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Fall 2020 - Pharmacology 2 > Vasoconstrictors - Quiz 1 > Flashcards

Vasoconstrictors - Quiz 1 Flashcards

1
Q

What ocurrs w/ the Sympathetic Stimulation of the Adrenal Medulla?

A

ACh binds to Nicotinic Receptor in the Adrenal Medulla, which then releases Epinephrine into the Blood to bind to Adrenergic Receptors

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2
Q

How does Sympathetic Stimulation release Norepinephrine?

A

Ach binds to Nicotinic Receptor on the Postganglionic Neurons, releasing Norepi to bind to Adrenergic Receptors

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3
Q

What happens w/ Autonomic Parasympathetic Stimulation?

A

ACh binds to Nicotinic Receptors on the Postganglionic Neurons, and ACh is released to bind to Muscarinic Receptors.

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4
Q

What is the difference b/t Somatic & Autonomic Response?

A

With Somatic, ACh is released and binds to Nicotinic Receptors in muscles WITHOUT Ganglia involvement

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5
Q

Which enzyme breaks down Dopamine into Norepi?

A

Beta Hydroxylase

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6
Q

What causes a release of Norepi from the Synaptic Vessel?

A

An Action Potential

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7
Q

What are the ways in which the Norepi Signal is Terminated?

A

Reuptake - 80%

Dilution - 20%

Monamine Oxidase (MAO)

Catechol-o-Methyltransferase (COMT)

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8
Q

Where are Alpha-1 Receptors located?

A

Periphery

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9
Q

Where are Alpha-2 Receptors Located?

A

Central

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10
Q

Where are Beta-1 Receptors located?

A

Heart

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11
Q

Where are Beta-2 Receptors Located?

A

Smooth Muscle

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12
Q

What happens when the Alpha-1 Receptor is activated?

A

↑Intracellular Calcium

Contract Smooth Muscle

Vaso & Bronchoconstriction

Inhibit Insulin

Breaks Down Glycogen

Gluconeogenesis

Relaxes GI

Dilates Pupils

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13
Q

What happens w/ the activation of Alpha-2 Receptors in the Presynpatic PNS?

A

↓Calcium Entry

&

↓Norepi Release

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14
Q

What happens w/ the activation of Alpha-2 Receptors in the Postsynaptic CNS?

A

Sedation

↓Sympathetic Outflow

↓BP

Platelet aggregation

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15
Q

What happens when Beta-1 Postsynaptic Receptors are activated?

A

Increases HR, Contractility, and Conduction Velocity

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16
Q

What happens when Beta-2 Postsynaptic receptors are activated?

A

Relax Smooth Muscles

Vaso & Bronchodilation

↑Insulin

↑Glycogen Breakdown

↑Gluconeogenesis

↓GI Motility

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17
Q

Which Autonomic System does Acetylcholine activate?

A

BOTH SNS & PNS

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18
Q

What is Tachyphylaxis?

A

Diminishing response to successive doses of a drug - happens w/ over exposure to agonists

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19
Q

What is Receptor Uncoupling?

A

Receptor CANNOT bind to G Protein - happens fast

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20
Q

What is Sequestration in regards to Receptor Down Regulation?

A

Receptors move from Cell Surface to Inside the Cell - happens slower than Uncoupling

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21
Q

What is happens to the receptors during Downregulation?

A

Receptors move from Cell Surface to inside the cell, then DESTROYED - very slow process

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22
Q

What is Pheochromocytoma?

A

Uncontrolled release of Catecholamines d/t adrenal tumor

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23
Q

Catecholamines are considered BOTH ______ & ______ that act on adrenergic receptors

A

Catecholamines are considered BOTH Neutrotransmitters & Hormones that act on adrenergic receptors

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24
Q

How are Sympathomimetics different from Catecholamines?

A

Same benzene ring, but DOES NOT have Hydroxyl Groups at the 3 & 4 Position

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25
Q

What enzyme can break down Sympathomimetics?

A

Only Monamine Oxidase (MAO)

(CANNOT go thru Reuptake)

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26
Q

The inhibition of which Signal Termination mechanism would cause the greatest potentiation of Epinephrine?

A

Reuptake

27
Q

How does the metabolism rate of Synthetic Non-Catecholamines compare to that of Catechols?

A

Slower

28
Q

What kind of reactions are involved w/ the metabolism of Catecholamines & Phenylephrine?

A

Sulfoconjugation Reactions

29
Q

Vasoconstrictors _______ Venous Return, Preload, and Cardiac Output

A

Vasoconstrictors INCREASE Venous Return, Preload, and Cardiac Output

30
Q

What are the Reflex changes caused by Vasoconstrictors?

A

↓HR

↓Conduction

↓Contractility

31
Q

What are the Non-Cardiac effects of Vasoconstrictors?

A

Bronchodilation

Glycogenolysis

CNS & Endocrine Stimulation

32
Q

How long can a person have a MAP of <65 mmHG before having End Organ Damage?

A

13 - 28 min

33
Q

How long can a person have a MAP of < 50 mmHg before having End Organ Damage?

A

1 Minute

34
Q

What are complications of using Vasoconstrictors?

A

Ventricular Failure

↓Renal Blood Flow

Masks Hypovolemia

35
Q

Which receptors does Epinephrine work on?

A

All of them - Alpha-1, Beta-1, Beta-2

36
Q

How much more potent is Epinephrine than Norepi?

A

2-10x more potent

37
Q

How does Epinephrine affect Blood Sugar?

A

↑Blood Sugar d/t decreased insulin secretion

38
Q

How does Epinephrine affect the kidneys?

A

↓Renal Blood Flow

&

Stimulates Renin Release

39
Q

Which receptor does Epinephrine act on at lower doses (1-2 mcg/min)?

A

Beta-2 in periphery, decreasing the SVR for better oyxgen exchange, but MAP stays the same

40
Q

At what dose of Epinephrine are the Beta-1 receptors stimulated?

A

Intermediate dose - 4 mcg/min

Increases HR, Contractility, CO, and Automaticity

41
Q

What happens w/ High doses of Epinephrine?

A

Potent Alpha-1 Stimulation causing vasoconstriction & can override the other receptor effects

Reflex Bradycardia

No CNS effects

42
Q

What are the risks of using Racemic Epinephrine?

A

Tachy Arrythmias

&

Rebound Airway Edema

43
Q

Which receptors does Norepi work on?

A

Alpha-1 > Beta-1

No Beta-2

44
Q

Why do Lower doses of Norepi increase Cardiac Output, but Higher doses decrease Cardiac Output?

A

Increased Afterload causes Reflex Bradycardia

45
Q

What receptors does Ephedrine work on?

A

Indirect & Direct Alpha-1 & Beta

Works on the Heart like Norepi w/ a little more HR effect

↑Contractility

46
Q

What happens with continued use of Ephedrine?

A

Tachyphylaxis

47
Q

How does Ephedrine affect the Uterus & Bronchial Smooth Muscle?

A

↑Uterine Blood Flow

&

Relaxes Bronchial Smooth Muscle

48
Q

How does Ephedrine compare to Epinephrine regarding BP response?

A

Ephedrine’s BP Reponse is Weaker, but Longer Lasting

49
Q

What are Ephedrine side effects?

A

Insomnia

Urinary Retention

Tremor

Psychosis

Palpitations

50
Q

How does Cocaine & Amphetamines affect Ephedrine?

A

Blocks Reuptake –> Exaggerate HTN & Arrythmias

51
Q

Which receptor does Phenylephrine work on?

A

Direct Alpha-1 to ↑Preload > Afterload

&

Small Beta-1

52
Q

Other than Blood Pressure, what else is Phenylephrine used for as treatment?

A

Priapism

Nasal Decongestant

Mydriasis - Pupil Dilation

53
Q

How does Phenylephrine affect the Pulmonary Vasculature?

A

↑PA Pressure & Resistance

54
Q

How does Phenylephrine compare w/ Norepi?

A

Phenylephrine is Weaker, but Longer Lasting

55
Q

How does DDAVP compare to Vasopressin regarding Antidiuretic Effect & Pressor Effect?

A

DDAVP is a much stronger Antidiuretic & has No Pressor Effect

56
Q

How is Vasopressin different from Catecholamines?

A

Vasopressin can work in Hypoxic & Acidic environments

57
Q

Which receptors does Vasopressin work on?

A

V1a - Pressor Effect

V2 - Antidiuretic Effect

58
Q

What are the effects of Vasopressin in the setting of Cardiac Failure?

A

Cardiac Ischemia

↑Preload & ↑Afterload

↑Wall Stress

LVH

59
Q

What is the advantage of using Vasopressin over Epinephrine?

A

Vasopressin is just as effective, but has no direct effect on HR & O2 Consumption

60
Q

How should weight loss products that contain Ephedrine be managed peri-operatively?

A

Tachyphylaxis - Hold for 24 hrs before surgery

61
Q

What is the treatment for Vasoconstrictor Extravasation?

A

Phentolamine - Alpha 1 & 2 Antagonist

62
Q

What does Giapreza (Angiotensin II) do?

A

Vasoconstriction & ↑Aldosterone Release

63
Q

What are the complications of using Giapreza (Angiotensin II)?

A

DVT

Tachycardia

Delirium

Thrombocytopenia

Fall 2020 - Pharmacology 2 (9 decks)

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