Adregenic Stimulants

Question 0

Norepinephrine

Answer 0

Adrenergic Stimulants
no class
a(1), B(1)
Must be IV
a1- vasoconstriction - increase TPR
B1- increase contractility, HR - Increased CO
- increased in vasoconstriction cause reflexive decrease in HR therefore the HR remains relatively unchanged
- if given atropine before NE injection than vagal tone is inhibited and there would be an increase in HR
- can cause such severe vasoconstriction at site of administration the area may become necrotic

Question 1

Epinephrine

Answer 1

Adrenergic Agonist
no class
a, B(1), B(2)
READ EPINEPHRINEEE- PG 13
tx anaphylactic shock, cardiac arrest and complete heart block, used to decrease diffusion of local anesthetics
side effects: tremor, throbbing, headache, high HTN, ventricular arrhythmia, cerebral hemorrhage

Question 2

Phenylephrine

Answer 2

Adrenergic Agonist 
a1 
potent vasoconstrictor-increase BP, w/reflex decrease in HR
nasal decongestant
mydriasis

Question 3

Pseudoephedrine

Answer 3

Adrenergic Agonist
a1
most often used as nasal decongestant, similar to phenylephrine
less tachycardia and CNS effects than ephedrine

Question 4

Tetrahydrazoline and Naphazoline

Answer 4

Adrenergic Stimulants
a1
used to clear eyes by causing vasoconstriction (visine, clear eyes, etc)
contraindicated in narrow-angle glaucoma and HTN

Question 5

Xyleometazoline

Answer 5

Adrenergic Agonist
a1
Nasal decongestant, rebound effect if used chronically

Question 6

Oxymetazoline

Answer 6

Adrenergic stimulants
a1, a2
Nasal decongestant, can cause hypotension if acts on a2

Question 7

Midodrine

Answer 7

a1 agonist
treat postural hypotension (given in daytime to prevent HTN upon laying down)
treat autonomic insufficiency

Question 8

Methoxamine

Answer 8

a1 agonist

used IV to treat hypotension

Question 9

Clonidine

Answer 9

Adrenergic Stimulants
a2
CNS Action to decrease NE release, peripheral decrease in BP, consider as prototype for A2 agonist, may also inc PSNS outflow from CNS, can cause sexual dysfunction in males
Pre-anesthetic: sedation and decrease secretions

Question 10

Methyldopa

Answer 10

Adrenergic Agonists
a2
Goes to CNS- reduces NE release, lowers peripheral BP

Question 11

Apraclonidine

Answer 11

Adrenergic Agonist
a2, decrease NE release (and thus B stim)
eye- decrease intraocular pressure

Question 12

Brimonidine

Answer 12

Adrenergic stimulants
a2-decrease NE release (and thus B stim)
eye- decrease intraocular pressure

Question 13

Tizandine

Answer 13

Adrenergic Stim
a2
reduce muscle spasticity

Question 14

Isoproterenol

Answer 14

Adrenergic stim
B(1), B(2)
Increase heart rate, increase contraction force
B1 is going to increase HR, B2 dilated BV–therefore initial rise in systolic pressure (b1) then blood vessels dilate (b2) –> reduction in BP but increase in HR
Used for cardiac arrest and complete heart block -
Side effects: tachycardia, palpitations, arrhythmia

Question 15

Dobutamine

Answer 15

adrenergic stim
B(1)
increase HR, Increase contractility, INCREASE CARDIAC OUTPUT – -
- VERY short half life (2mins), short lived effect
IV, used in stress tests for pts who are unable to work out
- patients with cardiogenic shock or CHF it may be infused constantly to maintain an increased CO
- May cause HTN in patients with a history of HTN- to avoid infuse slowly

Question 16

Terabutaline

Answer 16

Adrenergic Stimulants
B(2)
Relax uterus - suppress premature labour

Question 17

Salmeterol

Answer 17

Adrenergic Stim
B(2)
anti-asthmatic
potent vasodilator

Question 18

Ritrodine

Answer 18

Adrenergic stim
B(2)
relax uterus - suppress premature labour

Question 19

Dopamine

Answer 19

Adrenergic Stim.
D1
Vasodilation and increase renal blood flow, cardiac shock (high dose will act on B1)
Inc GFR and Na excretion

Question 20

Fenodolpam

Answer 20

Adrenergic stim
D1
dilation of vascular beds, dec BP, short term action
used to treat severe HTN

Question 21

Ephedrine

Answer 21

Adren. Stim
a and B, enhances NE release
CNS stimulants, highly bioavailable and long lasting, excretion inc by acidifying urine
Inc HR, may inc BP, bronchodilation

Question 22

amphetammine

Answer 22

Adren. Stim
indirect by displacing NE from neurons inc its release
CNS stimulant, meth is type of this drug with more CNS centralized effects

Question 23

Methylphenidate (ritalin)

Answer 23

Adren. stim
indirect via displacement of NE
CNS stimulant that causes paradoxical decrease in hyperactivity

Question 24

Cocaine

Answer 24

indirect
inhibits DA and NE reuptake
may cause severe HTN and stroke in healthy young adults
tachycardia, arrhythmia, MI
may be used in nasopharyngeal surgery to decrease local blood flow

Question 25

Tyramine

Answer 25

Adrenergic stim
indirect
Displaces NE rom vesicle, mimics NT, (tyrimine is a normal component of food but it is typically degraded by MAO in GI/Liver)

Question 26

albuterol

Answer 26

Adrenergic Stimulant
B(2)
Anti-asthmatic - potent bronchodilator

Question 27

B(2) Side Effects when given Orally?

Answer 27

Headache, skeletal muscle tremor, palpitation