Vascular Control (Autonomics)

Question 1

pyridostigmine

Answer 1

MOA: Reversible inhibitor of AChE

Clinical uses: Treatment of neurogenic orthostatic hypotension; treatment of myasthenia graves

Toxicity: Respiratory depression; bradycardia; lacrimation; diarrhea

Question 2

atropine

Answer 2

MOA: Non-selective muscarinic antagonist

Clinical uses: Reversal of vagal bradycardia; antitode for cholinesterase inhibitor toxicity

Toxicity: Tachycardia

Question 3

clonidine

Answer 3

MOA: Selective agonist at alpha2 receptors in CNS- this results in decreased sympathetic outflow

Clinical uses: hypertension

Toxicity: Postural hypotension; bradycardia; sedation; dry mouth

Question 4

dobutamine

Answer 4

MOA: Beta1 -selective agonist

Clinical uses: Increase cardiac output in acute heart failure; stress testing

Toxicity: Tachycardia

Question 5

dopamine

Answer 5

MOA: Dopamine agonist (also alpha and beta agonist)

Clinical uses: Shock; sometimes used in heart failure

Toxicity: Tachycardia; vasoconstriction; local necrosis

Question 6

epinephrine

Answer 6

MOA: Adrenergic agonist

Clinical uses: Emergency treatment of cardiac arrest; anaphylaxis;

Toxicity: Arrhythmia; local necrosis

Question 7

isoproterenol

Answer 7

MOA: Non-selective beta-adrenergic agonist

Clinical uses: Limited uses in bradycardia

Toxicity: Tachycardia; hypotension

Question 8

methyldopa

Answer 8

MOA: Converted to alpha-methylnorephrine, which acts as a selective agonist at alpha2 receptors in CNS- this results in decreased sympathetic outflow

Clinical uses: Limited use as antihypertensive in pregnancy

Toxicity: Postural hypotension; bradycardia; sedation; dry mouth

Question 9

midodrine

Answer 9

MOA: Alpha1-selective agonist

Clinical uses: Chronic orthostatic hypotension

Toxicity: Hypertension; bradycardia

Question 10

norepinephrine

Answer 10

MOA: Adrenergic agonist

Clinical uses: Restoration of BP in acute hypotensive states;

Toxicity: Arrhythmia; extravasation necrosis

Question 11

phenylephrine

Answer 11

MOA: Alpha-adrenergic agonist

Clinical uses: Test of baroreflex; short-term vasoconstriction; decongestant

Toxicity: Hypertension; bradycardia

Question 12

carvedilol

Answer 12

MOA: Antagonist at alpha1 and beta receptors (biased agonist at beta1 receptor)

Clinical uses: Hypertension; heart failure

Toxicity: Bradycardia; bronchoconstriction

Question 13

doxazosin

Answer 13

MOA: Alpha1 -selective antagonist

Clinical uses: Benign prostatic hyperplasia; hypertension (rare)

Toxicity: Orthostatic hypotension

Question 14

labetolol

Answer 14

MOA: Antagonist at alpha1 and beta receptors

Clinical uses: hypertension

Toxicity: Bradycardia; bronchoconstriction

Question 15

metoprolol

Answer 15

MOA: Beta1-selective antagonist

Clinical uses: hypertension; heart failure

Toxicity: Bradycardia; bronchoconstriction

Question 16

phentolamine

Answer 16

MOA: Non-selective alpha-adrenergic antagonist

Clinical uses: Treatment of extravasation of adrenergic agonists

Toxicity: Othostatic hypotension; tachycardia; nasal congestion

Question 17

phenoxybenzamine

Answer 17

MOA: Non-selective covalent (long-acting) alpha antagonist

Clinical uses: pheochromocytoma

Toxicity: Othostatic hypotension; tachycardia; nasal congestion

Question 18

propanolol

Answer 18

MOA: Non-selective beta adrenergic receptor antagonist

Clinical uses: Angina; arrhythmias; tremor; stage fright; migraine; hypertension

Toxicity: Bradycardia; bronchoconstriction