Q

the main effect of beta blockers on the heart is to?

A

Decrease the activity of the heart

70
Q

Blockade of beta 1 receptors produces affects the heart how?

A

decrease in heart rate and force of contraction and slows impulse conduction

71
Q

Beta 1 blocker effects are useful in patients with what conditions?

A

tachycardia

cardiac arrhythmias

cardiac conditions were excessive sympathetic activity is present

72
Q

decreasing cardiac function by beta blocker administration can also _____ blood pressure

A

decrease, beta blockers are commonly used in the treatment of hypertension

73
Q

is there any specific therapeutic indications for blocking the beta 2 receptors?

74
Q

beta blockers are divided into two groups which are?

A

nonselective beta blockers

selective beta blockers

75
Q

Nonselective beta blockers affect which receptors?

A

beta 1 and beta 2

76
Q

selective beta blockers affect which receptor?

A

beta 1 receptors

77
Q

however at higher doses the selective beta blockers may do what?

A

begin to block beta 2 receptors in addition to beta 1 receptors.

remember we talked about affinity, they have a much lower affinity for beta 2 receptors, but if there is saturation of beta 1 receptors then they have no other choice and they will start to interact with beta 2 receptors and produce side effects.

78
Q

how does beta blockers treat migraine?

79
Q

____ was the first beta blocker used clinically,it blocks both beta 1 and beta 2 receptors.

A

propranolol

80
Q

Propranolol and other beta blockers are used in the treatment of what three general conditions?

A

angina pectoris

hypertension

various cardiac arrhythmias

chronic heart failure

81
Q

how does beta blockers help gluacoma?

A

decrease intraocular pressure

82
Q

How does beta blockers help chronic heart failure?

A

decreases excessive sympathetic activity and slows the heart rate and appears to decrease the risk of sudden death

83
Q

name the nonselective beta blockers?

A

just know O-Z and end in olol

plus nadolol and carvedilol because they have NC not a clue to be cardioselective

84
Q

name the cardioselective beta blockers?

A

A-N and end in olol

except for Nadolol and carvedilol because they NC not a clue to be cardioselective.

85
Q

Common side effects that can occur from administration of beta blockers?

A

nausea

diarrhea

Serious: reduced heart rate

86
Q

in general nonselective beta blockers should not be used in which patient population and why?

A

asthma or other respiratory conditions, because blocking beta 2 receptor sites, nonselective beta blockers may cause bronchoconstriction in individuals with asthma or other respiratory conditions.

87
Q

So what type of beta blocker should be prescribed to asthma patient and patient with respiratory conditions? special consideration?

A

cardioselective beta blockers

At higher doses of cardioselective beta blockers theycan also interact with the beta 2 receptors and potentially cause bronchoconstriction.So make sure you stay in the lower range of therapeutic window with cardioselective beta blockers for asthma/respiratory patients.

88
Q

beta blockers can cause central nervous system effects such as?

A

drowsiness

mental depression

and other CNS distrubances

89
Q

alpha adrenergic agonist drug site of action?

A

alpha 1 receptor

90
Q

alpha adrenergic drugs agonist main effect?

A

smooth muscle contraction, vasoconstriction

91
Q

nonselective beta adrenergic agonist site of action is?

A

beta 1 and beta 2 receptors

92
Q

nonselective beta adrenergic agonist main effect?

A

cardiac stimulation

smooth muscle relaxation

bronchodilation

93
Q

selective beta 2 adrenergic agonist site of action ?

A

beta 2 receptors

94
Q

selective beta 2 adrenegic agonist main effect?

A

smooth muscle relaxation

bronchodilation

95
Q

alpha 1 adrenergic blockers site of action?

A

alpha 1 receptor

96
Q

alpha 1 adrenergic blocker main effect?

A

smooth muscle relaxation

vasodilation

97
Q

nonselective beta 1 and beta 2 adrenergic blockers site of action?

A

beta 1 and beta 2 receptors

98
Q

nonselective beta 1 and 2 adrenergic blockers main effect?

A

cardiac depression

smooth muscle contraction (beta 2 organs)

99
Q

selective beta 1 adrenergic blockers site of action?

A

beta 1 receptors

100
Q

selective beta 1 adrenergic blocker main effect?

A

cardiac depression (decrease HR/force of contraction)

101
Q

what are adrenergic drugs that simulate or mimick the sympathetic nervous system?

A

sympathomimetics

NURG 5710- Pharmacology Test Two (2 decks)

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