(1) Autonomic Drugs: Sympathetic (2.1-2.4)

Question 1

What effect does α1 stimulation have on the vasculature?

Answer 1

(1) Constrict arterioles ⇒ ↑ TPR
(2) Constrict veins ⇒ ↑ Preload

Question 2

Which adrenergic receptor leads to urinary retention?

Answer 2

α₁

Question 3

Which adrenergic receptor inhibits the release of insulin?

Answer 3

α₂

Question 4

Which adrenergic receptor inhibits lipolysis?

Answer 4

α₂

Question 5

Which adrenergic receptor inhibits the production of aqueous humor?

Answer 5

α₂

Question 6

Indication: Brimonidine

Answer 6

Open-angle glaucoma

Question 7

Which adrenergic receptor stimulates renin release?

Answer 7

β₁

Question 8

Which adrenergic receptor can cause hypokalemia?

Answer 8

β₂

Question 9

What effect does Phenylephrine have on P_sys, P_dia, and MAP?

Answer 9

(1) P_sys : ↑
(2) P_dia : ↑
(3) MAP: ↑

Question 10

What is the receptor specificity of Norepinephrine?

Answer 10

α > β

Question 11

What is the receptor specificity of Dobutamine?

Answer 11

β1 > β2

Question 12

What effect does Dobutamine have on P_sys, P_dia, and MAP?

Answer 12

(1) P_sys : ↑
(2) P_dia : ↓
(3) MAP: ↔

Question 13

Which sympathomimetic is used for cardiogenic shock?

Answer 13

Dobutamine

Question 14

What effect does Isoprotenerol have on P_sys, P_dia, and MAP?

Answer 14

(1) P_sys : ↔
(2) P_dia : ↓
(3) MAP: ↓

Question 15

Indications (2) : Terbutaline

Answer 15

(1) Asthma
(2) Preventing premature labor

Question 16

What is the receptor specificity of Epinephrine?

Answer 16

(1) Low doses: β > α
(2) High doses: α predominant

Question 17

Which adrenergic receptor stimulates lipolysis?

Answer 17

β₂

Question 18

Which adrenergic receptor stimulates the release of insulin?

Answer 18

β2

Question 19

Which adrenergic receptor stimulates the production of aqueous humor?

Answer 19

β₂

Question 20

What effect does Norepinephrine have on P_sys, P_dia, and MAP?

Answer 20

(1) P_sys : ↑
(2) P_dia : ↑
(3) MAP: ↑

Question 21

What effect does Epinephrine have on P_sys, P_dia, and MAP?

Answer 21

(1) P_sys : ↑
(2) P_dia : ↓
(3) MAP: ↔ / ↑

Question 22

Name 2 drugs which would be helpful in the acute management of distributive shock

Answer 22

(1) Phenylephrine
(2) Norepinephrine

Question 23

Treatment: Anaphylactic shock

Answer 23

Epinephrine

(“α1 counters vasodilation, β1 improves blood flow to tissues, and β2 opens up the airways”)

Question 24

What drug inhibits the conversion of tyrosine to L-DOPA?

Answer 24

Metyrosine

Question 25

**MOA**: Cocaine

Answer 25

Inhibits NET and DAT

Question 26

Why are β-blockers contraindicated in those on cocaine?

Answer 26

⇒ Unopposed α stimulation

Question 27

**MOA**: Atomoxetine

Answer 27

NET inhibitor ## Footnote *(NET = norepinephrine transporter)*

Question 28

**MOA**: Reserpine

Answer 28

Inhibits VMAT *("V" mat: vesicular monoamine transporter (VMAT))*

Question 29

What type of G-proteins are D₁ and D₂ receptors?

Answer 29

(1) _D₁_: G_s (2) _D₂_: G_i

Question 30

What receptor mediates the effects of a _low_ dose of dopamine?

Answer 30

_Low dose_: D₁ receptors ⇒ ↑ Renal blood flow

Question 31

What receptor mediates the effects of a medium dose of dopamine?

Answer 31

_Medium dose_: β₁ receptor⇒ ↑ Contractility/HR

Question 32

What receptor mediates the effects of a _high_ dose of dopamine?

Answer 32

_High dose_: α₁ receptor⇒ ↑ TPR

Question 33

Where does the conversion of dopamine into norepinephrine occur?

Answer 33

Within the synaptic vesicle

Question 34

**MOA**: Amphetamine

Answer 34

↑ Endogenous release of NE/DA

Question 35

**Indications** (3) : Clonidine

Answer 35

(1) Hypertension (2) ADHD (3) Tourettes

Question 36

**Treatment**: Gestational hypertension

Answer 36

α-methyldopa

Question 37

**Adverse Effect**: α-methyldopa

Answer 37

Drug-induced lupus *(Also Coombs-positive hemolytic anemia)*

Question 38

**Indication**: Tizanidine

Answer 38

Muscle relaxant

Question 39

**MOA**: Phentolamine

Answer 39

REVERSIBLE α1 and α2 antagonist

Question 40

**MOA**: Phenoxybenzamine

Answer 40

Irreversibly inhibits α1 and α2

Question 41

What drug should be used to treat cocaine toxicity?

Answer 41

Phentolamine

Question 42

Name a drug that provides symptomatic relief for BPH

Answer 42

Terazosin

Question 43

What sympatholytic is used to treat PTSD?

Answer 43

Prazosin

Question 44

What _adrenergic_ receptor does Mirtazapine inhibit?

Answer 44

α2

Question 45

**MOA**: Clonidine

Answer 45

α2 agonist

Question 46

**Adverse Effects** (2) : α1 antagonists

Answer 46

(1) Orthostatic hypotension (2) ⇒ Reflex tachycardia

Question 47

**Suffix**: α1 antagonist

Answer 47

"-osin"

Question 48

What type of sympatholytic are useful in _chronic stable angina_?

Answer 48

β blockers

Question 49

What are the primary indications for the cardio-selective β-blockers?

Answer 49

(1) CHF (2) MI

Question 50

Name 2 non-selective β + α1 blockers

Answer 50

(1) Carved**_i_**lol (2) Labet**_a_**lol * (Notice this class differs from the "-**_o_**lol" suffix)*

Question 51

What β-blocker is used to treat hypertension in pregnancy?

Answer 51

Labetalol

Question 52

Which class of sympatholytic is useful in _hypertrophic obstructive cardiomyopathy_?

Answer 52

β-blockers ## Footnote *(↓ Ventricle volume ∝ ↑ Outflow resistance ∴ β-blockers mediated ↓ in stroke volume helps with symptoms)*

Question 53

**Indications** - Non-cardiac (4) : β-blockers

Answer 53

(1) Migraines (2) Thyroid storm (3) Tremor (4) Glaucoma

Question 54

What drug is a selective β1-blocker with partial agonist activity?

Answer 54

Acebutolol

Question 55

What drug is a non-selective β-blocker with partial agonist activity?

Answer 55

Pindolol

Question 56

Which β-blockers are contraindicated in heart failure?

Answer 56

Partial agonists

Question 57

**Treatment**: β-blocker poisoning

Answer 57

Glucagon *(+ atropine)*

Question 58

What is a topical β-blocker useful in treating glaucoma?

Answer 58

Timolol

Question 59

What new EKG findings may present when on β-blockers?

Answer 59

Heart block

Question 60

How can you identify a β₁ selective antagonist?

Answer 60

Name start with A-BEAM *(_Note_: **N**evbivolol is the exception. However, it's memorable as it also induces _NO_ release)*

Question 61

Name 2 reasons β-blockers are helpful in CHF

Answer 61

(1) Prevents remodeling *(due to excess catecholamines)* (2) ↓ Renin *(and ∴ prevents fluid overload and AngII mediated remodeling)*

Question 62

**Adverse Effects** (3) : β-blockers

Answer 62

(1) ⇒ Heart block (2) Exacerbate asthma (3) Impotence