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Pharmacology II > L3 Adrenergic Stimulants (Exam #1) > Flashcards

L3 Adrenergic Stimulants (Exam #1) Flashcards

1
Q

What is the role of indirect-acting adrenergic effectors? Give four examples

A

Act on presynaptic neuron

- Cocaine, amphetamines, MAOIs, tyramine

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2
Q

What is the role of direct-acting adrenergic effectors?

A

Act on receptors directly to mimic SNS

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3
Q

How does denervation affect indirect-acting adrenergic effectors, and direct-acting adrenergic effectors?

A
  • Indirect: stops any activity

- Direct: can enhance activity

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4
Q

Which receptors does Norepinephrine (Levophed) act on?

A

A = B1

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5
Q

What is the primary use of Norepinephrine (Levophed), and how common is its use?

A

Increase BP in hypotensive crisis

- Rarely used - “give Levophed or leave them dead”

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6
Q

What is the primary AE associated with Norepinephrine (Levophed)?

A

Vasoconstriction/tissue necrosis at infusion site

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7
Q

Which receptors does Epinephrine (Adrenalin) act on?

A

All (B1 = B2 > A1)

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8
Q

What are the four primary uses of Epinephrine (Adrenalin)?

A
  • Anaphylactic shock
  • Vasoconstrictor (local anesthesia)
  • Emergency tx for cardiac arrest or complete heart block
  • Glaucoma (increases removal of fluid, decreases production of fluid)
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9
Q

How does low dose Epinephrine (Adrenalin) vs. high dose Epinephrine (Adrenalin) affect the CV system? Which dose is more commonly used clinically?

A
  • Low dose: B2 receptors = vasodilation = increase HR, but no change in BP
  • High dose: A1 receptors = override vasodilation and cause vasoconstriction = increase BP and HR then baroreflex slows HR; more common clinically
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10
Q

How do A-blockers affect Epinephrine (Adrenalin)? How do B-blockers affect Epinephrine (Adrenalin)?

A
  • A-blockers reverse Epi effect (lower BP)

- B-blockers increase BP without increasing HR

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11
Q

What are the five primary AEs associated with Epinephrine (Adrenalin)?

A
  • Tremors
  • Throbbing HA
  • Increase BP
  • Increase HR
  • Cause angina in CAD pts
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12
Q

What route of administration is preferred for Epinephrine (Adrenalin), and why?

A

IV because it will activate the B2 receptors (vasodilation) and prevent tissue necrosis or severe HTN

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13
Q

What is the primary CI associated with Epinephrine (Adrenalin), and why?

A

Patients using B-blockers because then A is unopposed and this can cause severe HTN

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14
Q

What is the primary action of Phenylephrine (Neofrin), and what are its three primary uses?

A
  • Increase BP in hypotensive emergency (VASOCONSTRICTS)
  • Decongestant (VASOCONSTRICTS)
  • Mydriasis (contract radial muscle)
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15
Q

What are the two primary AEs associated with Phenylephrine (Neofrin)?

A
  • Rebound effect (down regulation then upregulation causing increased stuffiness)
  • Ischemia of mucous membranes with prolonged use
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16
Q

What are the two primary CIs associated with Phenylephrine (Neofrin)?

A
  • HTN

- BPH

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17
Q

What medication is Pseudophedrine (Sudafed) similar to, and how is it different?

A

Pseudophedrine (Sudafed) is similar to Phenylephrine (Neofrin) but it is MORE effective
- Beware OTC because can make meth lol

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18
Q

What are the two primary uses of Oxymetazoline (Afrin)?

A
  • Nasal congestion (topical)

- Eye redness (topical)

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19
Q

What are the two primary CIs associated with Oxymetazoline (Afrin)?

A
  • Closed-angle glaucoma

- HTN

20
Q

What is the primary use of Clonidine and Methyldopa? What are two other possible uses?

In what group is Methyldopa considered the first line treatment for?

A

Treat HTN
- Can also decrease cravings in addicts and decrease hot flashes

Methyldopa is 1st line for HTN in pregnant women

21
Q

What are the two primary AEs associated with Clonidine and Methyldopa?

What is a significant AE that is specific to Methyldopa?

A
  • Xerostomia
  • Sedation/CNS effects

Methyldopa can also cause hemolytic anemia (+ Coombs)

22
Q

What are the two primary CIs associated with Clonidine?

A
  • Sudden withdrawal can cause HTN crisis

- Hypotension if using patch and it gets hot

23
Q

What is the primary use of Tizanidine?

A

Reduce muscle spasticity in neurological conditions

24
Q

What is the primary AE associated with Tizanidine?

A

Asthenia

25
Q

What type of receptors are affected by Phenylephrine (Neofrin), Pseudophedrine (Sudafed) and Oxymetazoline (Afrin)?

A

A1 (agonist)

26
Q

What type of receptors are affected by Clonidine, Methyldopa and Tizanidine?

A

A2 (agonist)

27
Q

What type of receptor is affected by Isoproterenol?

A

B (B1 = B2)

28
Q

What is the primary use of Isoproterenol (2)?

A

Emergency cardiac arrest or complete heart block

29
Q

What are the three primary AEs associated with Isoproterenol in large doses?

A
  • Tachycardia
  • Palpitations
  • Arrhythmias
30
Q

What are the three primary uses of Dobutamine (Dobutrex)?

A
  • Increase cardiac contractility and CO in cariogenic shock or end-stage HF
  • Used for stress echocardiogram
31
Q

What type of receptor is affected by Dobutamine (Dobutrex)?

A

B1

32
Q

What type of receptor is affected by Albuterol (Ventolin)?

A

B2

33
Q

What is the primary use of Albuterol (Ventolin)?

A

Asthma

34
Q

What are the two primary AEs associated with Albuterol (Ventolin), especially if given orally?

A
  • Tachycardia/palpitations

- Tremor

35
Q

What is the primary use of Mirabegron?

A

Treat overactive bladder (relaxes bladder wall)

36
Q

What are the two primary AEs associated with Mirabegron?

A
  • HTN

- Sinus tachycardia

37
Q

What is the primary use of Dopamine (Intropin)? What other drug is often used for this, and under what circumstances would Dopamine (Intropin) be preferred?

A

Short-term treatment of end-stage HF (refractory HF)

- Dobutamine is DOC but if patient has end-stage HF AND is hypotensive, use Dopamine (Intropin)

38
Q

What is the primary AE associated with Dopamine (Intropin), and why?

A

Avoid combining with MAOIs because Dopamine (Intropin) is metabolized by MAOs

39
Q

What is the primary use of Fenoldopam?

A

HTN emergency

40
Q

What is the general MOA of Indirect-Acting Sympathomimetics?

A

Increase NE release

41
Q

What is the primary use of Amphetamine (Adderall) and Methylphenidate (Ritalin)?

A

ADHD (CNS stimulant)

42
Q

What are the four primary AEs associated with Amphetamine (Adderall) and Methylphenidate (Ritalin)?

A
  • Tachycardia
  • Tremor
  • HTN
  • Psychosis
43
Q

What is the MOA of Cocaine specifically?

A

Inhibit NE reuptake by NET

44
Q

What are the four primary AEs associated with Cocaine?

A
  • HTN
  • Stroke
  • Tachycardia (leads to MI, arrhythmias)
  • Psychosis
45
Q

Which two Indirect-Acting Sympathomimetics can be used synergistically?

A

Amphetamine (Adderall)/Methylphenidate (Ritalin) and Cocaine

46
Q

What is the primary CI associated with Tyramine, and what can this lead to?

A

Use of MAOIs because Tyramine is metabolized by MAOs

- Can lead to HTN crisis

Pharmacology II (20 decks)

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