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116 Cards in this Set
- Front
- Back
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Trade name of epinephrine
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adrenaline chloride
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Trade name of Norepinephrine
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Levophed
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Trade name of Dopamine
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Dopamine
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Trade name of ephedrine
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ephedrine
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Mechanism of action of Epinephrine
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stimulates A1/A2 and B1/B2 (Beta more at low dose, add alpha at high dose)
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Mechanism of action of Norepinephrine
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α-agonist, β1-
agonist stimulates A1/A2 and BI (NOT NOT NOT Beta-2! ) |
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Mechanism of action of Dopamine
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β-agonist, some
α-agonist activity D1/B1 at low dose, see A1/A2/B1 like NE at high dose |
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Mechanism of action of Isoproterenol
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β-agonist
NONSPECIFIC B AGONIST stimulates BETAs only B1 & B2 |
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Mechanism of action of Dobutamine
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β1-agonist
B1 AGONIST at appropriate dose (B1>B2>A) |
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Mechanism of action of Terbutaline
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β2-agonist
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Mechanism of action of Albuterol
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β2-agonist
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Mechanism of action of Phenylephedrine
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α1-agonist
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Mechanism of action of Clonidine
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α2-agonist
A2 AGONIST; decreases sympathetic outflow from CNS, A2 is hooked up to Gi |
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Mechanism of action of Amphetamine (Adderall)
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Indirect
sympathomimetic |
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Mechanism of action of Methylphenidate (Ritalin)
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Indirect
sympathomimetic |
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Mechanism of action of Ephedrine
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Indirect
sympathomimetic |
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Mechanism of action of Psuedo-ephedrine (Sudafed)
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Indirect
sympathomimetic |
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Mechanism of action of Tyramine
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Displaces NE
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Mechanism of action of Propranolol
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β-blocker
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Mechanism of action of Timolol
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β-blocker
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Mechanism of action of Nadolol
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β-blocker
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Mechanism of action of Atenolol
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β1-blocker
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Mechanism of action of Metoprolol
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β1-antagonist
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Mechanism of action of Pindolol
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β-antagonist
(with partial agonist activity) |
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Mechanism of action of Esmolol
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β1-blocker
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Mechanism of action of Phenoxy-benzamine
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α-blocker
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Mechanism of action of Phentolamine
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α-blocker
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Mechanism of action of Prazosin
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α-blocker
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Mechanism of action of Doxazosin
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α1-antagonist
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Mechanism of action of Terazosin
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α1-blocker
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Elimination of Epinephrine
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COMT-urine
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Elimination of Norepinephrine
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MOA and COMT
-urine |
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Elimination of Dopamine
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MOA and COMT
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Elimination of Isoproterenol
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COMT-urine
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Elimination of Dobutamine
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COMT- urine
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Elimination of Terbutaline
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Urine
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Elimination of Albuterol
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Urine
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Elimination of Phenylephrine
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MAO
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Elimination of Clonidine
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Urine
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Elimination of Amphetamine (Adderall)
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Urine
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Elimination of Methylphenidate (Ritalin)
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Urine
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Elimination of Tyramine
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MAO
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Elimination of Ephedrine
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Urine
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Elimination of Psuedo-ephedrine
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Liver
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Elimination of Propranolol
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Liver
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Elimination of Timolol
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Liver
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Elimination of Nadolol
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Urine
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Elimination of Atenolol
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Urine
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Elimination of Metoprolol
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Liver
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Elimination of Pindolol
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Urine
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Elimination of Esmolol
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Esterases in RBC
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Elimination of Phenoxy-Benzamine
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Conjugates to receptor
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Elimination of Phentolamine
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Urine
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Elimination of Prazosin
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Liver
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Elimination of Doxazosin
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Liver
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Elimination of Terazosin
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Urine and Fecal
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Why use epinephrine
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Anaphylaxis,
shock, cardiac arrest and heart block |
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Why use norepinephrine
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Acute hypotension
due to shock |
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Why use dopamine
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cardiogenic shock
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Why use Isoproterenol
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Transient heart
block, bronchospasm during anesthesia |
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Why use Dobutamine
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Short term Rx for
low cardiac contractility |
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Why use Terbutaline
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Prevent and
reverse bronchospasm in asthma, bronchitis and emphysema |
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Why use Albuterol
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Bronchial SM
relaxation |
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Why use Phenylephrine
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Pressor agent for
anesthesia, nasal congestion, dilate pupil for eye exam, supraventricular |
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Why use Clonidine
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Hypertension due to sympathetic activation,
analgesia |
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Why use Amphetamine (adderall)
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ADHD
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Why use Methylphenidate (Ritalin)
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ADHD
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Why use Ephedrine
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Pressor agent with anesthesia
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Why use Pseudoephedrine (Sudafed)
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Nasal decongestion
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Why use Tyramine
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Not therapeutic
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Why use Propranolol
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Hypertension,
angina due to atherosclerosis, MI |
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Why use Timolol
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Glaucoma.
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Why use Nadolol
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Long-term angina,
hypertension |
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Why use Atenolol
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Hypertension,
angina, MI |
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Why use Metoprolol
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Hypertension,
long-term angina rx |
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Why use Pindolol
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Hypertension
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Why use Esmolol
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Supraventricular
tachycardia |
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Why use Phenoxybenzamine
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Pheochromocytoma
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Why use Phentolamine
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Test for
pheochromocytoma, rx for pheo. before surg., Catecholamine extravasation |
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Why use Prazosin
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Hypertension
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Why use Doxazosin
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Prostatic
hyperplasia, because it relaxes prostatic smooth muscle allowing urination hypertension |
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Why use Terazosin
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Prostatic
hyperplasia, hypertension |
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Which agonists have really short half lives
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Epi, norepi, dopamine, Isoproterenol, Dobutamine
phenylphendrine- less than 1 hr |
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Which antagonists have really short half lives
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Esmolol about 9 minutes Phentolamine about 2 hrs
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Beta blocker half lives
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Propranolol- 4 hrs
TImolol- 4 hrs Nadolol- 20-24 hrs |
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Tyramine half life
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normally very short
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Toxicity of Dopamine
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Low BP at low infusion rates
Ischemia at high infusion rates |
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contraindications of Dopamine
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Tachyarrhythmias
Vfib |
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Toxicity of Isoproterenol
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Tachyarrhythmias
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Contraindication of Isoproterenol
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Angina w/ arrhythmias
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Toxicity of Dobutamine
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Arrhytmias or hypotension at too high of a dose
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Toxicity of Albuterol
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Tachycardia, Muscle Tremor, or Tolerance
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Indications of Albuterol
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Bronchospasm Chronic Rx of obstructive airway Dx
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Toxicity of Phenylephrine
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Hypertension
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Toxicity of Clonidine
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Dry Mouth, Sedation, Bradycardia, Hypertensive crisis after acute withdrawal meaning a sudden stopping of treatment because may have become more sensitive to sympathetic drive
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toxicity for amphetamine, methamphetamine, ephedrine, pseudoephedrine, and tyramine
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tachycardia and anxiety
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Non-selective beta blockers
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propranolol, timolol (optho), nadolol (p with longer half life)
beta 1, 2 |
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Cardioselective Beta blocker
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atenolol and metoprolol (B1)
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Partial Agonist Beta blocker
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Pindolol B1 and 2
benefit is that maybe you don't get the side effect |
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Toxicity of Propranolol/Nadolo/Timolol
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bronchospasm* mask symptoms of hypoglycemia, insomnia, depression, bradycardia
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Contraindications of non-selective beta blockers
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bronchospasm during asthma, sinus bradycardia, 2nd and 3rd degree heart block, cardiogenic shock
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Contraindications of cardioselective beta blocker
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sinus brady
2 & 3 degree heart block cardiogenic shock severe heart failure |
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Which cardioselective beta blocker is given emergently
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esmolol for sever arrhythmias
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Toxicity of cardioselective beta blocker
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dizziness, depression, insomnia, hypotension, bradycardia
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Toxicity of Partial Agonist Beta blocker
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Dizziness
Depression Insomnia Hypotension |
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Contraindications for Pindolol
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Sinus brady
2&3 degree heart block cardiogenic shock |
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What can beta blockers increase?
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lipids
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Nonselective alpha blockers?
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phentolamine/phenoxybenzamine
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Toxicity of alpha blockers
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prolonged hypotension
reflex tachycardia nasal congestion |
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Contraindicatons for alpha blockers
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coronary artery disease
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Toxicity of selective alpha 1 blockers
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syncopy
orthostatic hypotension |
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Activity of alpha 1 receptors
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contract vascular smooth muscle
dilates the pupil |
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Activity of alpha 2 receptor
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inhibits NT release from adrenergic and cholinergic synapses
contracts some vascular smooth muscle |
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Activity of Beta 1 receptor
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Stimulates heart rate
increases force of contraction stimulates renin release |
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Activity of Beta 2 receptor
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relaxes respiratory, uterine, and vascular smooth muscle
causes tremor |
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Activity of Dopamine receptors
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relaxes renal and other splanchnic vessels
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