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55 Cards in this Set

  • Front
  • Back
a1 receptor
inc calcium
a2 receptor
dec adenylyl cyclase- reduction of cAMP production
B adrenergic receptor
inc adenylyl cyclase
rise in cAMP production
Dopamine receptors
D1- increased adenylyl cyclase inc cAMP
D2 dec. adenylyl cyclase reduce cAMP
alpha agonists
phenylephrine, methoxamine, a1>a2


clonidine a2>a1
mixed alpha and beta agonists
norepinephrine a1=a2, b1>b2
epinephrine a1=a2, b1 =b2
b agonists
dobutamine b1>b2 (heart)
isopoterenol b1=b2
terbutaline, metaproterenol, albuterol, ritodrine b2>b1, bronchodilation
dopamine agonists
dopamine d1=d2>>b>>a
fenoldopam D1>>D2
organ system effects: Blood vessels
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
organ system effects: heart
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
organ system effects: blood pressure
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
organ system effects: eye
a2- reduction of aq humor
a1- mydriasis
b2- inc of aq humor
organ system effects: respiratory tract:
B2 receptors ->relaxation

alpha receptors -> decongestion
organ system effects: GU tract
b2- relaxation of bladder wall and uterus

a1- urinary continence

ejaculation- normal alpha receptor function
organ system effects: glands
apocrine glands secrete in response to adrenergic stimulation
organ system effects: metabolic effects
inc potassium uptake into cells
organ system effects: kidney
a1- inhibit renin
b1- stimulate renin
organ system effects: CNS
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
which receptor causes platelet aggregation
a2
which receptor causes dec insulin production in pancreatic islet cells
a2
which receptor inhibits lipolysis in fat production
a2
which receptor promotes potassium uptake in skeletal muscle
b2
which receptor inc renin secretion in juxtaglomerular cells
b1
which receptor dilates renal blood vessels in smooth muscle
d1
which receptor moderates transmitter release in nerve endings
d2
epinephrine: rapid IV infusion
a1 and b1 activated
inc peripheral resistance, inc rate and force of contraction
-vagal discharge
epinephrine: small doses of epinephrine
b2 vasodilation
epinephrine- slow iv infusion
moderate inc in systolic pressure B1,
reduction in diastolic pressure
(b2 vasodilation)
-no baroreceptor reflex

-hr, co, sv and force all increase
epinephrine other effects
think exercise- bronchodilation for more o2, inc glucagon secretion, inc blood glucose
epinephrine therapeutic use
-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
norepinephrine
a1, a2, b1 stimulation

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

use: inc bp in acute hypotensive state
isoproterenol
b receptors- dec peripheral resistance, inc HR and force of contraction- causes baroreceptor reflex inc symp.

used: bronchodilator
dopamine
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
fenoldopam
D1 selective used to lower BP in severe hypertension
dobutamine
b1 receptor selective
use: short term tx of cardiac decompensation
phenylephrine
a1 selective
potent vasporessor, reflex dec in heart rate to treat tachycardia

decongestant
metaraminol
direct and indirect acting sympathomimetic
-used to reverse or prevent hypotension assoc with spinal anesthesia, hemorrhagic hypotension, surgical complication hypotension etc.
midodrine
a1 selective
uses: postural hypotension
clonidine
a2 selective- tx of systemic hypertension- activating a2 receptors in brain stem
-used for dx of phaeochromocytoma
guanfacine/guanabenz
more selective a2 agonist then clonidine but same mechanisms and apps
apraclonidine
a2 agonist used to reduce IOP topically
brimonidine
a2 agonist lower IOP in open-angle glaucoma through reduction in aq humor production
a2 agonist primarily used to reduce
systemic hypertension
b2 agonists primarily used to
vasodilate bronchodilate without cardiac effects of B1 activation

-used for asthma and uterus relaxation in preterm labor

albuterol, terbutaline, metaproterenol, salmeterol, formoterol
albuterol
b2 agonist
inhalation or oral to treat asthma or bronchospasm, preterm labor
terbutaline
inhalation, subq or oral to treat emergency asthma, bronchospas, preterm labor
metaproterenol
less selective for b2 then others, inhalation to treat bronchospasm
salmeterol
b2 selective agent with long duration of action

asthma bronchospasm copd
formoterol
b2 agonist, rapid onset, long duration
indirect acting sympathomimetics
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
ephedrine
-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
pseudoephedrine
less potent then ephedrine (misc sympathomimetic) used as decogestant
cocaine
blocks reuptake of catecholamines, can inc dopamine in CNS and cause hypertension and tachycardia
tyramine
indirect acting sympathomimetic

found in cheese and wines (patients on MAOi's should avoid this)
adverse effects of sympathomimetics
primarily CV

-inc BP an work and cause cardiac ischemia and failure

CNS toxicity does not occur with catecholamines