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49 Cards in this Set
- Front
- Back
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alpha methyl tyrosine
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ANTIHYPERTENSIVE
inhibits TH competes with tyrosine used in pheochromocytoma not used in US |
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Reserpine
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ANTIHYPERTENSIVE
Decreases cell stores of NE (puts NE to REST) blocks carrier of NE synaptic vesicles parasympathetics not inhibited: secretions, miosis, hyper GI, bradycardia, low BP, emotional depression Not used often in US |
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Guanethidine
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ANTIHYPERTENSIVE
has 3 pharm actions: 1. blocks transmission (acute) 2. prevents exocytosis (acute) (can't get off the island [GUAM]) 3. reduces NE stores not used in US |
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Clonidine
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ANTIHYPERTENSIVE
Acts on alpha2 receptors to reduce sympathetic outflow (CLObbers symp outflow) reduces BP Withdrawl: nervous, dizzy, tachy, inc. BP ALSO: reduces intraoccular pressure and used in withdrawl sympt. |
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Methyldopra
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ANTIHYPERTENSIVE
Acts on alpha2 receptors in medulla/brainstem --> reduces sympathetic outflow (sim to Clonidine) Also reduces renal vascular resistance Limited use in US |
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TCA antidepressants
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ANTIDEPRESSANT
Blocks NET transport and enhances activity of NE Desipramine most potent inhibitor of NET Interferes with other receptors SE: tremor, insomnia, blurred vision.... |
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Cocaine
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ABUSIVE DRUG
Completely, reversibly blocks action of NET, which increases NE and Epi Also can have local anesthetic action |
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Amphetamines
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Powerful CNS stimulant
i.e. Methamphetamine, dextroamphetamine, adderall |
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Antiasthematic agents
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EPI and ISO are potent beta2 receptor agonists; cause relaxation of bronchial smooth muscles
ISO = risk of cardiac stimulation |
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Anaphylactic shock
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parenteral EPI, NE, phenylephrine
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Circulatory shock
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IV NE
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Local anesthetics
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Decreases rate of removal from injection site
Mixed with anesthetic (EPI, PE) |
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Maintain BP in spinal anesthesia
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EPI, PE, methoxamine, etc.
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urticaria
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epinephrine, parenteral
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nasal decongestant
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pheylephrine, naphazoline
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mydriatic agent
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phenylephrine, ephedrine (topical)
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Dobutamine
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selective beta1 agonist
racemic mixture (alpha1 & alpha2 cancel out) Used in cardiac failure to improve CO |
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Order of potencies: alpha 2
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clonidine > alpha-methyl-NE >> oxymetazoline
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Order of potences: alpha2==1
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Naphazoline = EPI = NE
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order of potencies: alpha 1
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penylephrine > methoxamine
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order of potencies: beta2
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ISO > EPI >>> NE >>> PE
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order of potencies: beta 1
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ISO > EPI > NE >>> PE
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What do high doses of dopamine do?
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Increase heart rate, contractility and cardiac output
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heart rate
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increased
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heart contractility
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increased
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heart velocity
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increased
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arrythmias
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increased
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efficitncy
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decreased (O2 demands up up up)
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kidney vascular beds
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alpha 1: constriction
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skeletal muscle vascular bed
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alpha 1, some beta 2
constriction low dose epi: dilation any dose iso: dilation |
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liver/splanchnic vascular bed
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alpha 1, some beta 2
constricton low dose epi: dilation |
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coronaries
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dilations, always
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pancreas
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alpha cells: beta receptors: secretion glucagon
beta cells: alpha receptors: inhbition insulin |
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NE on BP
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increased TPR, increased FC
increased systolic and diastolic |
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EPI on BP
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decreased TPR, increased FC
increased systolic, decreased diastolic |
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ISO on BP
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decreased TPR, increased FC
increased systolic, decreased diastolic |
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bronchial sm
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beta 2, dilation
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GI tract sm
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alpha 1/ beta 2
relaxation |
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iris radial muscle
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alpha 1
contract = myadriasis |
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bladder sm
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alpha 1/beta 2
relaxation of detrussor (beta2) |
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uterus sm
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alpha 1/beta 2
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spleen
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alpha 1: contraction
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vas deferens and seminal vessicles
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alpha 1: contraction and expulsion
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metabolic effects of catecholamines
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increased synthesis of cyclic AMP -->
hyperglycemia, increased FFAs, increased lactic acid |
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Phenoxybenzamine
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noncompetitive irreversible (covalent)
STRONG AS AN OX alpha adrenergic antagonist |
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Phentolamine
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competitive reversible antagonist of alpha receptors: hypertension in pts with pheochromocytoma
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prazosin
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antagonist of alpha1 receptors
lowers BP |
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beta blockers
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Decreased O2 demands of heart
Initial increase in BP, then decreased Decreased secretion of renin by JG cells Decreases AQUEOUS HUMOR production and decreased pressure in glaucoma |
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beta blocker contraindications
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asthma
CHF if used with Ca++ channel blockers could result in AV block |
