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68 Cards in this Set
- Front
- Back
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Sympathomimetic |
Mimic sympathetic NS |
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Sympathetic responses |
Increase heart rate, force of contraction, velocity of electricity, peripheral vasoconstriction, BP Decrease blood flow to kidneys Breakdown stored resources increasing glucose Ischaemia = necrotic tissue |
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Adrenergic receptors bind to |
Epi norepinephrine dopamine |
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Adrenergic receptors promote the release of _____ and reuptake of _______. Also inhibit inactivation. Inhibit MAO |
Norepinephrine |
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MAO |
monoamine oxidase |
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Catecholamines |
IV, brief, not BBB Ex: epi, norepinephrine, and dobutamine |
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Noncatecholimines |
Oral, long, cross BBB Ex: ephedrine, albuterol, phenylephrine, terbutaline |
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Epi effects |
A 1 2 and B 1 2 |
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Norepinephrine effects |
A 1 2 and B 1 |
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Dopamine effects |
A 1 B 1 and dopamine |
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Dobutamine effects |
B 1 |
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Ephedrine effects |
A 1 2 and B 1 2 |
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Phenylephrine effects |
A 1 |
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Terbutaline effects |
B 2 |
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Albuterol effects |
B 2 |
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Alpha 1 receptor activation |
Vasoconstriction (elevated BP and nasal decongestion) Adjunct to local anesthesia bc vessels will constrict to prevent toxicity and keep it in the local area Mydriasis |
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Mydriasis |
Dilation of pupils |
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Adverse effects of alpha 1 activation |
Hypertension, necrosis, reflex bradycardia (elevated BP triggers baroreceptors and HR declines) |
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Alpha 2 receptor activation |
Minimal peripheral effects Primarily CNS effects Activate presynaptic neurons- reduce sympathetic stimulation of CVS and reduce pain response |
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Where are adrenergic drugs working |
In peripheral NS not CNS |
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Beta 1 receptor activation |
Stimulates the heart Cardiac arrest (restart arrested heart, positive inotrope by increasing force contraction, increase conduction of SC block) |
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Adverse effects of beta 1 activation |
Altered rate or rhythm, angina pectoris, MI by increasing the workload of heart |
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Beta 2 receptor activation |
Bronchodilation asthma pre term labor Uterine smooth muscle contraction can slow labor |
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Adverse effects of beta 2 receptor activation |
Tremor- skeletal muscle stimulation Hyperglycemia- promotes breakdown of glycogen to glucose |
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Dopamine receptor activation peripheral |
Dopamine is only neurotransmitter Peripheral receptors in kidney (dilate renal bv, protect kidney- shock, increase urine output) |
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Adrenergic agonist- epi |
Everything from anaphlactic shock to nasal decongestant alpha 1 All adrenergic receptors Cardiac, vascular, pulmonary effects Varied concentration and administration routes: IV, SC, topical, inhalation, intracardiac, intraspinal |
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What intensified the effects of epi |
TriC antidepressants and MAO inhibitors |
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Epi A 1 |
delay absorption of local anesthetics, control superficial bleeding, reduce nasal congestion, increase BP, and dilate pupils |
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Epi B 1 |
Cardiac stimulation, overcome AV block, and start a stopped heart |
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Epi B 2 |
Bronchodilation |
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Norepinephrine/levophed |
A 1 and B 1 (BP and heart rate) Easily and quickly broken down Only given IV drip no pb Strong A 1 less B 1 Constant monitoring |
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What is the drug of choice for lie threatening hypotension |
Norepinephrine/levophed |
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Dobutamine/dobutrex (mule) |
B 1 specific - increase force of heart Positive inotropic effect Improve CO in heart failure Effectiveness of drug needs to be balanced with patients condition (MI may be extended if workload increases) |
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What prolongs and intensifies the effect of dobutamine |
MAO inhibitors and TriC antidepressants |
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Dopamine/intropin |
Dose dependant Low doses- increase renal perfusion and urinary output, d-receptors High doses- vasoconstrict A 1, increase HR B 1 (decreases BP bc warm and vessels dilate) Balance with patient status- don't overwork heart, tachydysrythmias, tissue ischwmia, peripheral necrosis |
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Beta 2 drug |
Albuterol/ventolin |
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Albuterol/ventolin |
Asthma- mediated bronchodilation Side effect is tremor and tachycardia with large doses that effect B 1 Not beta selective |
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What is the drug of choice to delay preterm labor |
Terbutalene/brethine |
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Ephedrine noncatecholimine MOST USED |
Activates A 1 2 and B 1 2 directly Acts directly and increases norepinephrine release Nasal decongestion A 1 but when inhaled there is intense rebound, if taken oral there are a lot of side effects (HTN, dysthymias, angina, hyperglycemia, insomnia) Narcolepsy A 2 receptors to brain |
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Phenylephrine/neo-synephrine |
A 1 Nasal decongestion- orally and topically, BP side effects, less rebound than ephedrine and epi Parenteral increases BP (post op) |
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Amphetamines |
Agonist increases symp Increase release and slow reuptake of norepinephrine and dopamine CNS- euphoria PNS-cardiovascular (appetite suppressant, narcolepsy, ADHD) |
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Amphetamines ephedrine pseudoephedrine |
Nasal congestion, weight loss, cardiac events and stroke (f>m) BANNED in OTC products, used to make meth |
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Adrenergic antagonists |
Drugs that inhibit the sympathetic |
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Alpha blockade |
Used for essential hypertension Benign prostatic hyperplasia (relax smooth muscle in prostate) Pheochromocytoma- catecholamine secreting tumor (adrenal medulla) Raynaud's disease- peripheral vasospasms When overdose on a 1 agonist |
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Alpha 1 blockers |
Prazosin/minipress Vasodilation, htn Ortho static hypotension 1st dose effect is really bad Reflex tachycardia Nasal congestion Inhibition of ejaculation Sodium retention |
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A 1 blockers |
Tamsulosin/flomax BPH Selective so not so many side effects Specific to bladder neck prostate and urethra NOT USED FOR HTN can cause impotence Allow urine to flow easy |
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Impotence |
Occurs when a man can't get or keep an erection firm enough for sexual intercourse |
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Phentolamine/regitine |
A 1 and 2 Cause vasodilation to save tissues Prevent necrosis with extravasation of vasoconstriction (dopa/ levo) |
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What is a BP controller but not reducer |
Beta blocker |
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Beta blocker |
Therapeutic effects REDUCE CARDIAC WORKLOAD reduce heart rate, force of contraction, velocity of impulse conduction |
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Beta block therapeutic uses |
Angina pectoris, htn, dysthymias (tachy), MI, heart failure, migraine, hyperthyroidism, stage fright, Pheochromocytoma |
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Beta blockade adverse effects |
Bradycardia, reduced CO, precipitation of heart failure, AV heart block, bronchoconstriction, peripheral vasoconstriction, inhibition of glycogenolysis, rebound cardiac excitation (body will load up with epi) |
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Never give beta blockers to these people because they will have a heart attack |
AV heart block people |
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Common beta blockers Nonselective Selective Alpha 1 and beta 1 and 2 |
Propranolol/inderal (give when wheezing effect BP) nadolol/corgard Metoprolol/lopresson toprol and atenolol/tenormin (long acting) Carvedilol/coreg (IV) and labetalol/normodyne/trandate (effect heart rate and BP |
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lol= |
Beta blocker |
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Indirect acting anti-adrenergic |
Act centrally alpha 2 agonists |
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Indirect-acting anti-adrenergic Therapeutic uses and adverse effects GLOBAL RESPONSE NOT SPECIFIC |
Central acting, decrease sympathetic response- slow heart rate, decrease metabolic response (glucose), decrease BP Bradycardia, hypotension, hypoglycemia |
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Indirect anti-adrenergic agents Alpha 2- agonist |
Reserpine (rauwolfia serpenina)- stops the formation and release of NE, used for hypotension but has severe CNS effects: Deep depression, sedation, indifference to environment Cardiovascular and GI effects |
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Indirect adrenergic agents Alpha 2 agonist |
Clonidine/catapres- central acting, reduces activation of adrenergic system Primary indication HTN need to decrease BP, symp response, 2nd relief for Cancer (menopause flushing, withdrawal from opioids/nicotine, tourettes) Oral or transdermal |
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Adrenergic drugs effect receptors by changing the release of |
Norepinephrine |
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What is known as the big guns |
Catecholamines |
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Dobutamine is very |
Selective |
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Vascular decongestion doesn't get rid of |
Secretions, vessels so wide that when you constrict them you feel better |
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Alpha 2 decreases |
Symp response and treat pain caused by popcorn |
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Beta 1 will restart |
Hart and support weak heart |
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Beta 2 will increase |
BS |
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Dopamine will dilate |
Renal bv, protect in shock ->fluid left the vascular space |
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Why we are giving epi. IV vs inhale |
Your about to die or prevent asthma attack |
