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40 Cards in this Set
- Front
- Back
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Adrenergic Agents
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Drugs that stimulate the sympathetic nervous system (also known as)
* Adrenergic Agonists *Sympathomimetics |
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Norepinephrine (NE)
Epinephrine (EPI) |
Mimic the effects of the SNS neurotransmitters
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Epinephrine
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Increased heart rate
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Norepinephrine
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Should be relaxing
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Respond to NorEpinephrine
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Alpha-adrenergic receptors
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Respond to Epinephrine
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Beta-adrenergic receptors
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Respond to dopamine
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Dopaminergic receptors
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CARDIOVASCULAR
Alpha 1/ Beta 2 |
Blood Vessels - Constriction/Dialation
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CARDIOVASCULAR
Beta 1 |
Cardiac Muscle - Increased Contractility
Atrioventricular Node - Increased Heart Rate Sinoartrial Node - Increased Heart Rate |
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ENDOCRINE
Beta 1 |
Pancrease Release - Decreased Insulin
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ENDOCRINE
Beta 2 |
Liver - Glycogenolysis
Kidney - Increased Renin Secretion |
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GASTROINTESTINAL
Beta 2 |
Muscle - Decreased Motility
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GASTROINTESTINAL
Alpha 1 |
Sphincters - Constriction
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GENITOURINARY
Alpha 1 |
Bladder Sphincter - Constriction
Penis - Ejaculation |
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GENITOURINARY
Alpha 1 / Beta 2 |
Uterus - Contraction/Relaxation
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RESPIRATORY
Beta 2 |
Bronchial Muscles - Dilation
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Alpha 1 Adrenergic Receptors
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Located on postsynaptic effector cells (the cell, muscle, or organ that the nerve
stimulates) |
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Alpha 2 Adrenergic Receptors
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• Located on presynaptic nerve terminals (the nerve that stimulates the effector
cells) • Control the release of neurotransmitters |
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Predominant Alpha-
Adrenergic Agonist Responses |
• Vasoconstriction
• CNS stimulation |
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Beta-Adrenergic Receptors
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All are located on postsynaptic effector cells
• Beta1-adrenergic receptors—located primarily in the heart • Beta2-adrenergic receptors—located in smooth muscle of the bronchioles, arterioles, and visceral organs |
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Beta-Adrenergic Agonist
Response |
Results in:
**• Bronchial, GI, and uterine smooth muscle relaxation **•Glycogenolysis **•Cardiac stimulation |
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Responses to Stimulation
Cardiovascular: Alpha1 & Beta 2 |
Blood vessels - Constriction/
Dilation |
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Responses to Stimulation
Cardiovascular: Beta 1 |
*Cardiac Muscle - Increased
Contractility AV Node - Increased Heart Rate SA Node - Increased heart rate |
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Responses to Stimulation
Gastrointestinal: Beta 2 |
**Muscle - Decreased motility
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Responses to Stimulation
Gastrointestinal: Alpha 1 |
**Sphincters - Constriction
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Responses to Stimulation
Genitourinary Alpha 1 |
Bladder, Sphincter - Constriction
***Penis - Ejaculation |
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Responses to Stimulation
Genitourinary Alpha 1 and Beta 2 |
***Uterus - Contraction/Relaxation
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Responses to Stimulation
Respiratory Beta 2 |
Bronchial muscles - Dilation/Relaxation
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Catecholamines
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• Substances that can produce a sympathomimetic response
• Endogenous – Epinephrine, norepinephrine, dopamine • Synthetic – Isoproterenol, dobutamine, phenylephrine |
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Mechanism of Action
• Direct-acting sympathomimetic |
– Binds directly to the receptor and causes a
physiologic response |
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Mechanism of Action
Indirect-acting sympathomimetic |
• Causes the release of catecholamine from the storage sites (vesicles) in the nerve endings
• The catecholamine then binds to the receptors and causes a physiologic response |
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Mechanism of Action
Mixed-acting sympathomimetic |
• Directly stimulates the receptor by binding to it
and • Indirectly stimulates the receptor by causing the release of stored neurotransmitters from the vesicles in the nerve endings |
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Drug Effects
Stimulation of alpha-adrenergic receptors on smooth muscles results in: |
• Vasoconstriction of blood vessels
• Relaxation of GI smooth muscles • Contraction of the uterus and bladder • Male ejaculation • Decreased insulin release • Contraction of the ciliary muscles of the eye (dilated pupils) |
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Drug Effects
Stimulation of beta1 adrenergic receptors on the myocardium, AV node, and SA node results in cardiac stimulation |
**• Increased force of contraction **(positive inotropic effect)**
• Increased heart rate (positive chronotropic effect) • Increased conduction through the AV node (positive dromotropic effect) |
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Drug Effects
Stimulation of beta2-adrenergic receptors on the airways results in: |
• Bronchodilation (relaxation of the bronchi)
• Uterine relaxation • Glycogenolysis in the liver • Increased renin secretion in the kidneys |
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Indications
These agents may also affect uterine and vascular smooth muscles |
Examples:
• ephedrine • isoetharine • levalbuterol • salmeterol • albuterol (If they get off albuterol and go to levalbuterol, you normaly stay on it and not go back to albuterol) • epinephrine • isoproterenol • metaproterenol • terbutaline • Reduction of intraocular pressure and mydriasis (pupil dilation): treatment of open-angle glaucoma ****•Alpha- or beta2-receptors, or both • Examples: epinephrine and dipivefrin**** ****• Temporary relief of conjunctival congestion****(thing of allergies) •Alpha-adrenergic receptors • Examples: • epinephrine • phenylephrine • naphazoline • tetrahydrozoline |
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Therapeutic Uses
***Nasal decongestant*** |
****• Intranasal (topical) application causes constriction of dilated arterioles and reduction of nasal blood flow, thus
decreasing congestion**** •Alpha1-adrenergic stimulation Examples: • epinephrine • ephedrine • naphazoline • phenylephrine • tetrahydrozoline |
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Alpha-Adrenergic Side Effects
***CNS |
• Headache, restlessness, excitement, insomnia,
euphoria |
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Alpha-Adrenergic Side Effects
***Cardiovascular |
• Palpitations (dysrhythmias), tachycardia, vasoconstriction, hypertension
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Alpha-Adrenergic Side Effects
***Other |
• Anorexia, dry mouth, nausea, vomiting, taste changes (rare)
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