Adrenergic Drugs Affecting ANS

Question 1

Main neurotransmitter of sympathetic nervous system (sns)

Answer 1

Mainly norepinephrine (NE) -post ganglionic

Also epinephrine (adrenaline)

Question 2

Catecholamines moa

Answer 2

Bind to same target tissues as epinephrine

Natural-NE,Epi, dopamine
Synthetic- isoproterenol and dobutamine

Question 3

Adrenergic transmission

Answer 3

Alpha 1,2
Beta 1,2,3

*activation of each receptor subtype=characteristic response

Question 4

What breaks down NE?

Answer 4

COMT (catechol-O-methyltransferase) in synapse

MAO (monoamine oxidase) in cell

Question 5

Epinephrine vs Norepinephrine transmission

Answer 5

NE>synapse>alpha or beta receptor on target tissue

Epi goes directly into circulation but also works on receptors just like NE
-restart heart

Question 6

What breaks down Epi?

Answer 6

Liver

Question 7

Approaches to affecting adrenergic neuronal transmission

Answer 7

• synthesis of neurotransmitter in termalinal
• prevent storage of neurotransmitters in presynaptic nerve
• prevent release of neuros in presynap
• prevent destruction or reuptake of neurotransmitters
• bind to receptor on postsynaptic target tissue

Question 8

Alpha 1

Answer 8

NE>Epi (affinity)

Located on All sympathetic target organs besides heart

Tx:nasal congestion,hypotension

*Constriction of blood vessels and dilation of pupils

Question 9

Alpha 2

Answer 9

NE=Epi

Located on presynaptic nerve terminals

Tx:hypertension

*inhibit release of NE through feedback inhibition

Question 10

Beta 1

Answer 10

NE>Epi

Located on heart and kidneys

Tx:shock, heart failure, cardiac arrest

*Increased HR and force of contraction

Question 11

Beta 2

Answer 11

Epi>NE

Located on all sympathetic target organs

Tx: asthma, premature labor

*smooth muscle relaxation/inc metabolism

Question 12

Beta 3

Answer 12

NE=Epi

Located on adipose tissue/urinary bladder

Tx:overactive bladder

*inc adipose tissue lipolysis/relax detrusor muscle (bladder)

Question 13

Dopamine receptors

Answer 13

Located in arterioles,kidneys, and heart

Low doses-vasodilation through kidneys
High doses- alpha 1 and beta 1 agonism

Question 14

Adrenergic Drugs:agonists

Answer 14

Epinephrine (adrenalin)
Isoproternol (isuprel)
Pseudoephedrine (sudafed)
Phenylephrine (neo-synephrine)
Albuterol (ventolin)
Monoamine oxidase inhibitors(MAOI)

Question 15

Epinephrine(adrenalin) moa

Answer 15

Alpha and beta (+) which stimulates sns

Tx:cardiac arrest, asthama, allergic react.

Question 16

Isoproternol(isuprel) Moa

Answer 16

Beta 1 and 2 (+) which inc heart rate, smooth muscle relaxation(bronchodilation)

Tx:asthma, dsrhythmias, heart failure

Question 17

Pseudoephedrine(sudafed) moa

Answer 17

Alpha 1 and beta 2 (+) constrict blood vessels in nose

Tx: nasal decongestant

Question 18

Phenylephrine(neo-synephrine) moa

Answer 18

Alpha 1 (+)

Also used for nasal decongestant and acute hypotension

*can be used for vascular shock

Question 19

Albuterol (ventolin) moa

Answer 19

B(+) relaxation of smooth muscle(bronchodilation)

Tx:asthma, copd

Question 20

Monoamine oxidase inhibitors(MAOI) moa

Answer 20

Inhibit enzyme that breaks down catecholamines to inc NE

Tx:used in hypertensive crisis

Question 21

Alpha 1 antagonists

Answer 21

Autonomic drugs for heart

Prazosine(minipress)

Question 22

Prazosine (MiniPress) Moa

Answer 22

Alpha 1 (-) which causes vasodilation to dec blood pressure

Question 23

Beta Blockers (antagonists) Moa/tx

Answer 23

Dec HR, dec force of contraction, and dec AV node conduction

Tx: hypertension, angina pectoris, migraines, dysthymias

*can mask hypoglycemia in diabetics

Question 24

Beta blocker drugs

Answer 24

Atenolol(tenormin)
Metaprolol (lopressor, toprol)
Carteolol (cartol)

Question 25

Atenolol(tenormin) Moa

Answer 25

Beta 1 (-)

Cardiac selective

Question 26

Metaprolol (lopressor, toprol) Moa

Answer 26

Beta 1 (-)

Question 27

Carteolol (cartol)

Answer 27

Beta 1 and 2 (-)

Question 28

You can go cold turkey off Beta Blockers T/F

Answer 28

False