Pharm: Adrenergics Flashcards

1
Q

Epinephrine

A

Mechanism: alpha1 agonism (vasoconstriction) at high doses, beta1 agonism (increased HR and contractility) at low doses, beta2 agonism (bronchodilation, mild decrease in BP)
Use: cardiac arrest, severe HTN, bronchospasm in asthma and anaphylaxis
SE: HTN, arrhythmia, MI, pulmonary edema, headache, anxiety

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2
Q

Norepinephrine

A

Mechanism: alpha1 agonism (vasoconstriction), beta1 agonism (increased contractility)
Use: increases BP in treatment of severe hypotension and shock
SE: angina, MI, arrhythmia, decrease RPF

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3
Q

Dopamine

A

Mechanism: alpha1 agonism (vasoconstriction) at high doses, beta agonism (increased HR and contractility) and D1 (increased renal perfusion) agonism at low doses
Use: increases BP in treatment of severe hypotension and shock
SE: angina, arrhythmia, HTN, nausea

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4
Q

Dobutamine

A

Mechanism: beta1 agonism > increases HR and contractility > increases CO; alpha1 and beta2 effects are weak and produce mild vasodilation
Use: cardiogenic shock (pressor), cardiac stress testing
SE: arrhythmia, angina, hypotension, headache

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5
Q

Ephedrine, pseudoephedrine

A

Mechanism: stimulates release of NE and epinephrine > increases BP, increases CO, induces bronchodilation, stimulates CNS (amphetamine effects)
Use: nasal decongestant
SE: HTN, tremor, anxiety, arrhythmia

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6
Q

Cocaine

A

Mechanism: blocks Na/K ATPase, blocks presynaptic monoamine reuptake pumps (like DAT1) responsible for reuptake of NE, serotonin, and dopamine, thereby potentiating their effects
Use: local anesthesia
SE: HTN, paranoia, seizures, cardiac ischemia and infarction, arrythmia, addiction

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7
Q

Phenylephrine

A

Mechanism: alpha1 agonism > vasoconstriction (decreased mucosal secretions) and pupil dilation
Use: severe hypotension and shock, nasal congestion, mydriasis in eye exam
SE: arrhythmia, headache

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8
Q

Clonidine

A

Mechanism: alpha2 agonism in the vasomotor centers of the medulla > decreased release of NE and other NTs > decreased central adrenergic activity > decreased vasoconstriction, HR, CO
Use: HTN; useful in pts with renal disease because it does not decrease RPF
SE: rebound HTN, bradycardia, sedation

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9
Q

Isoproterenol

A

Mechanism: beta1 and beta2 agonism > increases HR and contractility, causes vasodilation and bronchodilation
Use: torsades de pointes (co-administer Mg), cardiac arrest, heart block
SE: tachyarrhythmias, anxiety, pulmonary edema

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10
Q

Albuterol, pirbuterol, bitolterol

A

Mechanism: beta2 agonism > bronchodilation; can also cause intracellular movement of K
Use: asthma, hyperkalemia (in high doses)
SE: tachycardia, tremor, aniety

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11
Q

Metoprolol, atenolol, esmolol, acebutolol

A

Mechanism: selective beta1 antagonism > decreases HR and contractility; minimal beta2 antagonism
Use: HTN, tachycardia, CAD
SE: mild bronchoconstriction (avoid in asthmatics), bradycardia, impotence, hypotension

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12
Q

Carvedilol, labetalol

A

Mechanism: alpha1 receptor blocker + beta blocker > decreases HR and contractility, vasodilation, bronchoconstriction
Use: CHF, HTN
SE: dizziness, hypotension, bradycardia

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13
Q

Propanolol, nadolol, pindolol, timolol

A

Mechanism: nonselective beta antagonism > decreased HR and contractility, decreased BP, bronchoconstriction
Use: HTN, CAD, hyperthyroidism-induced tachycardia, chronic migraines
SE: bronchoconstriction, arrhythmia, impotence, fasting hypoglycemia, hypotension

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14
Q

Prazosin, terazosin, doxazosin, tamsulosin, alfuzosin

A

Mechanism: selective alpha1 antagonist > vasodilation and decreased BP; decreases prostatic neck contraction to improve urinary flow
Use: HTN, BPH
SE: first-dose syncope, orthostatic hypotension, dizziness, nasal congestion

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15
Q

Phenoxybenzamine

A

Mechanism: irreversible alpha antagonist > decreases BP
Use: pheochromocytoma (esp. prior to surgical resection)
SE: orthostatic hypotension, tachycardia, nasal congestion

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16
Q

Methyldopa

A

Mechanism: alpha2 agonist that acts in the vasomotor centers of the medulla > decreases release of NE and other NTs > decreases vasoconstriction
Use: moderate HTN; useful in pts with renal disease because it does not decrease RPF
SE: sedation, dizziness, positive Coombs test, orthostatic hypotension

17
Q

Terbutaline, ritodrine

A

Mechanism: beta2 agonist > relaxation of smooth muscle in lungs (bronchodilation) and uterus (reduces contractions)
Use: delay preterm labor, status asthmaticus
SE: dizziness, tachycardia, anxiety, chest pain, tremor