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62 Cards in this Set
- Front
- Back
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What are 2 general types of Sympathomimetics?
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-Catecholamines
-Noncatecholamines |
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What are the 5 major catecholamine sympathomimetics?
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Never enter into debt during
NE/Epi Isoproterenol Dopamine/Dobutamide |
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What are the receptors that Epi is selective for?
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All - a1,a2,b1,b2
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What is Epi selective for at low doses?
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B1
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What are the 4 clinical applications of Epi?
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AHAG
-Anaphylaxis -Hypotension -Asthma -Glaucoma - OPEN ANGLE |
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What is the receptor selectivity of Norepi?
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a1/a2 > B1
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What is the main use of NE?
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Treating Hypotension
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2 side effects of Norepi:
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-Reflex bradycardia
-Decreased Renal perfusion (B1) |
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What receptors is Isoproterenol selective for?
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B1 = B2
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What is the clinical application of Isoproterenol?
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AV block - rare
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What is the receptor selectivity of Dopamine?
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D1=D2>B>a
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What are the clinical applications of Dopamine?
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-Shock
-Heart failure |
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Why is Dopamine a better drug for treating shock/hypotension than Norepinephrine?
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Dopamine INCREASES renal vascular perfusion by vasodilating the renal artery
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What is the receptor selectivity of Dobutamide?
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B1>B2
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What are the 2 clinical applications of Dobutamide?
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-Shock
-Cardiac stress testing in patients with heart failure |
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What are 6 NONcatecholamine sympathomimetics?
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CEAPAC
-Clonidine/methyldopa -Ephedrine -Amphetamine -Phenylephrine -Albuterol/Terbutaline -Cocaine |
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Where do Clonidine and alpha-methyldopa act? What is their effect?
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Centrally - reduce SNS outflow
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What are Clonidine and alpha-MD used for clinically?
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Hypertension esp in patients with renal disease
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What is the mechanism by which Ephedrine and Amphetamine both act as sympathomimetics?
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GENERAL INDIRECT agonists - stim release of the nonvesicular storage pool of NE/Epi
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What are 3 applications of Amphetamine?
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ONADD
-Obesity -Narcolepsy -Attention deficit disorder |
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What are 3 clinical applications of Ephedrine?
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-Hypotension
-Urinary incontinence -Nasal decongestion |
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What is the receptor selectivity of Phenylephrine?
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a1>a2
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What are 3 clinical applications of Phenylephrine?
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-Pupil dilation (mydriasis)
-Vasoconstriction (anesth) -Nasal decongestion |
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What is the receptor selectivity of Albuterol and Terbutaline?
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B2>B1!!
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So what are Albuterol and Terbutaline used for clinically?
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Asthma
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What is the mechanism of cocaine?
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General INDIRECT agonist - inhibits Uptake1 from removing NE from the synapse
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What are the 2 clinical applications of Cocaine?
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-Vasoconstriction
-Anesthesia |
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How will Norepinephrine affect
-Systolic pressure -Diastolic pressure -MAP -Pulse pressure -Heart rate |
-Increase SP (vasoconstrict)
-Increase DP (vasoconstrict) -Increase MAP -No change in PP -Reflex bradycardia |
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How will Epinephrine affect
-Systolic pressure -Diastolic pressure -MAP -Pulse pressure -Heart rate |
-Increase SP (vasoconstrict)
-Decrease DP (skel muscle B2) -No change MAP -Widens PP -Increases HR (B1) |
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How will Isoproterenol affect
-Systolic pressure -Diastolic pressure -MAP -Pulse pressure -Heart rate |
-Decrease SP (no alphas)
-Decrease DP (B2 - skel mm) -Decrease MAP -No change in pulse pressure -Markedly increased Heartrate via B1 and vasodilation reflex |
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What are 3 general categories of alpha blockers?
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-Nonselective alpha blockers
-Alpha1 selective -Alpha2 selective |
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What are the 2 NONselective alpha blockers? How are they different from each other?
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-Phenoxybenzamine - irreversible
-Phentolamine - reversible |
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What are Phenoxybenzamine and Phentolamine's clinical application?
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Pheochromocytoma
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What are the 2 toxic side effects of nonselectively blocking alpha 1/2 receptors?
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-Orthostatic hypotension
-Reflex TACHYcardia |
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What are 3 ALPHA-1 selective blockers?
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Prazosin
Terazosin Doxazosin |
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What are the 2 clinical applications of a1 blockade by Prazosin, Terazosin, and Doxazosin?
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-Hypertension
-BPH urinary retention |
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What are 3 side effects of Prazosin toxicity?
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-1st dose phenomenom - orthostatic hypotension
-Dizziness -Headache |
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What is the a2-selective alpha blocker?
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Mirtazapine
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What is Mirtazapine used for clinically?
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Depression
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What are 3 side effects of Mirtazapine?
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-Sedation
-Increased serum cholesterol -Increased appetite |
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What does Epi (in large doses) do to MAP in general?
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Increases it
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What does Phenylephrine do to MAP in general?
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Increases it
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What does an alpha blocker like Phentolamine do to the effects of Phenylephrine? What will be the resulting effect on MAP?
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Inhibits increased MAP; there will be no change in MAP
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What does an alpha blocker like Phentolamine do to the effects of Epinephrine? What will be the resulting effect on MAP?
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Inhibits increased MAP but actually causes DECREASED MAP because it does NOT inhibit the B2 agonist effects of Epineph - so there is still vasodilation
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What are the acronyms for 10 B-blockers?
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Nonselectives: Props To Nader who Pinned Labels
B1-selectives: ABEAM |
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What are 6 applications of B-blockers?
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HAMSCG
-Hypertension -Angina pectoris -MI -Superventric Tachycardia -Cong Heart failure -Glaucoma |
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What are the 2 ways B-blockers reduce hypertension?
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-Decrease CO
-Decrease renin secretion |
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How do B-blockers help Angina pectoris?
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-Decrease HR
-Decrease Contractility Reduces MVO2 - oxygen consumption |
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What do B-blockers do for MI?
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Reduce mortality
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What 2 b-blockers are used for treating SVT?
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-Propanolol
-Esmolol |
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How do Propanolol and Esmolol treat SVT?
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Slow AV node conduction velocity
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How do B-blockers treat CHF?
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Slow progression of chronic failure
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Which B-blocker is used for Glaucoma? Effect?
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Timolol - reduces aqueous humor secretion
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What are 4 effects of B-blocker toxicity?
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-Impotence
-Asthma exacerbation -CNS effect -CV effects |
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What do B-blockers do on the CNS?
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Sedation
Sleep alteration |
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What do B-blockers do to the CV system?
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-Slow heartrate - Bradycardia
-Decrease CO in CHF -AV block |
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In what patients should B-blockers be used with caution?
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Diabetics
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What are the 5 NONselective B-blockers?
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-Propanolol
-Pindolol -Timolol -Nadolol -Labetalol |
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Which 2 nonselective B-blockers are PARTIAL agonists?
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Pindolol and Labetalol
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What are the 5 B1-selective B-blockers?
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ABEAM
-Acebutoll -Betaxolol -Esmolol -Atenolol -Metoprolol |
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Which B1-selective B-blocker is a partial agonist?
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Acebutolol
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Which B1-selective B-blocker is short-acting?
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Esmolol
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