Pharm Module 1 Adrenergic Agonist And Antagonists Ii

Front 1

what is epinephrine

Back 1

A potent vasoconstrictor and cardiac stimulant.

Front 2

The rise in systolic blood pressure that occurs after epinephrine is due to what

Back 2

positive inotropic and chronotropic actions on the heart (predominantly β1receptors)

and the vasoconstriction induced in many vascular beds (a1receptors).

Front 3

Epinephrine also activates what

Back 3

β2 receptors in skeletal muscle blood vessels

Front 4

this activation causes what

Back 4

dilation

Front 5

how does epinephrine affect exercise

Back 5

contributes to increased blood flow

Front 6

Norepinephrine acts of which receptors

Back 6

alpha and beta

Front 7

NE acts more on which receptor

Back 7

alpha

Front 8

Norepinephrine _______peripheral resistance and both diastolic and systolic blood pressure

Back 8

increases

Front 9

NE has _______inotropic effects on the heart

Back 9

positive

Front 10

Phenylephrine acts mostly on which receptors

Back 10

a1 receptors

Front 11

Phenylephrinedoes does what to TPR

Back 11

increases

Front 12

Phenylephrine does what to venous capacitance

Back 12

decreases

Front 13

acts on what receptors in the iris?

causes what effect?

Back 13

alpha 1

mydriasis

Front 14

does what to blood pressure

Back 14

increases systolic and diastolic

Front 15

acts on what receptors in the nasal mucosa?

causes what effect?

Back 15

alpha 1

decongestion

Front 16

what isIsoproterenol (isoprenaline)

Back 16

Potent β-receptor agonist

Front 17

does it affect alpha receptors

Back 17

little effect

Front 18

what type of chronotropic and inotropic action? why?

Back 18

positive

because it activates β receptors almost exclusively. it is a potent vasodilator.

Front 19

what happens to cardiac output and BP

Back 19

CO increases and diastolic and mean arterial pressure decreases

Front 20

dopamine activates which receptors

and leads to what?

Back 20

D1 receptors

vasodilation

Front 21

does dopamine act on dose dependent receptors?

Back 21

yes

Front 22

at low doses, dopamine acts on which receptors? this causes what?

Back 22

dopaminergic receptors

increased renal, coronary, and cerebral blood flow.

Front 23

at what fusion rate does dopamine act on dopaminergic receptors

Back 23

2 to 5 mcg/kg/min

Front 24

when does dopamine begin to act on β receptors?

what happens?

Back 24

5mcg/kg/min

increase in cardiac contractility and heart rate

Front 25

when does dopamine begin to act at a-receptors in the periphery?

what level of dosage is it considered to be?

Back 25

10 to 20 mcg/kg/min

high

Front 26

what is Dobutamine

Back 26

relatively β1-selective syntheticcate cholamine

Front 27

does Amphetamine readily enters the CNS

Back 27

yes

Front 28

what does it affect

Back 28

stimulant effect on mood and alertness and a depressant effect on appetite

Front 29

Its peripheral actions are mediated primarily through the release of what

Back 29

catecholamines

Front 30

what differentiates Methamphetamine(N-methylamphetamine) from amphetamine?

Back 30

Meth has higher ratio of central to peripheral actions

Front 31

what is Ephedrine? what does it do?

Back 31

mild stimulant

Displaces NE from storage vesicles in presynaptic neurons

Front 32

what is Pseudoephedrine

Back 32

OTC component of many decongestant mixtures

Front 33

what are Xylometazoline and Oxymetazoline

Back 33

Directly-acting a agonists

Front 34

what are these drugs used for and why

Back 34

used as topical decongestants because of their ability to promote constriction of the blood vessels of the nasal mucosa

Front 35

what is Rhinitis medicamentosa

Back 35

rebound nasal congestion due to down regulation of alpha receptors

Front 36

what does it do

Back 36

decreased endogenous norepinephrine production, etc

Front 37

2 types of a2 Selective Agonists

Back 37

Clonidine and Apraclonidine

Front 38

what is clonidine used for

Back 38

Used in hypertension, diabetic diarrhea,narcotic addicts and to treat benzodiazepine withdrawal effects

Front 39

what are its side effects

Back 39

Postural hypotension, dry mouth, sedation, rebound hypertension

Front 40

what is Apraclonidine

what is it used for

Back 40

A clonidine derivative

Used in glaucoma

Front 41

what is Cocaine

Back 41

local anesthetic with a peripheral sympathomimetic action

Front 42

whats its action from

Back 42

inhibition of transmitter reuptake at noradrenergic synapses

Front 43

does it readily enter the CNS?

what does it produce?

Back 43

yes

amphetamine - like effect that is shorter lasting and more intense.

Front 44

the major action of cocaine on the CNS is to what

Back 44

inhibit dopamine reuptake

Front 45

what is Tyramine

Back 45

normal by-product of tyrosine metabolism in the body

Front 46

where is it also found

Back 46

in high concentrations in fermented foods such as cheese

Front 47

what happens if administered parenterally

Back 47

it has an indirect sympathomimetic action caused by the release of stored catecholamines

Front 48

its spectrum of action is similar to what

Back 48

NE

Front 49

when is the effect of tyramine is greatly intensified

Back 49

In patients treated with MAO inhibitors (particularly MAO-A isoform)

Front 50

who must avoid tyramine containing foods

Back 50

Patients taking MAO inhibitors

Front 51

Increased sympathetic system activity can lead to what

Back 51

pathological conditions

Front 52

Blockade of SNS can provide beneficial effect when______

Back 52

there is increased SNS activity

Front 53

Receptor specific blockers _______ the unwanted side effects associated with these blockers

Back 53

decreases

Front 54

3 types of adrenergic drugs

Back 54

Alphablockers

Betablockers

Alphaplus beta blockers

Front 55

2 types of alpha blockers

Back 55

Phenoxybenzamine

Phentolamine

Front 56

Phenoxybenzamine blocks what

Back 56

blocks α1> α2

Front 57

is it reversible or irreversible

Back 57

Irreversible,forms covalent bond with receptors

Front 58

Phentolamine blocks what

Back 58

blocks α1= α2

Front 59

is it reversible or irreversible

Back 59

reversible

Front 60

4 types of a1 selective blockers

Back 60

•Prazosin

• Terazosin

• Doxazocin

• Tamsulocin

Front 61

2 types of a2 selective blockers

Back 61

Yohimbine

Mirtazapine

Front 62

what is Mirtazapine used for

Back 62

antidepressant

Front 63

Alpha Blockers used for Pheochromocytoma

Back 63

•Phenoxybenzamine / Phentolamine

Front 64

Alpha Blockers used for essential HTN

Back 64

Prazosin

Front 65

alpha blockers used for Hypertension due to clonidine withdrawal

Back 65

•phenoxybenzamine /Phentolamine.

Front 66

which alpha blocker is used in Raynaud's Phenomenon

Back 66

prazosin

Front 67

which one is used in Benign prostatic hyperplasia (BPH)

Back 67

a blockers- Prazosin

a1a blockers - Tamsulosin is preferred

Front 68

how do they work

Back 68

They decrease the tone of prostate/ bladder muscles

Front 69

prostate has which receptors predominantly

Back 69

a1a

Front 70

bladder has which receptors

Back 70

a1a receptor 1/3, a1d receptor 2/3

Front 71

what happens in Benign Prostate Hyperplasia (BPH)

Back 71

Overactive a1areceptors in bladder trigone,prostrate and prostatic urethra ­INCREASES smoothmuscle tone – urinary retention

Front 72

Blockade of these receptors by what relaxesthese structures

Back 72

tamsulosin or terazosin

Front 73

alpha blockers do what to the bladder

Back 73

Increase urinary flow rate-more complete emptying of the bladder

Front 74

does it reverse the hyperplasia?

Back 74

no

Front 75

does it offer symptomatic relief

Back 75

yes

Front 76

best treatment for BPH

Back 76

tamsulosin+ finasteride

Front 77

what does finasteride do?

Back 77

finasteride is5-α reductaseinhibitor - inhibits conversion of testosterone to more potent dihydrotestosterone

Front 78

what is Yohimbine

Back 78

a2 selective blocker

Front 79

what does it do?

what are its potential uses?

Back 79

Enhances sexual activity – aphrodisiac

Potential uses: postural hypotension and impotence

Front 80

what is Mirtazapine

Back 80

a2 blocker

Front 81

what is it used for

Back 81

used in depression

Front 82

At higher doses, beta 1 selective drugs will also______

Back 82

block beta 2 receptors

Front 83

7 Non-selective β1 and β2 receptor blockers

Back 83

carteolol

nadolol

penbutolol

pindolol

propranolol

sotalol

timolol

Front 84

7 Selective β1 receptor blockers

Back 84

atenolol

acebutolol

betaxolol

bisoprolol

esmolol

metoprolol

nebivolol

Front 85

3 α and βreceptor blockers

Back 85

Carvedilol

labetalol

bucindolol

Front 86

the Beta blockade consists of what

Back 86

b1 - Decreases HR, CO

b1 - Decreases renin release

b2 - Decreases aqueous humor production

Front 87

6 b1 (Cardioselective) blockers

(ABEAMN)

Back 87

•Atenolol

•Betaxolol, bisoprolol

•Esmolol

•Acebutolol(with ISA)

•Metoprolol

•Nebivolol

Front 88

which one has a short half life of 10 minutes

Back 88

Esmolol

Front 89

advantages of b1 (Cardioselective) blockers

Back 89

safer in bronchial asthma, diabetes mellitus and peripheral vascular diseases

Front 90

clinical uses of Nonselective Beta Blockers

Back 90

•Hypertension

•Angina

•Migraine headache

•Cardiac arrhythmia

•Glaucoma

•Myocardial infarction

•Essential tremors

•Congestive cardiac failure

•Hyperthyroidism

•Stage fright / Performance anxiety

Front 91

how are Nonselective Beta Blockers in MI's

Back 91

prevents reinfarction and improves long term survival

Front 92

which one is used in CHF

Back 92

carvedilol

Front 93

which one is used in glaucoma

Back 93

timolol

Front 94

most common adverse effect of beta blockers

Back 94

bradycardia (inhibits AV conduction. If HR<60, should not use βblockers)

Front 95

chronic use of beta blockers is associated with what

Back 95

raised lipid levels (LDL andTG)---- mechanism unknown

Front 96

other adverse effects of beta blockers

Back 96

Weakness/Fatigue

Hypotension

hallucinations

Impotence

CHF

Masks symptoms of hypoglycemia

May cause hypoglycemia (decreases glycogenolysis)or hyperglycemia (inhibits insulin secretion).

Front 97

beta blocker overdose can lead to what

Back 97

severe cardiac failure in susceptible individuals

topical application can lead to toxicity

Front 98

antidote for beta blocker overdose

Back 98

glucagon

Front 99

what does it do

Back 99

binds to glucagon receptor - activates adenylyl cyclase - increases cAMP, and has inotropic and chronotropic effects on heart

Front 100

3 Non-Selective Beta Blockers Contraindications

Back 100

bronchial asthma

prinzmetal angina & peripheral vascular disease

diabetes mellitus

Front 101

Raynaud’s disease and Prinzmetal angina first drug of choice

Back 101

calcium channel blockers