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397 Cards in this Set
- Front
- Back
|
what does activation of alpha-1 adrenoceptors mediate?
|
smooth muscle contraction
leading to vasoconstriction dilation of pupils contraction of bladder sphincter muscle |
|
|
what does activation of alpha-2 adrenoceptors mediate?
|
inhibits the release of NE from sympathetic neurons
decreases the secretion of aqueous humor decreases the secretion of insulin |
|
|
what does the activation of beta-1 adrenoceptors mediate?
|
produces cardiac stimulation and increases secretion of renin
|
|
|
what does activation of beta-2 adrenoceptors mediate?
|
smooth muscle relaxation
|
|
|
what do the catecholamines include?
|
NE
epinephrine isoproterenol dopamine dobutamine |
|
|
how are catecholamines administered and why?
|
administered parenterally because they are rapidly metabolized
|
|
|
what are catecholamines primarily used to treat?
|
cardiac disorders
various types of shock |
|
|
besides adrenoceptors what does dopamine activate?
|
D1-receptors and thereby increases renal blood flow
|
|
|
what are noncatecholamines?
|
Pheylephrine
Albuterol are resistant to degradation by COMT |
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|
how does Phenylephrine work?
|
noncatecholamine
activates alpha-adrenoceptors and causes vasoconstriction |
|
|
how does albuterol work?
|
activates b2-adrenoceptors and produces bronchodilation
|
|
|
what are imidazoline compounds?
|
agents that activate a-adrenoceptors and imidazoline receptors
|
|
|
Example of imidazoline compounds?
|
Oxymetazoline: decongestant
clonidine: antihypertensive agent aproclonidine: agent used to treat glaucoma |
|
|
how do indirect acting adrenoceptor agonist work?
|
increase the synaptic concentration of NE
|
|
|
what type of drug is amphetamine? how does it work?
|
Indirect acting adrenoceptor agonist
causes reverse transport of NE by the catecholamine transporter |
|
|
what type of drug is cocaine? how does it work?
|
Indirect acting adrenoceptor agonist
blocks the reuptake of NE by the catecholamine transporter |
|
|
what type of drug is pseudoephedrine?
|
both direct and indirect actions
- used as a nasal decongestant |
|
|
what is the mechanism of signal transduction for alpha-1 adrenoceptors?
|
phospholipase C activation
increased IP3 release of calcium |
|
|
what are the effects of alpha-1 stimulation?
|
contraction of smooth muscle
exocrine gland secretion neuronal excitation |
|
|
what is the mechanism of signal transduction for alpha-2 receptors?
|
inhibition of adenylyl cyclase and decreased cAMP
|
|
|
what is the effect of alpha-2 stimulation?
|
inhibition of NE release
decreases in aqueous humor decrease in secretion of insulin, platelet degradation, and CNS system effects |
|
|
what is the mechanism of action of B1-receptors?
|
adenyly cyclase activation
increased cAMP protein kinase activation |
|
|
what is the mechanism of signal transduction for alpha-1 adrenoceptors?
|
phospholipase C activation
increased IP3 release of calcium |
|
|
what are the effects of alpha-1 stimulation?
|
contraction of smooth muscle
exocrine gland secretion neuronal excitation |
|
|
what is the mechanism of signal transduction for alpha-2 receptors?
|
inhibition of adenylyl cyclase and decreased cAMP
|
|
|
what is the effect of alpha-2 stimulation?
|
inhibition of NE release
decreases in aqueous humor decrease in secretion of insulin, platelet degradation, and CNS system effects |
|
|
what is the mechanism of action of B1-receptors?
|
adenyly cyclase activation
increased cAMP protein kinase activation |
|
|
what is the mechanism of signal transduction for alpha-1 adrenoceptors?
|
phospholipase C activation
increased IP3 release of calcium |
|
|
what are the effects of alpha-1 stimulation?
|
contraction of smooth muscle
exocrine gland secretion neuronal excitation |
|
|
what is the mechanism of signal transduction for alpha-2 receptors?
|
inhibition of adenylyl cyclase and decreased cAMP
|
|
|
what is the effect of alpha-2 stimulation?
|
inhibition of NE release
decreases in aqueous humor decrease in secretion of insulin, platelet degradation, and CNS system effects |
|
|
what is the mechanism of action of B1-receptors?
|
adenyly cyclase activation
increased cAMP protein kinase activation |
|
|
what is the effect of B1-receptor activation?
|
increase in secretion of renin and increases in heart rate, contractility, and conduction
|
|
|
what is the effect of B2-receptor activation?
|
Glycogenolysis
relaxation of smooth muscle & uptake of potassium in skeletal muscle |
|
|
what is the mechanism of action of B2-receptor activation ?
|
adenylyl cyclase activation
increased cAMP protein kinase activation |
|
|
what is the mechanism of signal transduction for B3 receptors?
|
adenylyl cyclase activation
increased cAMP protein kinase activation |
|
|
what is the effect of B3 receptor activation?
|
Lipolysis
|
|
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what is the mechanism of signal transduction for D1 receptors?
|
increased cAMP
|
|
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what is the effect of stimulation of D1 receptors?
|
relaxation of smooth muscle
|
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what is the mechanism of signal transduction of D2 receptors?
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decreased cAMP
increased potassium currents decreased calcium influx |
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what is the effect of D2 receptor activation ?
|
modulation of NT in the sympathetic and CNS
|
|
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what is the mechanism of action for Imidazoline receptor activation?
|
uncertain
|
|
|
what is the effect of activation of imidazoline receptors?
|
natriuresis
decreases sympathetic outflow from the CNS |
|
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where are alpha-1 receptors found?
|
primarily in the smooth muscle
|
|
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where are B1-receptors found?
|
primarily in the smooth muscle
|
|
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where are B2-receptors found?
|
predominately in the cardiac tissue
|
|
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where are alpha-2 receptors found ?
|
some receptors are located on sympathetic neurons where they produce feedback inhibition of NT release
|
|
|
what receptors are found on platelets?
|
alpha-2
beta-2 |
|
|
what are the direct acting Catecholamines?
|
Dobutamine
Dopamine Epinephrine Isoproternol Norepinephrine |
|
|
describe receptor affinity for Dobutamine.
|
B1 > B2 >>> alpha
|
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describe the receptor affinity for Dopamine.
|
D1=D2 >> B1 >> a1
|
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describe the receptor affinity for Epinephrine.
|
a1 = a2 < B1=B2
|
|
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describe the receptor affinity of Isoproterenol.
|
B1=B2 >>>>>> a
|
|
|
describe the receptor affinity of Norepinephrine
|
a1 = a2 > B1>>B2
|
|
|
what is the pharmacological effect of Dobutamine?
|
cardiac stimulation (B1)
Vasodilation (B2) Not for septic shock |
|
|
what is the clinical use for Dobutamine?
|
Cardiogenic shock
acute heart failure Cardiac stimulation during heart surgery |
|
|
what is the pharmacological effect of Dopamine?
|
Renal vasodilation (D1)
Cardiac stimulation (B1) Increased blood pressure (B1 & a1) |
|
|
what are the clinical uses of Dopamine?
|
cadiogenic shock
septic shock heart failure adjunct to fluid administration in hypovolemic shock |
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what are the pharmacological effects of Epinephrine?
|
vasoconstriction
increased blood pressure (a1) cardiac stimulation (B1) Bronchodilation (B2) |
|
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what are the clinical uses for Epinephrine?
|
Anaphylactic shock
Cardiac arrest Ventricular fibrillation Reduction in bleeding during surgery Prolongation of the action of local anesthetics |
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|
what is the pharmacological effects of Isoproterenol?
|
Cardiac stimulation (B1)
Bronchodilation (B2) |
|
|
what are the clinical uses for Isoproterenol?
|
Asthma
AV block Bradycardia |
|
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what are the pharmacological effects of Norepinephrine?
|
Vasoconstriction and increased blood pressure (a1)
|
|
|
what are the clinical uses for Norepinephrine?
|
Hypotension
shock |
|
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Name the direct acting Noncatecholamine?
|
Albuterol
Apraclonidine Clonidine Midodrine Oxymetazoline Phenylephrine Ritodrine Terbutaline |
|
|
describe the receptor affinity of Albuterol.
|
B2>> B1 >>>>> a
|
|
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describe the receptor affinity of Apraclonidine.
|
a2 > a1 >>>>> B
|
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describe the receptor affinity of Clonidine.
|
a2 > a1 >>>>>> B
|
|
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describe the receptor affinity of Phenylephrine.
|
a1 > a2 >>>>>> B
|
|
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describe the receptor affinity of Ritodrine.
|
B2 >> B1 >>>>> a
|
|
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describe the receptor affinity of Terbutaline.
|
B2 >> B1 >>>>> a
|
|
|
what is the pharmacological effect of Albuterol?
|
bronchodilation (B2)
|
|
|
what is the clinical use of Albuterol?
|
asthma
|
|
|
what are the pharmacological effects of Apraclonidine?
|
decrease aqueous humor formation (a2)
|
|
|
what are the clinical uses of Apraclonidine?
|
short term control of intraocular pressure
|
|
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what are the pharmacological effects of clonidine?
|
decreased sympathetic outflow from CNS (a2 & imidazoline)
|
|
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what are the clinical uses of Clonidine?
|
hypertension
opiod dependence |
|
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what is the pharmacological effect of Midodrine?
|
Vasoconstriction (a1)
|
|
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what are the clinical uses of Midodrine?
|
orthostatic hypotension in severe cases
|
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what is the pharmacological effect of Oxymetazoline?
|
vasoconstriction (a1)
|
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what is the clinical use of Oxymetazoline?
|
nasal and ocular decongestion
|
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what are the pharmacological effects of Phenylephrine?
|
vasoconstriction, increased blood pressure, mydriasis (a1)
|
|
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what are the clinical uses of Phenylephrine?
|
Nasal and ocular decongestion
mydriasis maintenance of blood pressure and treatment of shock given via IV |
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what are the pharmacological effects of RItodrine?
|
uterine relaxation (b2)
|
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what is the clinical use of Ritodrine?
|
premature labor
|
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what is the pharmacological effects of Terbutaline?
|
Bronchodilation (B2)
|
|
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what is the clinical use of Terbutaline?
|
Asthma
|
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name the indirect acting agents that are adrenoceptor agonist.
|
Amphetamine
Cocaine |
|
|
what are the pharmacological effects of Amphetamine?
|
increase in norepinephrine release
Central nervous system stimulation |
|
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what are the clinical uses of Amphetamine?
|
Narcolepsy
attention deficit disorder |
|
|
what are the pharmacological effects of cocaine?
|
inhibition of norepinephrine uptake
|
|
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what is the clinical use of cocaine?
|
local anesthesia
|
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name something significant about mixed acting agents that are adrenoceptor agonist.
|
activate both a & b receptors
can cause tachycardia via B1 |
|
|
Name the mixed acting adrenoceptor agonist.
|
Ephedrine
Pseudoephedrine |
|
|
what is the pharmacological effect of ephedrine?
|
vasoconstriction (a1)
|
|
|
what is the clinical use of ephedrine?
|
nasal decongestant
|
|
|
what is the pharmacological effect of pseudoephedrine?
|
vasoconstriction (a1)
|
|
|
what is the clinical use of pseudoephedrine?
|
nasal decongestant
|
|
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Describe the cardiovascular effects of Norepinephrine.
|
increases peripheral resistance and blood pressure
leds to reflex bradycardia |
|
|
describe the cardiovascular effects of Epinephrine.
|
increases heart rate while reducing peripheral resistance and the mean arterial pressure increases slightly
|
|
|
describe the cardiovascular effects of Isoproterenol.
|
increases heart rate
significantly lowers peripheral resistance mean arterial pressure declines |
|
|
describe the cardiovascular effects of Dopamine.
|
increase heart rate
increases cardiac output lowers vascular resistance Mean arterial pressure increases |
|
|
what does Tyramine cause?
|
release of catecholamines
|
|
|
what normally breaks Tyramine down?
|
MAO rapidly breaks tyramine down
|
|
|
what happens if a person take an MAOI and eats certain foods?
|
it can cause acute hypertension because Tyramine is not broken down
|
|
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what are the Genitourinary indications for sympathomimetic drugs?
|
Premature labor: Ritodrine or Terbutaline
Stress incontinence: |
|
|
what are the cardiovascular indications for sympathomimetic drugs?
|
Congestive heart failure: sympathomimetic drugs that elicit a positive inotropic effect may be useful in the treatment of CHF.
Dobutamine & Dopamine are used most often |
|
|
what are the respiratory indications of sympathomimetic drugs?
|
asthma: drugs that activate B2-adrenoceptors are useful in the treatment of asthma because they cause bronchial smooth muscle relaxation.
B2-selective agonist: Albuterol, metaproterenol, and terbutaline widely used because they have less cardiac effects than the non-selective adrenoceptor agonist Epinephrine |
|
|
what are the adverse effects of sympathomimetic drugs?
|
Cardiovascular effects:
marked increase in blood pressure - cerebral hemorrhage - pulmonary edema - angina or precipitation of MI -Excessive vasoconstriction at the site of injection may cause ischemia - can be reverse by a-receptor antagonist - Sinus tachycardia - LIfe threatening arrhythmias |
|
|
what are the adverse effects of Epinephrine?
|
restlessness, throbbing headache, tremor, palpitations, cerebral hemorrhage, cardiac arrhythmias
|
|
|
what are the contraindications of Epinephrine?
|
not used in patients receiving non-selective-B-blockers
- can cause massive increase in BP with b-blockers |
|
|
what are the adverse side effects of Norepinephrine?
|
similar to epinephrine with greater elevation of blood pressure, necrosis, and sloughing at injection site
|
|
|
what are the adverse effects of Isoproterenol?
|
palpitations
tachycardia headache flushed skin arrhythmias |
|
|
what are the adverse side effects of Clonidine?
|
drug mouth
sedation sexual dysfunction bradycardia - reduced sympathetic outflow |
|
|
what are the adverse side effects of Pheylephrine?
|
similar to NE
throbbing headache tremor palpitations cerebral hemorrhage cardiac arrhythmias |
|
|
what are the adverse side effects of Albuterol?
|
skeletal muscle tremor
restlessness apprehension anxiety tachycardia arrhythmias myocardial ischemia |
|
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what are the adverse side effects of Ritodrine and Terbutaline?
|
similar to albuterol
severe pulmonary edema in women receiving ritodrine for premature labor |
|
|
what is the function of indirect acting sympathomimetics?
|
drugs that promote NT release
drugs that prevent NT release |
|
|
what are adverse side effects of Amphetamine?
|
produces vasoconstriction, cardiac stimulation, increased BP, stimulant effect on mood and alertness, and depressant effect on appetite
|
|
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what drugs prevent neurotransmitter reuptake?
|
Cocaine an indirect acting sympathomimetic
|
|
|
what drugs possess both direct and indirect actions on the release of NE?
|
Ephedrine
Pseudoephedrine |
|
|
what is Ephedrine used for?
|
nasal decongestant
stress incontinence |
|
|
what is psuedoephedrine used for?
|
nasal decongestant
stress incontinence |
|
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what are the adverse side effects of Ephedrine?
|
hypertension
insomnia tachyphylaxis urinary retention adverse CV effects in susceptible individuals |
|
|
what are the adverse effects of Pseudoephedrine?
|
similar to ephedrine
hypertension insomnia tachyphylaxis urinary retention adverse CV effects in susceptible individuals |
|
|
should cough and cold products that can be purchased OTC be used in children less than 2 years of age?
|
NO
use caution with children under 6 years of age |
|
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what drugs are competitive a1-blockers?
|
Doxazosin
Prazosin Terazosin |
|
|
what is the pharmacological effect of competitive a1-blockers?
|
Doxazosin, Prazosin, Terazosin
- cause vasodilation and decrease blood pressure - relax bladder, urethral, and prostate smooth muscle |
|
|
what are the clinical uses for a1-blockers?
|
Hypertension
Urinary symptoms due to benign prostatic hyperplasia Raynauds phenomenon & Systemic Sclerosis off-label: PTSD - increase sleep and decrease nightmares |
|
|
what type of drug are Alfuzosin and Tamsulosin, and Silodosin?
|
competitive a1-blockers
|
|
|
what are Alfuzosin, Tamsulosin, and Silodosin used clinically for?
|
- relax the bladder, urethral and prostate smooth muscle
- uroselective - urinary symptoms due to BPH |
|
|
what type of drug is Phenoxybenzamine?
|
noncompetitive a1 and a2-blocker
|
|
|
what is the pharmacological effects of phenoxybezamine?
|
causes vasodilation
decreases blood pressure |
|
|
what is the clinical use of phenoxybenzamine?
|
hypertension in pheochromocytoma
|
|
|
Phentolamine
|
competitive a1 & a2-blocker
duration of action IV: 15 min duration of action IM/SC: 3-7 hrs |
|
|
what is the pharmacological effects of Phentolamine?
|
causes vasodilation
decreases vascular resistance and blood pressure |
|
|
what is the clinical use of phentolamine?
|
hypertension due to pheochromocytoma
treat necrosis and ischemia after injection of an a-adrenoceptor agonist |
|
|
what is Yohimbe?
|
competitive a2>>a1 blocker
OTC herbal preparation sometimes taken to treat ED could cause BP/HR abnormalities and sleep disturbances |
|
|
what are the adverse effects of Phentolamine?
|
hypotension
tachycardia cardiac arrhythmias ischemic cardiac events GI stimulation may result in abdominal pain, nausea, and exacerbation of peptic ulcer |
|
|
what are the adverse side effects of Phenoxybenzamine?
|
postural hypotension accompanied by reflex tachycardia and arrhythmias
inhibition of ejaculation and aspermia after orgasm |
|
|
what are the adverse side effects of Prazosin, Terazosin, Doxazosin?
|
first dose phenomenon
orthostatic hypotension headache dizziness fainting reflex tachycardia edema |
|
|
describe the negative feedback mechanism that decreases the amount of sympathetic stimulation to the heart.
|
NE activates presynaptic a2-adrenergic receptors and this inhibits formation of cAMP and decreases the release of NE
|
|
|
how does Phentolamine work?
|
blocks a2-receptor mediated inhibition of NE release. This increases the stimulation of cardiac b1-adrenergic receptors and results in tachycardia (blocking negative feedback)
|
|
|
why does Prazosin cause less tachycardia than phentolamine?
|
Prazosin, a selective a1-blocker does not block a2-receptor mediated inhibition of NE release therefore prazosin causes less tachycardia than does phentolamine
|
|
|
what are the clinical uses of b-blockers?
|
Neurological disease
Hypertension Ischemic heart disease Cardiac arrhythmias Glaucoma Hyperthyroidism |
|
|
how doe b-blockers work in the treatment of neurological disease?
|
reduction in the frequency and intensity of migraine
reduction in somatic manifestation of anxiety reduction in essential tremor |
|
|
why do b-blockers work in treatment of hypertension?
|
effective and well tolerated
often used with diuretic or vasodilator |
|
|
how do b-blockers work in the treatment of ischemic heart disease?
|
reduce the frequency of anginal episodes
improves exercise tolerance |
|
|
how do b-blockers work in the treatment of cardiac arrhythmias?
|
effective in the treatment of both SVT and ventricular arrhythmias
Reduce ventricular ectopic beats, particularly if ectopic activity has been precipitated by catecholamines Slow ventricular response rate in atrial flutter and fibrillation |
|
|
what other cardiac disorders are b-blockers used to treat?
|
increase stroke volume in some patients with obstructive cardiomyopathy
useful in dissecting aortic aneurysm to decrease the rate of development of systolic pressure |
|
|
why are b-blockers used in the treatment of Glaucoma?
|
reduction in intraocular pressure
|
|
|
why are b-blockers used in the treatment of hyperthyroidism?
|
decreases HR, BP, anxiety, and tremor
|
|
|
Name the B1-blockers.
|
Acebutolol
Atenolol Esmolol Metoprolol |
|
|
what are the pharmacological effects of B-blockers?
|
decrease cardiac rate, output, AV node conduction, and oxygen demand
decreases blood pressure |
|
|
what is the clinical use of Acebutolol?
|
hypertension
cardiac arrhythmias NOT for migraines |
|
|
what is the clinical use of Atenolol?
|
b1-blocker
hypertension angina pectoris acute MI Essential tremor |
|
|
what is the clinical use of Esmolol?
|
B1-blocker
administered via IV Acute SVT Acute Hypertension |
|
|
what is the clinical use of Metoprolol?
|
B1-selective with MSA
Hypertension angina pectoris acute MI |
|
|
what type of b-blocker is Nadolol?
|
B1 & B2-blocker
|
|
|
what is the clinical use of Nadolol?
|
non-selective b-blocker
hypertension angina pectoris migraine headache |
|
|
what type of b-blocker is Pindolol?
|
b1 & b2-blocker
|
|
|
what is the clinical use of Pindolol?
|
Hypertension
NOT for MIGRAINES |
|
|
Propanolol.
|
B1- and B2-blocker
hypertension angina pectoris hypertrophic subaortic stenosis essential tremor migraine headache acute thyrotoxicosis acute MI Pheochromocytoma |
|
|
Timolol
|
B1 & B2-blocker
|
|
|
what is the pharmacological effect of Timolol?
|
decreases cardiac rate, output, AV node conduction, and oxygen demand
decreases blood pressure decreases intraocular pressure |
|
|
what is the clinical use of Timolol?
|
Hypertension
Acute MI Migraine headaches Glaucoma: topical- reduce secretion of aqueous humor |
|
|
Name the non-selective a- and b-blockers.
|
Carvedilol
Labetolol |
|
|
Carvedilol
|
b1 & b2 blocker
a1-blocker strong antioxidant properties cardioprotective causes vasodilation decreases heart rate and blood pressure in patients with hypertension increases CO in patients with heart failure tx: hypertension & heart failure |
|
|
Labetalol
|
B1& B2-blocker with MSA
a1-blocker causes vasodilation decreases heart rate and blood pressure tx: hypertension |
|
|
what non-selective b-blocker has intrinsic sympathomimetic activity?
|
Pindolol
|
|
|
what non-selective b-blocker has membrane stabilizing activity?
|
Pindolol: low
Propanolol: high |
|
|
what b1-blocker has intrinsic sympathomimetic activity?
|
Acebutolol has low sympathomimetic activity
|
|
|
what b1-blocker must be administered via IV?
|
Esmolol
|
|
|
what are the adverse side effects of b-receptor blockers?
|
CNS: sedation, sleep disturbances, depression, psychotic reactions
Pulmonary fxn: worsening of pre-existing asthma and other forms of airway obstruction CV: may cause or exacerbate heart failure, acute MI, or cardiomegaly. Bradycardia, life threatening bradyarrhythmias. Cold extremities, abrupt discontinuation can exacerbate angina and increase risk of sudden death Metabolism: blunt recognition of hypoglycemia and may delay recovery from insulin induced hypoglycemia. USE b1-specific antagonist to avoid Drug interactions: effects are additive to CCB and with other antihypertensive drugs |
|
|
what is the CNS?
|
brain and spinal cord
|
|
|
what is the PNS?
|
ganglia outside of the spinal cord
|
|
|
what are the motor portions of the PNS divided into?
|
somatic motor division
autonomic motor division |
|
|
what is the somatic motor division of the PNS?
|
motor axon that connects the brain and spinal cord to skeletal muscle
|
|
|
what is the autonomic motor division of the PNS?
|
cells and axons that innervate smooth muscle, cardiac muscle, and glands
|
|
|
what can the autonomic nervous system be divided into?
|
Sympathetic
Parasympathetic Enteric |
|
|
describe the sympathetic nervous system.
|
Fight or Flight
ganglia near spinal column and innervate various target organs |
|
|
describe the parasympathetic NS.
|
ganglia found within organs they innervate
"Rest and Digest" |
|
|
what is the Enteric nervous system?
|
neurons in the wall of the gut
Gastric motility and secretion |
|
|
what inhibits the Enteric NS?
|
sympathetic NS
|
|
|
what activates the Enteric Nervous system?
|
Parasympathetic Nervous system
"rest and digest" |
|
|
describe the anatomy of the Sympathetic NS?
|
from thoracic and lumbar of spinal cord to ganglia near the spinal cord and then from the ganglia to organs
- Short pre-ganglionic - Long post-ganglionic |
|
|
Describe the anatomy of the Parasympathetic NS?
|
Rest & digest
From brainstem (CN III, VII, IX, X) and sacral spinal cord to ganglia (near or in organs) and then from the ganglia to organs. - Long pre-ganglionic - short post-ganglionic - ganglia often located in the target organs |
|
|
what receptor do Preganglionic fibers synapse on?
|
Ionotropic
Fast with Nicotinic receptor |
|
|
what receptor do Post-ganglionic fibers synapse on?
|
metabotropic
slower with Muscarinic receptors |
|
|
what NT acts on preganglionic receptors?
|
ACh acts on Nicotinic receptors
- muscle (somatic) - Ganglia, CNS |
|
|
what NT acts on Postganglionic receptors?
|
Parasympathetic: Muscuarinic receptor > ACh
Sympathetic: Adrenocreceptors (Epi/NE) |
|
|
__________ is the primary NT at somatic (preganglionic nicotinic) and parasympathetic (postganglionic) receptors.
|
ACh
|
|
|
Norepinephrine is the primary NT at the _________ NS (postganglionic) junctions.
|
Norepinephrine
|
|
|
what are the non-adrenergic and non-cholingergic NTs found in the ANS?
|
Peptides
Nitric oxide Serotonin |
|
|
describe the functions of ACh.
|
Somatic & Parasympathetic NT
- Ionotropic receptors: excitatory - Nicotinic receptors - Metabotropic receptors - Muscarinic receptors |
|
|
what muscarinic receptors are excitatory?
|
M1, 3, 5
|
|
|
what muscarinic receptors are inhibitory?
|
M2 & 4
|
|
|
what breaks down ACh?
|
acetylcholinesterase
|
|
|
what type of neuron is Norepinephrine active on?
|
adrenergic neurons
Sympathetic neurons |
|
|
where is dopamine concentrated in?
|
locus ceruleus
|
|
|
what are the excitatory adrenergic receptors?
|
alpha1
beta1,2,3 |
|
|
what breaks down ACh?
|
acetylcholinesterase
|
|
|
what breaks down Dopamine and NE?
|
MAO and COMT
|
|
|
what breaks down Serotonin?
|
MAO and ALDH
|
|
|
Hemicholinum
|
inhibits synthesis of ACh
|
|
|
Vesamicol
|
prevents vesicular storage of ACh by increasing the release of ACh
|
|
|
Botulinum Toxin
|
inhibits release of ACh
- inhibits muscle contraction |
|
|
black widow spider venom
|
inhibits release of ACh
|
|
|
cholinesterase inhibitors: Physostigmine
|
inhibits breakdown of ACh = increased ACh
|
|
|
Name ACh agonist.
|
Acetylcholine
Bethanechol Pilocarpine - activate the postsynaptic receptor |
|
|
Name ACh antagonist.
|
Atropine
Tubocrurarine - blocks postsynaptic receptors |
|
|
what type of receptor does atropine block?
|
Muscarinic receptors
|
|
|
What type of receptor does Tubocrurarine block?
|
Nicotinic receptors
|
|
|
if a drug is going to effect the sympathetic nervous system NT, what NT is it affecting?
|
Norepinephrine
|
|
|
Metyrosine
|
inhibits synthesis of NE by decreasing tyrosine hydroxylase
|
|
|
Reserpine
|
prevents vesicular storage of NE
|
|
|
Bretylium
|
inhibits release of NE
- neuronal blocking agent |
|
|
Amphetamine
|
inhibits the release of NE
- increases NE in synapse |
|
|
Cocaine
|
inhibits the reuptake of NE
decreased reuptake > increased NE |
|
|
Phenelzine (MAOI)
|
inhibits the breakdown of NE
decreases breakdown = increased NE |
|
|
Name direct acting b-agonist that cause NE release by activating the postsynpatic receptor.
|
Albuterol
Dobutamine Epinephrine |
|
|
Name NE receptor antagonist that block postsynaptic receptor.
|
Phentolamine
Propanolol |
|
|
what type of receptors does Phentolamine block?
|
a-adrenoceptors (post synpatic)
|
|
|
what type of receptors does Propanolol block?
|
b-adrenoreceptor (pre-synaptic)
Anxiolytic |
|
|
what type of receptors does Labetalol antagonize?
|
a- and b-adrenreceptors
|
|
|
when muscarinic (ACh) and a-adrenoreceptors are stimulated what is the action?
|
smooth muscle cell contraction
|
|
|
when b-adrenoreceptors (NE) are stimulated what is the action?
|
smooth muscle relaxation (b-2)
cardiac stimulation (b-1) |
|
|
what modulates the baroreceptor reflex?
|
adrenoreceptor (NE) agonist and antagonist
|
|
|
Name the ACh receptors
|
Nicotinic
Muscarinic |
|
|
describe Nicotinic receptors
|
Preganglionic
Somatic Parasympathetic/Sympathetic |
|
|
describe Muscarinic receptors
|
postganglionic
parasympathetic |
|
|
where are nicotinic receptors found?
|
Nicotinic receptors are found at all autonomic ganglia, somatic neuromuscular junction, and CNS
|
|
|
what occurs with the activation of nicotinic receptors at autonomic ganglia by ACh?
|
activated nicotinic receptors = excitation of postganglionic neurons leading to release of NT at postganglionic neuroeffector junctions
|
|
|
what occurs with activation of the nicotinic receptor at somatic nerves and skeletal muscle.
|
activated nicotinic receptors = depolarization of motor end plate and leads to increase calcium from SR = muscle contraction
|
|
|
what occurs when nicotinic receptors are activated in the CNS?
|
activation of nicotinic receptors in the brain = excitation of pre and post synaptic neurons
|
|
|
describe a nicotinic receptor.
|
ionotropic
excitation fast |
|
|
what is the nicotinic receptor structure?
|
polypeptide pentamer with ACh binding sites
|
|
|
how does acetylcholine affect the channel that a nicotinic receptor controls?
|
ACh gated Na Channels: activation leads to increase sodium influx = depolarization
|
|
|
where are muscarinic receptors found in the body?
|
smooth muscle
cardiac tissue glands at parasympathetic neuroeffector junctions Presynaptic sympathetic and parasympathetic autonomic nerves |
|
|
what occurs after a muscarinic receptor has been activated by ACh?
|
decreased NT release
|
|
|
how are the parasympathetic and sympathetic nervous systems connected?
|
Muscarinic receptors are present at sympathetic nerve terminal = connection between parasympathetic and sympathetic NS
- release of ACh from parasympathetic NS = decrease NE from sympathetic nerves |
|
|
describe the Muscarinic receptor.
|
metabotropic (GPCR)
slow M1-M5 M1,3,5: increase PLC = increase IP3 and DAG M2,4: decrease cAMP |
|
|
A nicotinic ACh receptor have neurotransmission and muscle contraction properties. Where are the three types of receptors found?
|
Muscle type: NM Junction: increases sodium influx: muscle contraction
Ganglionic type: Autonomic ganglia: increase Na influx: neuronal excitation CNS type: CNS: increases Na influx: neuronal contraction |
|
|
Describe the Muscarinic ACh receptor properties according to their locations in the body.
|
M1: neutral: ANS ganglia, presynaptic, CNS: increases IP3: modulation of central/peripheral
M2: cardiac: Cardiac tissue: decrease cAMP, increase IP3: cardiac slowing M3: glandular: smooth muscle/glands: increase IP3: smooth muscle/gland M3: vascular smooth muscle: increase cGMP: vasodilation |
|
|
describe what a direct acting ACh receptor agonist does.
|
binds and activates ACh receptors
|
|
|
describe the function of an indirect ACh acting receptor Agonist.
|
inhibits cholinesterase: decreases ACh breakdown: increases ACh
Augment ACh signal transduction |
|
|
Name the Choline Esters that are Direct Acting Receptor Agonist of ACh.
|
Acetylcholine
Bethanechol Carbachol Methacholine |
|
|
Name the direct acting agonist that are plant alkaloids for ACh receptors.
|
Muscarine
Nicotine Pilocarpine |
|
|
where are muscarinic receptors found in the body?
|
smooth muscle
cardiac tissue glands at parasympathetic neuroeffector junctions Presynaptic sympathetic and parasympathetic autonomic nerves |
|
|
what occurs after a muscarinic receptor has been activated by ACh?
|
decreased NT release
|
|
|
how are the parasympathetic and sympathetic nervous systems connected?
|
Muscarinic receptors are present at sympathetic nerve terminal = connection between parasympathetic and sympathetic NS
- release of ACh from parasympathetic NS = decrease NE from sympathetic nerves |
|
|
describe the Muscarinic receptor.
|
metabotropic (GPCR)
slow M1-M5 M1,3,5: increase PLC = increase IP3 and DAG M2,4: decrease cAMP |
|
|
A nicotinic ACh receptor have neurotransmission and muscle contraction properties. Where are the three types of receptors found?
|
Muscle type: NM Junction: increases sodium influx: muscle contraction
Ganglionic type: Autonomic ganglia: increase Na influx: neuronal excitation CNS type: CNS: increases Na influx: neuronal contraction |
|
|
Describe the Muscarinic ACh receptor properties according to their locations in the body.
|
M1: neutral: ANS ganglia, presynaptic, CNS: increases IP3: modulation of central/peripheral
M2: cardiac: Cardiac tissue: decrease cAMP, increase IP3: cardiac slowing M3: glandular: smooth muscle/glands: increase IP3: smooth muscle/gland M3: vascular smooth muscle: increase cGMP: vasodilation |
|
|
describe what a direct acting ACh receptor agonist does.
|
binds and activates ACh receptors
|
|
|
describe the function of an indirect ACh acting receptor Agonist.
|
inhibits cholinesterase: decreases ACh breakdown: increases ACh
Augment ACh signal transduction |
|
|
Name the Choline Esters that are Direct Acting Receptor Agonist of ACh.
|
Acetylcholine
Bethanechol Carbachol Methacholine |
|
|
Name the direct acting agonist that are plant alkaloids for ACh receptors.
|
Muscarine
Nicotine Pilocarpine |
|
|
what type of drug are:
Cevimeline Varenicline |
Direct acting ACh- receptor antagonist
|
|
|
Acetylcholine
|
Nicotinic and Muscarinic
- hydrolyzed by choline esterase - Miosis (ophthalmologic exam) - Coronary angiography - Vasodilation |
|
|
Bethanechol
|
Direct acting ACh-receptor Agonist
Muscarinic NOT hydrolyzed by Choline esterase Oral administration GI and GU stimulation |
|
|
Carbachol
|
Direct Acting ACh receptor agonist
Nicotinic and Muscarinic NOT hydrolyzed by Choline esterase Ocular administration Miosis during ophthalmic surgery Glaucoma |
|
|
Methacholine
|
Direct Acting ACh receptor agonist
Nicotinic and Muscarinic hydrolyzed by choline esterase inhalation administration Asthma challenge |
|
|
what type of drug is Muscarine?
|
Muscarinic Plant Alkaloid ACh receptor agonist
- NO medical use |
|
|
What drug is a nicotinic ACh receptor agonist that is a plant alkaloid, administered orally/transdermally, and used for smoking cessation?
|
Nicotine
|
|
|
Pilocarpine
|
Plant Alkaloid ACh receptor Agonist
Muscarinic receptor Topical ocular/oral administration Glaucoma Xerostomia |
|
|
Cevimeline
|
ACh receptor Agonist
M3: excitatory increases IP3 Oral administration Xerostomia RX: dry eyes |
|
|
Varenicline
|
Acetylcholine receptor Agonist
Nicotinic receptor agonist Oral administration Smoking cessation decreases cravings and withdrawal symptoms |
|
|
what are the classes of drugs that indirectly act as ACh receptor agonist?
|
Drugs that inhibit cholinesterase
- Reversible cholinesterase inhibitors - irreversible cholinesterase inhibitors Drugs that augment ACh |
|
|
name the reversible cholinesterase inhibitors.
|
Donepazil
Edrophonium Neostigmine Physostigmine Pyridostigmine |
|
|
name the irreversible cholinesterase inhibitors
|
Echothiophate
Isoflurophate Malathion |
|
|
Name the drugs that Augment ACh
|
Sidenafil
Vardenafil Tadalafil |
|
|
Describe Donepazil
|
Reversible cholinesterase inhibitor
Oral administration Clinical use: Alzheimers disease |
|
|
describe Edrophonium
|
Reversible cholinesterase inhibitor
IV administration Clinical use: Myasthenia gravis diagnosis |
|
|
describe Neostigmine
|
Reversible Cholinesterase inhibitor
Oral, SC, or IM administration Clinical use: Myasthenia gravis, GI, GU stimulation |
|
|
describe Physostigmine
|
Reversible Cholinesterase inhibitor
Topical ocular administration, IM, IV Clinical use: Glaucoma, Reversal CNS effects of antimuscarinic drugs |
|
|
describe Pyridostigmine
|
Reversible Cholinesterase inhibitor
Oral, IM, IV administration Clinical use: Myasthenia gravis, antidote for curariform drug toxicity |
|
|
describe Echothiophate
|
Irreversible cholinesterase inhibitor
Topical ocular administration Clinical use: Chronic Glaucoma and Accommodation estropia |
|
|
Isoflurophate
|
Irreversible Cholinesterase inhibitor
Topical ocular administration Clinical use: Glaucoma and accommodation estropia |
|
|
You child plays on a baseball team and they share batting helmets. One of the children on his team has gotten head lice. If you child has it too, what will you use to treat him?
|
Malathion
- Irreversible Cholinesterase inhibitor - Topical administration Clinical use: Pediculosis (lice) |
|
|
describe the action of Sidenafil.
|
Drug that augments ACh
- Viagra - decreases 5-PDE = decrease degradation of cAMP = increase cGMP = increased vasodilation |
|
|
what would a patient need Vardenafil for? Can the patient eat food with it?
|
Vardenafil is a drug that augments ACh and is a Sidenafil minor drug for ED.
Patients can eat food with it since it is not affected by food |
|
|
Which of the drugs that augment ACh receptors has the longest half life?
|
Tadalafil (Cialis)
absorption not affected by food |
|
|
what is the most common side effect of Sidenafil?
|
HEADACHE
|
|
|
What is carbachol most commonly used to treat?
|
Choline ester ACh receptor agonist.
used to treat Chronic open-angle glaucoma |
|
|
What is Pilocarpine most commonly used to treat?
|
Direct acting ACh receptor agonist
Chronic open-angle and acute angle closure glaucoma |
|
|
Your patient has chronic glaucoma and accommodative estropira. What would you treat them with?
|
Echothiophate
Isoflurophate Irreversible cholinesterase inhibitors |
|
|
It has been determined your patient that has come to the ER has organophosphate poisoning. How do you treat them?
|
this is cholinergic poisoning
- Echothiophate, Isoflurophate, Malathion are possible causative agents - Give ACh antagonist (Atropine) and cholinesterase regenerator |
|
|
what do ACh receptor Antagonist do?
|
block either Nicotinic or Muscarinic receptors
can affect almost every organ system Wide range of clinical applications |
|
|
What do Nicotinic receptor antagonist do?
|
block neurotransmission at nicotinic receptors
Ganglionic blocking agents and neuromuscular blocking agents used to relax smooth muscle |
|
|
what do Muscarinic receptor antagonist do?
|
used to relax smooth muscle
decrease gland secretion stimulate heart |
|
|
what is an example of a Belladona alkaloid that is an ACh receptor antagonist?
|
Atropine
|
|
|
what is an example of a semisynthetic/synthetic muscarinic antagonist?
|
Ipratropium
|
|
|
what do muscarinic agonist do?
|
smooth muscle contraction
increase gland secretion decrease heart rate and conduction pupil constriction |
|
|
what do Muscarinic antagonist do?
|
Opposite effects of parasympathetic NS
- relax smooth muscle - decrease gland secretion - stimulate heart (Increase HR & cardiac contraction) - Pupil dilation - decrease respiratory secretions - bronchial smooth muscle relaxation/bronchodilation - Some can relax GI and slow motility, cause urinary retention, and CNS with sedation or excitement Can decrease heat loss and lead to hyperthermia and flushing |
|
|
what are muscarinic antagonist used to treat?
|
Bradycardia
Obstructive lung disease Intestinal spasms Overactive urinary bladder - increase HR, cardiac contraction, decrease salivary and respiratory secretions, relax GI & GU |
|
|
Muscarinic Antagonist/Agonist are used to produce mydriasis and cyclopegia in ophthalmologic exams.
|
Muscarinic Antagonist
- Mydriasis: pupil dilation - Cyclopegia: decrease accommodation |
|
|
how do muscarinic antagonist cause mydriasis?
|
relax iris sphincter muscle
relax ciliary muscle |
|
|
how do muscarinic antagonist cause cyclopegia?
|
decrease accommodation
- increase tension of suspensory ligaments attached to the lens: lens flattens: causes focus on distant objects - decrease lens ability to increase refractory power to focus on near objects |
|
|
What toxicity is referred to by this mnemonic: drug as a bone, blind as a bat, red as a beet, and mad as a hatter? and why?
|
Atropine toxicity
Symptoms: dry mouth, decreased sweating, blurred vision, flushing, hyperthermia, delirium, hallucinations, and coma Urinary retention is also a symptom as well as transient tachycardia and palpitations |
|
|
why are muscarinic antagonist used in ophthalmologic exams?
|
muscarinic antagonist aid in the examination of the retina by causing mydriasis
|
|
|
what muscarinic antagonist should be used in children vs. adults in causing mydriasis for an ophthalmologic exam?
|
Atropine (long-lasting) may be necessary in children, but shorter-acting drugs (tropicamide) are preferred and used in adults and older children
|
|
|
what two muscarinic antagonist are used to prevent increased airway secretions and laryngospasm elicited due to inhalation of anesthetics?
|
Atropine or Scoplamine
|
|
|
what muscarinic antagonist is used to prevent bronchoconstriction?
|
Ipratropium is inhaled and used in the treatment of COPD and asthma
|
|
|
Would you administer atropine to a patient with asthma or COPD?
|
NO
atropine inhibits ciliary activity which would increase thickness of mucus |
|
|
________ __________ may be used to improve depressed cardiac output resulting from increased vagal tone.
|
Muscarinic antagonist
- MI - Hyperactive carotid sinus reflex - Idiopathic dilated cardiomyopathy |
|
|
How would a patient become toxic with cholinergic poisoning?
|
Cholinergic excess resulting from exposure to cholinesterase inhibitors elicits effects resulting from the stimulation of both nicotinic and muscarinic receptors
Lessened by administration of atropine |
|
|
what is the treatment for Cholinergic poisoning?
|
Lessend by administration of atropine
The cholinesterase regenerator Pralidoxime may also be administered to patients exposed to organo-phosphate cholinesterase inhibitors |
|
|
Your patient has been exposed to organophosphate poison. What do you do for them.
|
Patient was probably exposed to Echothiophate, Isoflurophate, or Malathion which are irreversible cholinesterase inhibitors
Give ACh antagonist: atropine Give Cholinesterase regenerator: Pralidoxime |
|
|
List the side effects of Muscarinic antagonist
|
Dry mouth
blurred vision hot skin flushed skin delirium tachycardia agitation |
|
|
What patients are muscarinic antagonist contraindicated in?
|
closed angle glaucoma
prostatic hyperplasia gastric ulcer USe extreme caution in children |
|
|
what nicotinic receptor antagonist is a ganglionic blocking agent?
|
Trimethaphan
- blocks ACh at Nicotinc receptor - emergency treatment of malignant HTN - increase hypoTN surgery |
|
|
Name the depolarizing blocking agent that is an ACh receptor Antagonist.
|
Succinylcholine
|
|
|
what is Succinylcholine used for?
|
Depolarizing ACh receptor antagonist
only depolarizing agent Muscle relaxation during surgery Causes muscle fasciculations |
|
|
what is the Duration of Action of Succinylcholine?
|
short DOA 5-10 minutes
|
|
|
Is succinylcholine hydrolyzed by cholinesterase inhibitors?
|
NO
|
|
|
what is the method of elimination of succinylcholine?
|
Plasma cholinesterase
|
|
|
what are the non-depolarizing agents that are ACh receptor Antagonist?
|
Atracurium
Cisatracurium Pancuronium |
|
|
what are the non-depolarizing ACh receptor antagonist clinically used for?
|
Muscle relaxation during surgery
|
|
|
Atracurium
|
ACh-receptor antagonist
non-depolarizing Intermediate DOA 30-60 minutes route of elimination: plasma esterase |
|
|
Cisatracurium
|
ACh-receptor Antagonist
Non-depolarizing Intermediate DOA decreased by spontaneous chemical degradation |
|
|
Pancuronium
|
ACh-receptor antagonist
Non-depolarizing agent Long DOA: 60-120 minutes Elimination by renal excretion used for muscle relaxation during surgery |
|
|
name the muscarinic receptor antagonist:
|
Atropine
Scopolamine Propantheline glycopyrrolate dicyclomine Tropicamide Ipratropium Benzotropine Oxybutynin Tolterodine Homatropine Cyclopentolate |
|
|
What muscarinic receptor ACh-antagonist are used in for Ophthalmolgic exams?
|
Atropine
Tropicamide Homatropine cyclopentolate |
|
|
Describe Atropine
|
Muscarinic ACh-receptor antagonist
clinical use: Ophthalmologic exam, decreases cholinesterase toxicity, bradycardia |
|
|
Scopolamine
|
Muscarinic ACh-receptor antagonist
Rx: decrease motion sicknes s |
|
|
Propantheline
|
Muscarinic ACh-receptor antagonist
decrease hypermotility and peptic disease |
|
|
Glycopyrrolate
|
decrease hypermotility
peptic disease Muscarinic ACh-receptor antagonist |
|
|
Dicyclomine
|
Muscarinic ACh-receptor antagonist
decrease hypermotility Peptic disease (IBS) |
|
|
Tropicamide
|
Muscarinic ACh-receptor antagonist
Ophthalmologic exams |
|
|
Ipratroprium
|
Muscarinic ACh-receptor antagonist
Asthma Emphysema |
|
|
Benzotropine
|
Parkinson's disease
|
|
|
Oxybutynin
|
Muscarinic ACh-receptor antagonist
Relief of bladder spasm after urological surgery (GU) |
|
|
Tolterodine
|
Muscarinic ACh-receptor antagonist
decrease urinary incontinence |
|
|
Homatropine
|
Muscarinic ACh-receptor antagonist
Ophthalmologic exam |
|
|
Cyclopentolate
|
Muscarinic ACh-receptor antagonist
Ophthalmologic exams |
|
|
what are the monoamine NT?
|
Norepinephrine
Dopamine Serotonin |
|
|
What do adrenergic receptors release?
|
Norepinephrine
|
|
|
what adrenergic receptors are excitatory?
|
a-1
B1-3 |
|
|
what adrenergic receptors are inhibitory?
|
a-2
|
|
|
where is Dopamine stored?
|
Concentrated in the VTA and SNc
|
|
|
what dopamine receptors are excitatory?
|
D1 and D5
|
|
|
what dopamine receptors are inhibitory?
|
D2, 3, and 4
|
|
|
what does a-1 stimulation cause on a cellular basis?
|
increased PLC - Increased IP3 - increased Calcium
|
|
|
what actions occur due to a-1 stimulation?
|
contraction of smooth muscle
vasoconstriction increased blood pressure increased gland secretion |
|
|
what is the mechanism of a-2 adrenergic receptors?
|
decreased adenylyl cyclase - decreased cAMP
|
|
|
what is the action from stimulation of a-2 receptors?
|
decreased sympathetic function from CNS (decreased NE)
decreased secretion of aqueous humor |
|
|
what is the mechanism of all beta-adrenergic receptor stimulation?
|
increased adenylyl cyclase - increased cAMP
|
|
|
what actions do b-1 receptors cause?
|
increased HR
increased contractility increased conduction increased renin secretion |
|
|
what does stimulation of b2 receptors cause?
|
relaxation of smooth muscle
vasodilation bronchodilation increased potassium in skeletal muscle Uterine relaxation |
|
|
what does stimulation of b3-receptors cause?
|
Lipolysis
|
|
|
what is the mechanism of action of D1 receptors?
|
increase adenylyl cyclase - increased cAMP
|
|
|
what is the mechanism of action of D2 receptors?
|
decreased adenylyl cyclase - decreased cAMP
|
|
|
what does stimulation of D1 receptors cause?
|
relaxation of smooth muscle
|
|
|
what does stimulation of D2 receptors cause?
|
modulation of Neurotransmitter in CNS and Sympathetic NS
|
|
|
what does stimulation of Imidazoline receptors cause?
|
decreased sympathetics from CNS (decreased NE)
Natriuresis |
|
|
what do muscarinic receptors (ACh) and alpha-1 adrenergic receptors (NE) have in common?
|
both contract smooth muscle
|
|
|
what do beta-2 adrenergic receptors and D1 receptors have in common?
|
both relax smooth muscle
|
|
|
what do muscarinic (ACh) and alpha-2 adrenergic receptors have in common?
|
Treatment of Glaucoma
|
|
|
where do adrenergic receptors receive there NT from?
|
Adrenergic receptors receive NE from postganglionic neurons b/c adrenoceptors are located on/in target organs
|
|
|
True or False
NE is sympathetic only |
True
|
|
|
what is the pharmacological effect of dobutamine?
|
cardiac stimulation (b1)
Vasodilation (B2) |
|
|
what is the clinical use of Dobutamine?
|
Cardiogenic shock
Acute HF NOT septic shock |
|
|
what is the pharmacological effect of Dopamine?
|
Cardiac stimulation (B1)
Renal vasodilation (D1) increased Blood Pressure (B1, a1) |
|
|
what is the clinical use of Dopamine?
|
Cardiogenic shock
Septic shock Hypovolemic shock CHF |
|
|
what is the pharmacological effect of Epinephrine?
|
vasoconstriction and increase BP (a1)
Cardiac stimulation (B1) Bronchodilation (B2) |
|
|
what is the clinical use of Epinephrine?
|
Anaphylactic shock
Cardiac arrest V fib decrease bleeding |
|
|
what is the pharmacological effect of Isoproterenol?
|
Cardiac stimulation (B1)
Bronchodilation (B2) |
|
|
what is the clinical use of Isoproterenol?
|
Asthma
AV block Bradycardia |
|
|
what is the pharmacological effect of Norepinephrine?
|
vasoconstriction and increase BP (a1)
|
|
|
what is the clinical use of Norepinephrine?
|
Hypotension
Shock |
|
|
What is the pharmacological effect of Albuterol?
|
Bronchodilation (B2)
|
|
|
what is the clinical use of Albuterol?
|
ASthma
|
|
|
what is the pharmacological effect of Apraclonidine?
|
decrease aqueous humor formation (a2)
|
|
|
what is the clinical use of Apraclonidine?
|
control intracranial pressure (short term)
|
|
|
what is the pharmacological effect of Clonidine?
|
decrease sympathetic stimulation of CNS (a2 & imidazole)
|
|
|
what is the clinical use of Clonidine?
|
HTN
Opiod dependence |
|
|
what is the pharmacological effect of Midodrine?
|
Vasoconstriction (a1)
|
|
|
what is the clinical use of Midodrine?
|
orthostatic HTN (severe)
|
|
|
what is the pharmacological effect of Oxymetazoline?
|
Vasoconstriction (a1)
|
|
|
what is the clinical use of Oxymetazoline?
|
nasal and ocular decongestion
|
|
|
what is the pharmacological effect of Phenylphrine?
|
Vasoconstriction
increase BP Mydriasis (a1) |
|
|
what is the clinical use of Phenylphrine?
|
Nasal and Ocular decongestion
Mydrias Maintain BP RX: Shock via IV administration |
|
|
what is the pharmacological effect of Ritodrine?
|
uterine relaxation (b2)
|
|
|
what is the clinical use of Ritodrine?
|
Premature labor
|
|
|
what is the pharmacological effect of Terbutaline?
|
Bronchodilation (b2)
Uterine relaxation (B2) |
|
|
what is the clinical use of Terbutaline?
|
Asthma
Premature labor |
|
|
name tow indirect acting adrenergic receptor agonist?
|
Amphetamine
Cocaine |
|
|
what is the mechanism of action of amphetamine?
|
increases NE release
CNS stimulation |
|
|
what is the clinical use of amphetamine?
|
narcolepsy
ADD |
|
|
what is the pharmacological effect of cocaine?
|
decreased NE reuptake
increased NE |
|
|
what is the clinical use of Cocaine?
|
local anesthesia
|
|
|
what are the mixed acting adrenoreceptor agonist?
|
Ephedrine
Pseudoephedrine |
|
|
what is the clinical use of Ephedrine?
|
Nasal decongestant
|
|
|
what is the pharmacological effect of Ephedrine?
|
Vasoconstriction (a1)
|
|
|
what is the pharmacological effect of Pseudophedrine?
|
Vasoconstriction (a1)
|
|
|
what is the clinical use of Pseudophedrine?
|
Nasal decongestant
|
