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31 Cards in this Set
- Front
- Back
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Mechanism types of Adrenergic drugs |
Direct Acting Indirect Acting Dual Acting |
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Adrenergic receptor sites |
Alpha (1&2) Beta (1&2) Dopamine (1-4) |
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Alpha-1 activation includes |
vasoconstriction |
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alpha-2 activation includes |
decreases PRESYNAPTIC release of catecholamines |
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Beta-1 Activation includes |
tachycardia increased force of myocardial contraction |
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Beta-2 Activation includes: |
bronchodilation dilation of blood vessels in skeletal muscle contraction of uterine smooth muscle (not in latter stages of pregnancy) hyperglycemia (glycogenolysis & gluconeogenesis) mydriasis (but decreases IOP by stimulating outflow and inhibiting production of aqueous humor) |
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Routes of Epi |
nasal ophthalmic inhalation parenteral routs |
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What drugs can cause potentiation of Epi |
TCA's and MAO inhibitors |
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Epi brochondialtion is blocked by what? |
propranolol |
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Advantage of DA over epi and NE |
causes less myocardial oxygen demand and fewer arrhythmias than E & NE |
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NE vs E advantage |
NE is more specific direct activation of alphia-adrenergic sites --> strong vasoconstriction |
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Main use of NE |
pressor action in acute hypotensive states |
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Main contraindications of NE |
hypovolemic shock (lots of blood loss) |
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What would enhance the pressor effects of NE |
tricyclic antidepressants and MAO inhibitors |
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Dopamine |
direct activation of DOPA renal --> vasodilation /increased renal bloodflow Activates myocardial beta-1 receptors (increased force of contraction / CO) High Doses = apha receptors --> vasoconstriction |
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Advantage of DA over NE/E |
less myocardial oxygen demand and fewer arrhythmias |
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Use of DA |
correction of adverse hemodynamic effects during shock |
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T/F DA pressor effects are enhanced by only MAO inhibitors? |
FALSE
MAO inhibitors tricyclic antidepressants |
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Major pharmacologic effect of Alpha-1 adrenergic vasopressor amines |
systemic vasoconstriction |
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Mephentermine stimulation / effects |
Direct: activation of alpha-1 sites (some beta-1) Indirect: release of NE Pressor: increased CO (beta-1), peripheral vasoconstriction (alpha-1) ***may produce reflex bradycardia (reduced with atropine) |
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Epi as a opthalmic decong |
beta-adrenergic effect decreases formation of aq. humor |
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Advantage of Alpha-1 adrenergic ophthalmic decongestants over anticholinergic agents |
unlike antichol's they do not cause - cycloplegia - Increase in intraocular pressure (IOP) |
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Contraindication of Alpha-1 adrenergic ophthalmic decongestants |
narrow-angle glaucome (production of mydriasis) |
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Uses of Alpha-1 adrenergic ophthalmic decongestants |
examination of fundus of the eye treatment of open-angle glaucoma (increased outflow & decreased production of aq. humor) dilation of the pupil prior to intraocular surgery |
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Dipivefrin effects / uses etc... |
reduce IOP in chronic open-angle glaucoma lipid-soluble PRO-DRUG of EPI Fewer ADRS than E, less drug required (better absorption) contraindicated in narrow-angle glaucoma |
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Alpha-2 Adrenergic ophthalmic decongestants |
Clonidine activate alpha 2 autoreceptors on presyn membrane hypotension, sedation & analgesia |
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beta-1 adrenergic synthetic catecholamines |
Dobutamine Relatively specific: direct act Beta1 on myocardium minimial action on alpha and beta 2 acute treatment of heart failure due to depressed contractility |
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Smooth muscle relaxant drugs |
Isoxuprine Ritodrine |
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Contraindications of Ritodrine |
don't give prior to 20th week of pregnancy if condidtion that makes pregnancy dangersous exists: antepartum hemorrhage, fetal death |
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Beta-1 & Beta-2 Synthetic catecholamines |
Isoproterenol Ephedrine |
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CNS stimulants and Anorexiants |
Amphetamine derivs Ephedrine Phenylpropanolamine |
