Adrenergic Agonists

Front 1

What drug would you use to treat severe congestive heart failure with compromised renal function?

Back 1

Dopamine

Front 2

What are the cardiovascular effects of dopamine?

Back 2

At low doses, which may not increase heart rate or icnrease bp, domapine increases blood flow the kidney, due to stimluation of D1 receptors in renal blood vessels. Higher doses stimulate cardiac B1 receptors to icnrease cardiac output. Still higher doses will stimulate vascular a-receptors to cause generalized vasocinstriction, maybe overcoming the renal vasodilation. rem: dopamine is vasodilatory to kidney, increases renal blood flow.

Front 3

What is tachyphylaxis?

Back 3

repeated doses of a drug given at short intervals produces successively smaller responses.

Front 4

What drugs can be used to correct a hypotensive state, through vasoconstriction at alpha-1 receptors?

Back 4

phenylephrine, ephedrine, metaraminol, epinephrine

Front 5

What drugs are used in ophthalmic procedures, through alpha-1 receptor-mediated pupillary dilation/mydriasis?

Back 5

epinephrine, phenylephrine, ephedrine,

Front 6

What adrenergic agonists can be used to releave hypertension through vasodilatory effects at alpha-2 receptors?

Back 6

clonidine. Acts to decrease norepi release from action on presynaptic terminals.

Front 7

What are the bronchodilators?

Back 7

For COPD: salmeterol. For asthma: terbutaline, metaproterenol, & albuterol. They relax smooth muscle at B-2 receptors.

Front 8

What drug would you use in a situation of premature labor? What adrenergic receptors does it stimulate??

Back 8

ritodrine, B-2 agonist

Front 9

What do you prescribe for narcolepsy? How about ADHD?

Back 9

amphetamine; amphetamine, methylphenidate

Front 10

What is the drug of choice for treatment of type I hypersensitivity reactions in response to allergens?

Back 10

epinephrine

Front 11

Which receptors mediate the peripheral excitatory effects on smooth muscle, e.g. constriction in many vascular beds and contraction of the radial muscle of the iris?

Back 11

alpha-receptors

Front 12

which receptors mediate the peripheral inhibitory effects leading to decreased GI motility, dilation of bronchial musculature, and vasodilation in skeletal muscle beds?

Back 12

Beta-receptors

Front 13

Which adrenergic receptors mediate metabolic effects such as increase in the rate fo liver and skeletal muscle glycogenolysis & liberation of free faty acids from adiposes tissue?

Back 13

beta-receptors

Front 14

What chemicals (ie, the sympathmimetic amines), produce maximum alpha- and beta-receptor activities?

Back 14

catecholamines with OH groups at 3 and 4 carbons produce max acitivyt. removal of one or both OH groups decreases both activities, especially beta.

Front 15

Why are catecholamines not effectively delivered orally?

Back 15

They are destroyed in the GI tract and metabolized by MAO and COMT in the liver.

Front 16

What are the effects of epinephrine, and through which receptors are they mediated?

Back 16

(1) decrease in blood flow, cutaneously through alpha, mucosal through alpha, and renal through alpha. (2) increase in blood flow, in skeletal uscle through B2, cerebrally secondarily to increase in systolic BP, and coronary secondarily to increased cardiac work), and (3) increased cardiac stimulation, ionotropy through B1, chronotropy through B1, automaticity through B1. (4) bronchodilation, B2, inhibition of intestinal muscle tone through a and B2.

Front 17

What are some side effects of epinephrine?

Back 17

Fear, palpitation, discomfort. hypertensive and hyperthyroid patients are especially susceptible to epi's effects. cerebral hemorrhage and cardiac arrhythmias are possible complications paritculary if it is administered intravenously by mistake.

Front 18

What are the effects of norepi, compared to epi?

Back 18

More specific drug, potent stimulant of all alphas, and cardiac B1 receptors but not B2. Thus, there is more marked increase in diastolic pressure than wtih epinephrine.

Front 19

Name the primary alpha-1 agonist and its therapeutic uses.

Back 19

Phenylephrine, PRESSOR AGENT in HYPOTENSIVE STATES. Also, mydriasis and nasal decongestion.

Front 20

Name 2 alpha-2 agonists

Back 20

clonidine, used as antihypertensive, and brimonidine, treats glaucoma by decreasing production and increasing outflow of aqueous humor.

Front 21

What's the major Beta-2 (nonselective) agonist?

Back 21

Isoproterenol -- has affinitiy for both betas; STRONG C-V EFFECTS. IV injection gives increased rate and force of contraction and transient increase in systolic pressure, but B-receptor st. in vasculature casuses decreased blood pressure. Also relaxes bronchial and GI smooth muscles

Front 22

What is ISO used to treat?

Back 22

AV-block or cardiac arrest.

Front 23

Name the 4 beta-2 agonists used for treatment of asthma. Which is also used for COPD?

Back 23

albuterol, salmeterol, metaproterenol, and terbutaline. they are superior to ISO because they are beta-2 specific, so no tachycardia or palpitations. also, Structural mods make them less susceptible than iso to metabolic breakdown, as none are substrates for COMT.

Front 24

Name 4 sympathomimetics with indirect action? in general, how do they work?

Back 24

Tyramine, dopamine, amphetamine (and methamphetamine), ephedrine*, metaraminol*. they work by either geting transporoted into the terminal by NET and then causing NE to flow out of vesciel and out of terminal (tyramine, amphetamine or simply by inhibiting NET (cocaine).

Front 25

Ritodrine is a....

Back 25

*Beta-2 agonist* used in pre-term labor to REDUCE UTERINE CONTRACTIONS - beta 2 receptors on uterine smooth muscle promote muscle relaxation.

Front 26

Name two almost-identical *selective beta-1-receptor antagonists*, that lead to decreased hr and contractility, but because they avoid beta-2s, are good for ppl with chronic lung disease

Back 26

atenolol & metaprolol