Adrenergic Agonists (Catecholamines And Sympathomimetics)

Front 1

List 5 primary sympathomimetics.

Back 1

PENIT

phenylephrine, epinephrine, norepinephrine, isoproterenol, terbutaline

Front 2

Which receptor(s) does epinephrine stimulate?

Back 2

alpha-1, alpha-2, beta-1, beta-2

Front 3

Which receptor(s) does norepinephrine stimulate?

Back 3

alpha-1, alpha-2, beta-1

Front 4

Which receptor(s) does phenylephrine stimulate?

Back 4

alpha-1

Front 5

Which receptor(s) does isoproterenol stimulate?

Back 5

beta-1, beta-2

Front 6

Which receptor(s) does terbutaline stimulate?

Back 6

beta-2

Front 7

Blood vessels with alpha-1 receptors are located where (4)?

Back 7

skin, kidney (renal artery), brain, sphincters of GI system, where they...

Hint 7

cause vasoconstriction, decreasing blood flow to these organs during sympathetic stimulation

Front 8

Alpha-1 receptors are located in smooth muscle of blood vessels as well as the ________ in women and the ________ in men.

Back 8

uterus, seminal tract, the effects being.....

Hint 8

contraction of the uterus in pregnancy and ejaculation

Front 9

Alpha-1-mediated contraction is drowned out by the beta-2-mediated effects in the _____ and ______.

Back 9

bladder and bronchioles (overall effect of sympathetic stimulation is...)

Hint 9

relaxation of bladder (inhibiting micturition) and bronchioles (facilitating easy breathing)

Front 10

While alpha-1 receptors in most smooth muscle mediates contraction/vasoconstriction, the exceptions are relaxation/vasodilation in the ____ and _____.

Back 10

Smooth muscle of the GI tract (other than sphincters) and erectile tissue, resulting in...

Hint 10

lack of motility and vasodilation causing erection

Front 11

Alpha-1 receptors in the eye are located in the ______ muscles, contraction of which results in ______.

Back 11

dilator pupillae (radial part of the iris); mydriasis (without cycloplegia)

Front 12

Vasoconstriction mediated by alpha-1 agonists has what clinical applications (4)?

Back 12

blood pressure elevation, hemostasis, nasal decongestion, prolongation of local anesthetic action

Front 13

Activation of CNS alpha-2 receptors _____ sympathetic outflow to the periphery.

Back 13

reduces; this explains the use of alpha-2 agonists as ______.

Hint 13

antihypertensives

Front 14

Stimulation of alpha-2 receptors in the eye results in what?

Back 14

decreased aqueous humor production by the ciliary body, which explains the use of alpha-2 agonists in treating ______.

Hint 14

glaucoma

Front 15

Beta-1 agonist heart effects

Back 15

Increased contractility (inotropic effect) and heart rate (chronotropic effect), resulting in increased cardiac output. This explains the use of these drugs in ___________.

Hint 15

shock

Front 16

Beta-2 agonists dilate __________ and relax the __________.

Back 16

bronchioles; uterus (explains use in ______, ________, _______)

Hint 16

asthma, COPD, preventing premature labor (controversial)

Front 17

Advantages of non-catecholamines (3).

Back 17

orally effective, long duration of action, can cross blood-brain barrier to produce CNS effects. (what's the biochemical distinction?)

Hint 17

lack of catechol functional group (OH on adjacent carbons)

Front 18

What are the three mechanisms of action for sympathomimetics?

Back 18

direct-acting, indirect-acting, mixed-acting (how is each response affected by reserpine?)

Hint 18

direct--not affected; indirect--abolished; mixed--reduced

Front 19

Cardiac effects of epinephrine?

Back 19

positive inotropism, chronotropism, and automaticity (mediated by what receptor)

Hint 19

beta-1

Front 20

Epinephrine effects on blood flow in the heart, kidney, skin?

Back 20

increased coronary flow, decreased renal and cutaneous flow (mediated by?)

Hint 20

NO, alpha-1, alpha-1

Front 21

Epinephrine effects on skeletal muscle at low (physiologic) dose?

Back 21

increased blood flow (mediated by)

Hint 21

Beta-2 (epi has high affinity for this receptor with low density)

Front 22

Epinephrine's effect on skeletal muscle at high (therapeutic) doses?

Back 22

decreased blood flow (mediated by?)

Hint 22

alpha-1 receptors (lower affinity but higher density)

Front 23

Drug interactions of epinephrine (4)?

Back 23

MAO inhibitors, tricyclic antidepressants, general anesthetics, alpha- and beta-blockers

Front 24

Clinical uses of IV norepinephrine?

Back 24

hypotensive state, cardiac arrest (notably not used for ______ or _______)

Hint 24

asthma or anaphylactic shock (no beta-2 receptors

Front 25

Clinical uses of isoproterenol (IV or IM)?

Back 25

AV block/bradycardia, cardiac arrest, bronchospasm during anesthesia (no longer used for asthma because __________)

Hint 25

beta-2 selective drugs are preferred

Front 26

Effects of dopamine on the heart?

Back 26

inotropic effect (no chronotropic effect)

Front 27

Renal effects of dopamine via D-1 receptor?

Back 27

dilation of renal blood flow, increasing GFR (what does this do to sodium?)

Hint 27

increases excretion (diuretic effect)

Front 28

Clinical applications of dopamine?

Back 28

renal failure, severe congestive heart failure, treatment of shock (why does it work to treat shock?)

Hint 28

at high doses, activates alpha-1 receptors which decreases skeletal muscle blood flow

Front 29

Therapeutic use of dobutamine (IV)?

Back 29

cardiac stimulant to treat CHF (advantage over isoproterenol?)

Hint 29

Because it's selective for beta-1 receptors, there is less reflex tachycardia

Front 30

What are the clinical uses of phenylephrine?

Back 30

nasal decongestant, vasopressor, mydriatic, detumescent (why?)

Hint 30

selective for alpha-1 receptors means marked vasoconstriction (also why it's a high alert medication)