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40 Cards in this Set

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Adrenergic Agents
Drugs that stimulate the sympathetic nervous system (also known as)

* Adrenergic Agonists

*Sympathomimetics
Norepinephrine (NE)

Epinephrine (EPI)
Mimic the effects of the SNS neurotransmitters
Epinephrine
Increased heart rate
Norepinephrine
Should be relaxing
Respond to NorEpinephrine
Alpha-adrenergic receptors
Respond to Epinephrine
Beta-adrenergic receptors
Respond to dopamine
Dopaminergic receptors
CARDIOVASCULAR

Alpha 1/ Beta 2
Blood Vessels - Constriction/Dialation
CARDIOVASCULAR

Beta 1
Cardiac Muscle - Increased Contractility

Atrioventricular Node - Increased Heart Rate

Sinoartrial Node - Increased Heart Rate
ENDOCRINE

Beta 1
Pancrease Release - Decreased Insulin
ENDOCRINE

Beta 2
Liver - Glycogenolysis

Kidney - Increased Renin Secretion
GASTROINTESTINAL

Beta 2
Muscle - Decreased Motility
GASTROINTESTINAL

Alpha 1
Sphincters - Constriction
GENITOURINARY

Alpha 1
Bladder Sphincter - Constriction


Penis - Ejaculation
GENITOURINARY

Alpha 1 / Beta 2
Uterus - Contraction/Relaxation
RESPIRATORY

Beta 2
Bronchial Muscles - Dilation
Alpha 1 Adrenergic Receptors
Located on postsynaptic effector cells (the cell, muscle, or organ that the nerve
stimulates)
Alpha 2 Adrenergic Receptors
• Located on presynaptic nerve terminals (the nerve that stimulates the effector
cells)

• Control the release of neurotransmitters
Predominant Alpha-
Adrenergic Agonist Responses
• Vasoconstriction

• CNS stimulation
Beta-Adrenergic Receptors
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
Beta-Adrenergic Agonist
Response
Results in:

**• Bronchial, GI, and uterine smooth muscle relaxation

**•Glycogenolysis

**•Cardiac stimulation
Responses to Stimulation

Cardiovascular:

Alpha1 & Beta 2
Blood vessels - Constriction/
Dilation
Responses to Stimulation

Cardiovascular:

Beta 1
*Cardiac Muscle - Increased
Contractility

AV Node - Increased Heart Rate

SA Node - Increased heart rate
Responses to Stimulation

Gastrointestinal:

Beta 2
**Muscle - Decreased motility
Responses to Stimulation

Gastrointestinal:

Alpha 1
**Sphincters - Constriction
Responses to Stimulation

Genitourinary

Alpha 1
Bladder, Sphincter - Constriction

***Penis - Ejaculation
Responses to Stimulation

Genitourinary

Alpha 1 and Beta 2
***Uterus - Contraction/Relaxation
Responses to Stimulation

Respiratory

Beta 2
Bronchial muscles - Dilation/Relaxation
Catecholamines
• Substances that can produce a sympathomimetic response

• Endogenous – Epinephrine, norepinephrine, dopamine

• Synthetic – Isoproterenol, dobutamine, phenylephrine
Mechanism of Action

• Direct-acting sympathomimetic
– Binds directly to the receptor and causes a
physiologic response
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
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
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)
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)
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
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
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
Alpha-Adrenergic Side Effects

***CNS
• Headache, restlessness, excitement, insomnia,
euphoria
Alpha-Adrenergic Side Effects

***Cardiovascular
• Palpitations (dysrhythmias), tachycardia, vasoconstriction, hypertension
Alpha-Adrenergic Side Effects

***Other
• Anorexia, dry mouth, nausea, vomiting, taste changes (rare)