Autonomic Drugs

Front 1

What receptors do EPINEPHRINE act on?

Back 1

a1, a2, B1, B2

B1 receptor is most sensitive to epi at LOW [ ]'s (B LOW)

Front 2

What are the clinical uses of EPINEPHRINE?

Back 2

Cardiac stimulant.
Prevents superficial bleeding from small arterioles or capillaries.
Prevents spread of local anesthetics.
Bacterimic shock.
Anaphylactic shock.
Asthma.

Front 3

What are the toxic effects of EPINEPHRINE?

Back 3

1. tremor
2. CNS - anxiety, headache, fear
3. Cerebral hemorrhage
4. Cardiac dysrhythmias

Front 4

How is EPI usually administered?

Back 4

Patenterally by inhalation and by topical administration

NOT ORALLY

Front 5

Does EPI cross the BBB?

Back 5

NO, b/c it is very polar

Front 6

How is the action of EPI terminated?

Back 6

MAO, COMT, Uptake 1 and Uptake 2

mostly by Uptake 1

Front 7

What are the metabolic actions of EPI?

Back 7

1. increase body temp and O2 consumption (calorigenic effect)
2. increase blood concentration of glc, lactic acid, K+, FFA, glycerol

Front 8

What receptor does NE act on?

Back 8

a1, a2 > B1 agonist

Front 9

What receptor does PHENYLEPHRINE act on?

Back 9

a1 agonist

Front 10

What are the clinical uses for PHENYLEPHRINE?

Back 10

1. Allergic Rhinitis (b/c its a nasal decongestant)
2. Mydriatic
3. reduces aqueous humor and intraocular pressure
4. maintains BP during general and local anesthetic

Front 11

What receptors does ISOPROTERENOL act on?

Back 11

B1 and B2

Front 12

What is the clinical use of ISOPROTERENOL?

Back 12

powerful cardiac stimulant

Front 13

What is the side effect of ISOPROTERENOL?

Back 13

arrhythmias

Front 14

What receptor does ALBUTEROL, TERBUTALINE, SALMETEROL, FORMOTEROL, and RITODRINE act on?

Back 14

B2

Front 15

Which two B2 agonists prevent premature uterine contractions?

Back 15

Terbutaline and Ritodrine

Front 16

Which two B2 agonist are long acting drugs that prevent asthmatic attacks?

Back 16

Salmeterol and Formoterol

Front 17

What B2 agonist is a short acting drug used in acute asthma attacks?

Back 17

Albuterol

Front 18

What are the toxic effects of B2 Agonists?

Back 18

1. Tachycardia
2. Tremor
3. Hyperglycemia
4. Hypokalemia

Front 19

ISOPROTERENOL reduces ____________ BP

Back 19

ISOPROTERENOL reduces
__diastolic____ BP

Front 20

What receptor does DA act on?

Back 20

DA is a selective B1 agonist

some a1,B2, D1, D2 activity

Front 21

What does DA do at LOW doses?

Back 21

At low doses DA increases BF in renal/mesenteric vascular beds (D1 receptors) and induces vomitting (D2 receptor)

Front 22

What does DA do at MODERATE doses?

Back 22

At moderate doses DA has a positive inotropic effect on the heart (B1)

Front 23

What does DA do at HIGH doses?

Back 23

At high doses DA causes vasoconstriciton (a1)

Front 24

How is DA administered?

Back 24

IV infusion

Front 25

DA is a precursor for what?

Back 25

Epi and NE

Front 26

Is DA more or less likely to cause tachycardia and dyshythmias than isoproterenol?

Back 26

less likely

Front 27

How does DOBUTAMINE differ from DA?

Back 27

DOBUTAMINE :
1. does not increase renal or mesenteric BF
2. does not activate DA receptors in the area postrema
3. does not release NE (no local ischemia at IV injection site)

Front 28

What is the duration of DOBUTAMINE?

Back 28

short (t1/2 is 2 min)

Front 29

What physiologic effects of a1 receptor agonists?

Back 29

vasoconstriction - increases TPR
contraction of the radial muscle -mydriasis
contraction of smooth muscle (splenic capsule, sphincters)

Front 30

What physiologic effects of a2 receptor agonists?

Back 30

inhibit release of NE,
relaxes GI smooth muscle by inhibiting the release of ACh in the enteric nervous system,
reduces secretion of insulin from the pancreas,
reduces outflow of the SNS and lowers BP

Front 31

What are the physiologic effects of B1 receptor agonists?

Back 31

increase rate and force of contraction of cardiac muscle,
increase the secretion of renin from juxtaglomerular cells

Front 32

What are the physiologic effects of B2 receptor agonists?

Back 32

dilation of the bronchioles,
inhibition of the release of inflammatory mediators from mast cells,
relaxation of visceral smooth muscle (urinary bladder, GI smooth muscle),
dilation of blood vessels,
increases the secretion of glucagon from the pancreas,
relaxation of the uterus during the 3rd trimester

Front 33

What are the physiologic effects of B3 receptor agonists?

Back 33

activates phosphoralase - increases glc blood levels,
activates lipase - increases FFA blood levels

Front 34

What are the physiologic effects of D1 receptor agonists?

Back 34

increases BF in the renal and mesenteric vascular beds.

Front 35

What receptors does PHENYLEPHRINE act on?

Back 35

a1>a2 agonist

Front 36

What are the clinical uses of PHENYLEPHRINE?

Back 36

opthalmic surgery (pupil dilation), vasoconstriction, neurogenic shock, allergic rhinitis, maintains BP during general and local anesthetic

Front 37

What receptor does CLONIDINE act on?

Back 37

centrally acting a2 agonist,
decreases central adrenergic outflow

Front 38

What are the clinical uses of CLONIDINE?

Back 38

1. HTN
2.migraine headaches
3. opiate withdrawl

Front 39

What is the mechanism of TYRAMINE?

Back 39

TYRAMINE is a catecholamine releasing agent

Front 40

What metabolizes TYRAMINE?

Back 40

MAO

Front 41

What is can happen to a person taking MAO inhibitors that ingests too much TYRAMINE?

Back 41

increase release of stored catecholamines causes an increase in BP (HTN), headache, could possible blow vessel in brain