Sympathomimetics Flashcards by Mark Sutherland | Brainscape

Q

Where are most alpha-2 receptors located?

A

On the presynaptic terminal

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Q

Are catecholamines water soluble or water insoluble?

A

Water soluble

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Q

Norepinephrine

A

Catecholamine, direct on A1 and A2, less on some B1

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Q

Epinephrine

A

Catecholamine, direct on A1, A2, B1, B2

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Q

Isoproterenol

A

Catecholamine direct on B1 and B2

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Q

Dopamine

A

Catecholamine direct on A1,B1,B2 and DA (renal vessels)

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Q

Dobutamine

A

Catecholamine, direct on B1, others

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Q

Phenylephrine

A

Non-catecholamine, direct on A1

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Q

Tetrahydrozoline

A

Non-catecholamine, direct on A1

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Q

Nephazoline

A

Non-catecholamine, direct on A1

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Q

Oxymetazoline

A

Non-catecholamine, direct on A1

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Q

Ritodrine

A

Non-catecholamine, direct on B2 more than B1

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Q

Metaproterenol

A

Non-catecholamine, direct on B2 more than B1

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Q

Albuterol

A

Non-catecholamine, direct on B2 more than B1

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Q

Salbutamol

A

Non-catecholamine, direct on B2 more than B1

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Q

Salmeterol

A

Non-catecholamine, direct on B2 more than B1

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Q

Formoterol

A

Non-catecholamine, direct on B2 more than B1

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Q

Terbutaline

A

Non-catecholamine, direct on B2 more than B1

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Q

Clonidine

A

Non-catecholamine, direct on A2

Q

Ephedrine and pseudoephedrine

A

Non-catecholamine, indirect on a and b (increased release)

Q

Amphetamine

A

Non-catecholamine, indirect on a and b (increased release)

Q

Cocaine

A

Non-catecholamine, indirect on a and b (decreased uptake)

Q

Tyramine

A

Non-catecholamine, indirect on a and b

Q

What suffix is commonly associated with beta-agonists?

A

ol

Q

What response do blood vessels give to alpha-beta agonists at different concentrations?

A

Low concentration - beta response, high concentration - alpha response

Q

Which sympathomametics cross the blood brain barrier well and why?

A

Amphetamine and ephedrine because they do not have OH groups (they cause CNS stimulation in the brain)

Q

Which isomer is more potent in sympathomimetics

A

L-isomer in periphery, d-isomer in CNS

Q

What chemical change increases a drugs beta activity?

A

N-alkylation

Q

A botched IV infusion with a type of sympathomimetic can damage tissue. What type and why?

A

Alpha agonist. Because they cause BV constriction, if they end up the tissue you can get necrosis

Q

What happens to catecholamines if exposed to air?

A

Solution can turn pink, drug has deteriorated

Q

Give the effects of an alpha1 agonist on the lung, GI, Heart, BVs, Eye, Uterus, Glands, Liver, Pancreas, Skeletal muscle, and CNS

A

Lungs - none, GI - decreased activity, Heart - none, BVs - constriction, Eye - Mydriasis, Uterus - none, Glands - secretion, Liver - Glycogenolysis, gluconeogenesis, Pancreas - none, Skel muscle - none, CNS - alertness

Q

Give the effects of a beta1 agonist on the lung, GI, heart, BVs, eye, uterus, glands, liver, pancreas, skel muscle, CNS, and kidney

A

Lung - none GI - none, Heart - Increased HR, contract, velocity, BVs - none, Eye - increased inflow, uterus - none, glands - none, liver - none, pancreas - none, skel muscle - none, CNS - fatigue, hunger, kidney - renin

Q

Give the effects of a beta2 agonist on lungs, GI, heart, BVs, Eye, uterus, glands, liver, pancreas, skel muscle, CNS, and kidney

A

Lungs - Bronchorelaxation, GI - decreased activity, heart - increased HR, contract, velocity (less than B1), BVs - dilation, eye - increased inflow, uterus - relaxtion, glands - none, liver - glycogenolysis and gluconeogenesis, pancreas - insulin secretion increased, skel muscle - increased activity, CNS - fatigue, hunger, kidney - renin

Q

What is the only end organ effect of alpha2 agonism?

A

Decreased insulin secretion from the pancreas

Q

Why is hyperthyroidism a contraindication for beta agonists?

A

Because T3 regulates B2 receptors on heart (increases their sensitivity)

Q

Why is Raynauds disease a contraindication for alpha agonists?

A

Because the blood vessels are already constricted in Raynauds and alpha agonists constrict them more

Q

What type of sympathomimetic increases blood glucose?

A

B2 agonists (this is despite an increase in insulin secretion that occurs with B2 agonism)

Q

Give the effect of norepinephrine on blood pressure and the reason for this effect

A

Increase diastolic, smaller increase in systolic and MBP. Due to increase in peripheral resistance

Q

Give the effect of epinephrine on blood pressure and the reason for this effect

A

Increase systolic, diastolic no change, increase MBP. Due to increase in HR and CO

Q

Give the effect of isoproterenol on blood pressure and the reason for this effect

A

Increase systolic, decrease diastolic and mean (Peripheral Resistance decreases, CO up initially but down due to pooling)

Q

Give the effect of dopamine on blood pressure and the reason for this effect

A

Increase systolic, no change in diastolic, increase MBP. Due to increase HR and CO (no change in resistance except for renal dilation)

Q

Three vascular uses of alpha agonists

A

Nasal decongestion, stopping superficial bleeding, prevent spread of local anesthetic

Q

What drug is given for CHF and why?

A

Dobutamine (a selective B1 agonist). Has fewer other effects while having the desired effect (increased CO)

Q

What does histamine cause during anaphylactic shock and what is given to combat this (explain why)

A

Histamine causes bronchoconstriction and vasodilation. Epinephrine is given to combat that (alpha and beta agonist) because it causes bronchorelaxation (B2) and vasoconstriction (A1)

Q

What is the mechanism of open angle glaucoma and what is given to combat this?

A

Problem with outflow so give a parasympatheticomimetic to contract the cilliary body and increase ourflow or a beta antagonist to decrease inflow.

Q

What autonomic drug might you give to reduce premature contractions?

A

A beta 2 agonist