Adrenergic Agonists And Sympathomimetics

Front 1

a1 receptor

Back 1

inc calcium

Front 2

a2 receptor

Back 2

dec adenylyl cyclase- reduction of cAMP production

Front 3

B adrenergic receptor

Back 3

inc adenylyl cyclase
rise in cAMP production

Front 4

Dopamine receptors

Back 4

D1- increased adenylyl cyclase inc cAMP
D2 dec. adenylyl cyclase reduce cAMP

Front 5

alpha agonists

Back 5

phenylephrine, methoxamine, a1>a2


clonidine a2>a1

Front 6

mixed alpha and beta agonists

Back 6

norepinephrine a1=a2, b1>b2
epinephrine a1=a2, b1 =b2

Front 7

b agonists

Back 7

dobutamine b1>b2 (heart)
isopoterenol b1=b2
terbutaline, metaproterenol, albuterol, ritodrine b2>b1, bronchodilation

Front 8

dopamine agonists

Back 8

dopamine d1=d2>>b>>a
fenoldopam D1>>D2

Front 9

organ system effects: Blood vessels

Back 9

VSM-sympathetic (no parasymp)

a-adrenergic receptors inc arterial resistance in skin and splanchnin vessels

b2 receptors promote smooth muscle relaxation and vasodilation

epinephrine- b2 mediated vasodilation occurs

d1 - vasodilation of renal splanchnic coronary and cerebreal arteries

Front 10

organ system effects: heart

Back 10

most due to b1 receptor
Calcium up, inc pacemaker, rate of contraction, inc conduction velocity in AV node, dec refractory period, inc contractility, dec cardiac systole, inc work and O2 consumption

may be overcome by reflex activity

Front 11

organ system effects: blood pressure

Back 11

alpha agonist- increase vascular resistance- dec venous capacitance- inc BP- reflex increase in vagal tone- dec in heart rate

-dec venous capacitance, dec pooling- inc venous return- inc cardiac output- inc SV- inc contractility

if hypotensive, reflex doesn't occur

beta agonist- inc cardiac output (B1), dec peripheral resistance (B2)-> reflex- more stimulation to inc rate

Front 12

organ system effects: eye

Back 12

a2- reduction of aq humor
a1- mydriasis
b2- inc of aq humor

Front 13

organ system effects: respiratory tract:

Back 13

B2 receptors ->relaxation

alpha receptors -> decongestion

Front 14

organ system effects: GU tract

Back 14

b2- relaxation of bladder wall and uterus

a1- urinary continence

ejaculation- normal alpha receptor function

Front 15

organ system effects: glands

Back 15

apocrine glands secrete in response to adrenergic stimulation

Front 16

organ system effects: metabolic effects

Back 16

inc potassium uptake into cells

Front 17

organ system effects: kidney

Back 17

a1- inhibit renin
b1- stimulate renin

Front 18

organ system effects: CNS

Back 18

have to cross BBB

amphetamine - low dose mild alerting and imrpoved attention
medium- anorexia, euphoria, insomnia,
high- psychotic

bc of inc dopamine activity

a2- dec sympathetic outflow

Front 19

which receptor causes platelet aggregation

Back 19

a2

Front 20

which receptor causes dec insulin production in pancreatic islet cells

Back 20

a2

Front 21

which receptor inhibits lipolysis in fat production

Back 21

a2

Front 22

which receptor promotes potassium uptake in skeletal muscle

Back 22

b2

Front 23

which receptor inc renin secretion in juxtaglomerular cells

Back 23

b1

Front 24

which receptor dilates renal blood vessels in smooth muscle

Back 24

d1

Front 25

which receptor moderates transmitter release in nerve endings

Back 25

d2

Front 26

epinephrine: rapid IV infusion

Back 26

a1 and b1 activated
inc peripheral resistance, inc rate and force of contraction
-vagal discharge

Front 27

epinephrine: small doses of epinephrine

Back 27

b2 vasodilation

Front 28

epinephrine- slow iv infusion

Back 28

moderate inc in systolic pressure B1,
reduction in diastolic pressure
(b2 vasodilation)
-no baroreceptor reflex

-hr, co, sv and force all increase

Front 29

epinephrine other effects

Back 29

think exercise- bronchodilation for more o2, inc glucagon secretion, inc blood glucose

Front 30

epinephrine therapeutic use

Back 30

-emergency asthma
-prolong local anesthetic (local vasoconstriction)
-emergency cases of cardiac arrest or complete heart block (IV)
-open angle glaucoma (inc aq outflow)
-anaphylactic shock DOC, dopamine preferred for non-anaphylactic shock

Front 31

norepinephrine

Back 31

a1, a2, b1 stimulation

HR, force of contraction, peripheral resistance inc, reflex reduce hr though.

use: inc bp in acute hypotensive state

Front 32

isoproterenol

Back 32

b receptors- dec peripheral resistance, inc HR and force of contraction- causes baroreceptor reflex inc symp.

used: bronchodilator

Front 33

dopamine

Back 33

only given IV
-D1- dilation of renal coronary and mesenteric arteries
D2- inhibit NE release

positive ionotropic effect at higher doses (b1)

uses: congestive heart failure in patients with oliguria or normal peripheral vascular resistance

Front 34

fenoldopam

Back 34

D1 selective used to lower BP in severe hypertension

Front 35

dobutamine

Back 35

b1 receptor selective
use: short term tx of cardiac decompensation

Front 36

phenylephrine

Back 36

a1 selective
potent vasporessor, reflex dec in heart rate to treat tachycardia

decongestant

Front 37

metaraminol

Back 37

direct and indirect acting sympathomimetic
-used to reverse or prevent hypotension assoc with spinal anesthesia, hemorrhagic hypotension, surgical complication hypotension etc.

Front 38

midodrine

Back 38

a1 selective
uses: postural hypotension

Front 39

clonidine

Back 39

a2 selective- tx of systemic hypertension- activating a2 receptors in brain stem
-used for dx of phaeochromocytoma

Front 40

guanfacine/guanabenz

Back 40

more selective a2 agonist then clonidine but same mechanisms and apps

Front 41

apraclonidine

Back 41

a2 agonist used to reduce IOP topically

Front 42

brimonidine

Back 42

a2 agonist lower IOP in open-angle glaucoma through reduction in aq humor production

Front 43

a2 agonist primarily used to reduce

Back 43

systemic hypertension

Front 44

b2 agonists primarily used to

Back 44

vasodilate bronchodilate without cardiac effects of B1 activation

-used for asthma and uterus relaxation in preterm labor

albuterol, terbutaline, metaproterenol, salmeterol, formoterol

Front 45

albuterol

Back 45

b2 agonist
inhalation or oral to treat asthma or bronchospasm, preterm labor

Front 46

terbutaline

Back 46

inhalation, subq or oral to treat emergency asthma, bronchospas, preterm labor

Front 47

metaproterenol

Back 47

less selective for b2 then others, inhalation to treat bronchospasm

Front 48

salmeterol

Back 48

b2 selective agent with long duration of action

asthma bronchospasm copd

Front 49

formoterol

Back 49

b2 agonist, rapid onset, long duration

Front 50

indirect acting sympathomimetics

Back 50

amphetamine, methamphetamine, methylphenidate
pemoline

inc release of all catecholamines but methylphenidate blocks reuptake of dopamine

inc dopamine centrally, inc NE peripherally

use: ADHD (methylphenidate due to lack of peripheral cv effects), narcolepsy

do not give with MAO inhibitors- if so- hypertensive crisis and death

Front 51

ephedrine

Back 51

-misc sympathomimetic- direct and indirect

can enter CNS and act as stimulant
-raises BP by inc CO and inducing peripheral vasoconstriction

use: nasal congestion relief and combat fall in BP during anesthesia

Front 52

pseudoephedrine

Back 52

less potent then ephedrine (misc sympathomimetic) used as decogestant

Front 53

cocaine

Back 53

blocks reuptake of catecholamines, can inc dopamine in CNS and cause hypertension and tachycardia

Front 54

tyramine

Back 54

indirect acting sympathomimetic

found in cheese and wines (patients on MAOi's should avoid this)

Front 55

adverse effects of sympathomimetics

Back 55

primarily CV

-inc BP an work and cause cardiac ischemia and failure

CNS toxicity does not occur with catecholamines