8. Adrenergic Agonists - Indirect/mixed Acting Adrenergic Agonists

Front 1

How do indirect acting adrenergic agonists work?

Back 1

By causing the release of endogenous NE from nerve terminals via displacement of it

Front 2

What is the only purely indirect acting adrenergic agonist?

Back 2

Tyramine

Front 3

In what is Tyramine found in high levels?

Back 3

-Cheese
-Fermented sausages
-Wines
-Beer

Front 4

What happens to Tyramine normally in people?

Back 4

It is not absorbed from the GI tract because it is metabolized by MAO to inactive metabolites

Front 5

What patients are at risk of Tyramine toxicity? What is the toxic effect?

Back 5

Patients on MAOIs - can cause hypertensive crisis (too much NE effects)

Front 6

How do mixed acting adrenergic agonists work?

Back 6

By both:
-Increasing endogenous NE release
-Stimulate adrenergic receptors themselves

Front 7

What are the 3 mixed acting adrenergic agonists?

Back 7

-Amphetamine
-Meth
-Ephedrine/Pseudoephedrine

Front 8

How does Amphetamine get into presynaptic terminals to kick NE out of its storage vesicles?

Back 8

Via NET - uptake 1

Front 9

What does Amphetamine do once inside the presynaptic terminal?

Back 9

Kicks NE out of its storage vesicles until enough is free in the terminal that it gets released into the synapse

Front 10

What adrenergic receptors can Amphetamine also act as a weak agonist of?

Back 10

alpha and beta

Front 11

Where is Amphetamine a potent adrenergic stimulator? What form of it?

Back 11

CNS - the d-isomer

Front 12

What does Amphetamine have a weak inhibiting effect on?

Back 12

NET - for other drugs that use this transporter

Front 13

What are 3 therapeutic uses of Amphetamine?

Back 13

-Appetite suppressant
-Narcolepsy
-ADD

Front 14

Is Methamphetamine clinically available?

Back 14

no

Front 15

What are the 4 isomers of Ephedrine?

Back 15

d/l Ephedrine
d/l Pseudoephedrine

Front 16

What 3 receptors can be activated by Ephedrine, and how?

Back 16

-B2 (direct agonist)
-a1/b1 - increases NE release

Front 17

What has Ephedrine been previously used to treat due to its direct B2 agonist properties?

Back 17

Asthma - but no longer due to heart stimulant effects via B1 activation

Front 18

What is the main receptor selectivity of Pseudoephedrine?

Back 18

a1
B2 very little

Front 19

What is Pseudoephedrine mainly used to treat?

Back 19

Nasal congestion - in OTCs

Front 20

What 2 types of allergies are adrenergic agonists used to treat?

Back 20

-Bronchial asthma
-Anaphylaxis

Front 21

2 drugs used for bronchial asthma:

Back 21

-Albuterol
-Terbutaline

Front 22

Drug for Anaphylactic shock:

Back 22

Epinephrine

Front 23

6 Cardiovascular uses of adrenergic agonists:

Back 23

-Nasal decongestion
-Prolong action of local anesthetics
-Paroxysmal atrial tachycardia
-Elevate BP
-Stress testing
-Bradycardia

Front 24

What 2 drugs are used to treat nasal congestion?

Back 24

-Phenylephrine
-Pseudoephedrine

Front 25

What 2 drugs are used to prolong the action of local anesthetics via vasoconstriction?

Back 25

-Phenylephrine
-Epinephrine

Front 26

What drug is used to treat Paroxysmal atrial tachycardia?

Back 26

Phenylephrine

Front 27

How does Phenylephrine treat Paroxysmal atrial tachycardia?

Back 27

By producing reflex bradycardia due to its hypertensive effects

Front 28

What are 2 types of low BP that adrenergic agonists are used to treat?

Back 28

-Drug/injury/surgically induced hypotension
-Hypotensive shock due to MI, infection, or cardiac surgery

Front 29

What drug is used to treat hypotension induced by spinal anesthetics, neurological injury, or surgical removal of pheochromocytoma?

Back 29

Phenylephrine

Front 30

What drugs are used to treat shock due to MI (cardiogenic), infection, or cardiac surgery?

Back 30

Dopamine or dobutamine

Front 31

What drug is used for stress testing?

Back 31

Dobutamine

Front 32

What 2 drugs are used for Bradycardia?

Back 32

-Isoproterenol
-Epinephrine

Front 33

What are 3 ophthalmology uses of adrenergic agonists?

Back 33

-Mydriasis
-Conjunctival decongestion
-Control hemorrhage

Front 34

What 2 drugs are used for opthalmologic effects?

Back 34

-Phenylephrine
-Epinephrine

Front 35

What is an obstetrics use of adrenergic agonists? Which one?

Back 35

-Delay delivery (relax uterus)
Ritodrine

Front 36

What are 2 CNS uses of adrenergic agonists? What is used to treat them both?

Back 36

-Narcolepsy
-ADD
Amphetamine

Front 37

What are 3 side effects of alpha agonists?

Back 37

Cerebral hemorrhage anxiety Restlessness Throbbing headache
CHARTH

Front 38

What are 4 side effects of beta agonists?

Back 38

-Palpitations
-Angina
-Cardiac arrythmias
-Restlessness/anxiety