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59 Cards in this Set

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naturally occuring catecholamines
dopamine, epi, NE
B(beta)1 receptors agonized by:
dobutamine (Dobutrex) - used to stim heart in acute heart failure
B1 sites + actions
heart - increased HR + contractility
kidney - increased renin sec.
B2 receptors agonized by:
albuterol, metoproterenol (Alupent)
B2 receptor sites + actions
bronchial tree - bronchodilation
skeletal muscle - vasodilation
A(alpha)1 receptors agonized by:
phenylephrine
A1 sites + actions
skin + skeletal muscle - vasocontriction
nasal mucosa-->vasocontriction-->decongestion
nasal glands - decreased secretions
A2 receptors agonized by:
clonidine, methyldopa
A2 sites + actions
vasomotor center - medulla-->decreased HR + BP
epinephrine
inc. CO
A1 vasopressor action
NE (Levophed)
same as epi --> inc. systolic + diastolic BP
Isoproterenol
only B1 and B2 activity, no alpha
B1 = inc. HR/contractility
B2= bronchodilation
slight inc. in systolic BP
Dopamine
renal vasodilation (keep kidneys working in cardiogenic shock)
no change in TPR
use _____ in cardiogenic shock for positive inotropy
dobutamine
phenylephrine
sympathomimetic
not catecholamine
mydriatic/decongestant (a1)
ephedrine
sympathomimetic
not catecholamine
pressor agent (a1) used in surgery if BP too low/chronic orthostatic hypotension/decongestant
causes release of stored catacholamines, enters the CNS
oxymetazoline
sympathomimetic
not catecholamine
decongestant (a1)
amphetamine
sympathomimetic
not catecholamine
-causes release of stored catecholamines
-enters CNS well - mood stim, appetite suppressant
phenylpropanolamine
sympathomimetic
not catecholamine
weak mood stim, fairly safe appetite suppresant, may cause HTN in large doses
Methylphenidate = ritalin
sympathomimetic
not catecholamine
ADHD in kids
Pemoline (cylert)
sympathomimetic
not catecholamine
ADHD in kids
4 amphetamines 2gether
adderall
sympathomimetic
not catecholamine
for ADHD in adults
cocaine
local anesthetic
decreases NE reuptake
-causes HTN, arrythmias, MI, CVA, paranoia, dec. fetal brain development
a1 agonists for nose
pseudoephedrine
phenylephrine
phenylpropanolamine
oxymetazoline
asthma & COPD sympathomimetics
B2 agonists (albuterol = prototype)
anaphylatic shock sympathomimetics
epinephrine b/c it acts on
a1 --> vasoconstriction
b1-->stim. heart
b2--> bronchodilation
-given as .3-.5 mL of 1:1000 solution, i.m.
-also give antihistamine (benadryl, 50 mg i.v. or i.m.) and steroid (methylprednisone, 50-100 mg i.v.)
premature labor sympathomimetics
b2 agonists - ritodrine, terbutaline -->relax the uterus
(a1 mediate uterine contraction)
main sympathomimetics in cold/sinus meds:
ephedrine
pseudoephedrine
phenylpropanolamine
phenylephrine
pyrilamine
oxymetazoline
decongestants are not selective for ____ receptors and can also affect ____ receptors
a1, b1
noncardioselective b-blockers
-block b1 and b2
-propanolol (Indural), timolol (Blocadren)
noncardioselective b-blockers w/ a1 blockers
-also block a1 receptors of arterioles, so permit dilation, dec. TPR
-atenolol (Tenormin)
-metoprolol (Lopressor)
b-blocker side effects
-increase plasma triglycerides and decrease HDL (potentially atherogenic)
-mask normal signs of hypoglycemia (except sweating!)
-aggravate obstructive airway disease
-reduced exercise tolerance, lethargy
adrenergic neuron blocking drugs are also known as:
NE depleting drugs
-lower BP by preventing release of NE from postgang synaptic terminals
-have effects esp. on peripheral sympathetic nerves
-decrease TPR and CO
ex. of adrenergic neuron blocking drugs
-guanethidine (Ismelin)
-reserpine +HCT+ hydralazine (Ser-Ap-Es)
*hydralazine is a direct vasodilator
side effect of adrenergic neuron blocking drugs
postural hypotension - dec. release of NE from sympathetic terminals = no increase in symp. tone to the veins when u stand up
which type of alpha receptors live in the vasomotor nucleus of the medulla (the nucleus of the tractus solitarius)
mostly a2
when a2 receptors are agonized they cause:
arteriolar dilation (opposite of a1!)
baroreceptor reflex:
-BP goes up, stretch of the baroreceptors causes an increase in frequency of ap's in vagal and CN9 nerves
-this decreases efferent sympathetic activity from vasomotor system to spinal cord
-decreased output from cord = permits vasodilation
alpha agonists
clonidine (Catapres)
methyldopa (Aldomet)
peripheral alpha blockers (a1)
prazosin (Minipres)
terazosin (Hytrin)
a blocker/b blocker (2gether)
carvedilol (Coreg)
labetolol (Normodyne, Trandate)
dilation of the arterioles causes decreased ____ while dilation of the veins decreases ______
TPR, venous return
the -azosin drugs also have the ability to ?
decrease smooth muscle tone in the bladder neck and prostate gland
anti-HTN for heart failure
ace inhibs
anti-HTN for MI
b blockers
anti-HTN for MI w/ systolic dysfunction
ace inhibs
anti-HTN for angina
BB or CCB
anti-HTN for essential tremor
BB (non-cardioselective)
anti-HTN for hyperthyroidism
BB
most common single agent drug interactions
-cimetidine
-digoxin
-antacids
-warfarin
-propanolol
-theophylline
what happens after drug administered?
-liberation
-absorption
-distribution
-metabolism
-excretion
parameters to describe fate of drug
-VD
-Cl
-t1/2
-bioavailability (F)
-protein binding
volume of distribution
volume in which drug is distributed
(amount of drug in body to concentration of drug in plasma or blood)
total clearance
= ClH + ClR + ClL + ClOther
first pass
percentage of orally administered drug removed on first pass thru GI wall and/or liver b4 reaching systemic circ.
= 1 - fractional bioavailability
chelation
irreversible binding of drugs in the GI tract
drugs that interact and chelate
-tetracyclines
-quinolone abx (Fe)
-antacids (Al, Ca, Mg)
-dairy products (Ca)
-dose 1 hr b4 or 2 hrs after
pharmacogenetics
diff in drug metabolizing ability
-arise from gen. determined diff in basal level of expression of enzyme
poor metabolizers will have hi plasma concentrations of ______ and lo concentrations of ______
plasma compounds, metabolites