Adrenergic Agents Flashcards Preview

Pharmacology > Adrenergic Agents > Flashcards

Flashcards in Adrenergic Agents Deck (72):
1

Epinephrine (mechanism)

Stimulates a1, a2, b1, b2 (b > a)

2

Norepinephrine (mechanism)

Stimulates a1 > a2 > b1

3

Epinephrine (4 uses)

Anaphylaxis
Open angle glaucoma
Asthma
For severe hypotension

4

Norepinephrine (use)

For severe hypotension (but decreases renal perfusion)

5

Isoproterenol (mechanism)

Nonselective b-agonist

6

Isoproterenol (use)

For evaluation of tachyarrhythmias (specifically in hemodynamically stable TdP to increase sinus rate and shorten QT interval)

7

Isoproterenol (side effects)

Can precipitate tachyarrhythmias and worsen ischemia (increases risk of MI)

8

Dopamine (mechanism)

Stimulates D1 = D2 > b > a

9

Dopamine (3 uses concerning heart)

Unstable bradycardia
CHF
Cardiogenic shock

10

Dopamine (side effect)

Arrhythmias

11

Dobutamine (mechanism)

b1 agonist -> increases HR, contractility, conduction velocity, myocardial O2 consumption
Also decreases peripheral vascular resistance by having a little bit of b2 effect too

12

Dobutamine (2 uses)

CHF (inotropic > chronotropic)
Cardiac stress testing

13

Dobutamine (side effect)

Arrhythmias (b/c it increases cardiac conduction velocity)
Angina (b/c it increases myocardial O2 consumption by increasing HR and having positive inotropic effect)

14

Phenylephrine (mechanism)

Stimulates a1 > a2

15

Phenylephrine (4 uses)

Hypotension (vasopressor)
Mydriatic
Reduces secretion (so decongestant for rhinitis, hyperemia, edema)
Open obstructed eustachian tubes

16

Albuterol (mechanism)

Stimulates b2 > b1

17

Albuterol (use)

Acute asthma

18

"-terol" (mechanism)

Salmeterol and formoterol
Stimulates b2 > b1

19

"-terol" (2 uses)

Salmeterol and formoterol
Long-term asthma
Long-term COPD control

20

Terbutaline (mechanism)

Stimulates b2 > b1

21

Terbutaline (use)

Reduces premature uterine contractions

22

Amphetamine (mechanism)

Increases NE by being agonist, reuptake inhibitor, and causing release of stored NE

23

Amphetamine (3 uses)

ADHD
Obesity
Narcolepsy

24

Ephedrine (mechanism)

Increases NE by being agonist and causing release of stored NE

25

Ephedrine (3 uses)

Nasal decongestion
Urinary incontinence
Hypotension

26

Cocaine (mechanism)

Reuptake inhibitor of catecholamines & general agonist

27

Cocaine (never use with)

b-blockers if cocaine intoxication is suspected -> unopposed a1 activation -> extreme HTN

28

Cocaine (use)

Local anesthetic

29

Difference between effects of NE and isoproterenol on HR

NE has a effects whereas isoproterol doesn't
So NE causes reflex bradycardia (a1-mediated), isoproterenol causes increased HR (b1-mediated)

30

Difference between effects of NE and isoproterenol on BP

NE has a effects whereas isoproterol doesn't
So NE causes increase in BP (a1-mediated), isoproterenol causes decrease in BP (b2-mediated)

31

Clonidine (mechanism)

a2-agonist (sympatholytic)

32

Clonidine (3 uses)

HTN urgency (doesn't decrease renal BF)
ADHD
Severe pain
Off-label for ethanol/opioid withdrawal

33

Clonidine (side effects)

Rebound HTN if stopped immediately
CNS & resp depression
Pro sympa stuff (bradycardia, hypotension, small pupil)

34

Methyldopa (mechanism)

a2-agonist (analog of L-dopa that gets converted in brain to methyl-NE)

35

Methyldopa (use)

HTN in pregnancy (safe to use in pregnancy)

36

Methyldopa (side effects)

Hemolytic anemia (direct Coombs +)
SLE-like syndrome
Hepatotoxicity

37

Phenoxybenzamine (mechanism)

Nonselective a-blocker (irreversible) -> dose-response curve shifted right and down (rather than just shifted right like the other REVERSIBLE a blocker) -> can look like noncompetitive binding

38

Phenoxybenzamine (use)

Pre-op pheochromocytoma resection (prevents catecholamines crisis)

39

Phenoxybenzamine (side effects)

Orthostatic hypotension, reflex tachycardia

40

Phentolamine (mechanism)

Nonselective competitive a-blocker (reversible)

41

Phentolamine (3 uses)

MAOI crisis (pts on MAOi who eat tyramine-containing foods)
Cocaine overdose
Pheochromocytoma

42

Phentolamine (side effects)

Orthostatic hypotension, reflex tachycardia

43

Prazosin and other "-osin" (mechanism)

a1-blocker

44

Prazosin and other "-osin" (use)

Urinary sx of BPH (esp tamsulosin)
Prozosin also used for PTSD
All used for HTN except tamsulosin

45

Prazosin and other "-osin" (side effects)

1st-dose orthostatic hypotension
dizziness, headache

46

Mirtazapine (mechanism)

Atypical antidepressant
a2-blocker -> increases release of NE and 5-HT
Potent 5-HT2 and 5-HT3 ANTAgonist

47

Mirtazapine (use)

Depression

48

Mirtazapine (side effects)

Sedation (desirable in depressed pts w/ insomnia tho),
Increases appetite and weight gain, increases serum cholesterol
Dry mouth

49

Yohimbine (mechanism)

a2-blocker

50

Yohimbine (historic use)

erectile dysfx (replaced by PDE inhibitors now)

51

B1-blockers

A-M (first half of alphabet, ending in "-olol")
acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol

52

Nonselective b-blockers

N-Z (second half of alphabet, ending in "-olol")
nadolol, pindolol (partial agonist), propanolol, timolol
More side effects from b2 blockade (bronchoconstriction in lungs)

53

Nonselective a & b blockers

Things with modified suffix
carvedilol, lavetalol
Also get decreased SVR from a blockade

54

Nebivolol (mechanism)

Blocks b1 (cardiac)
Stimulates b3 (activates NO synthase in vasculature)

55

Timolol (use)

Glaucoma (reduces aq humor secretion)

56

Metoprolol (use)

SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval)

57

Esmolol (use)

SVT (reduces conduction velocity - class II antiarrhythmic -> prolongs PR interval)
Acute HTN emergency (ultra short acting)

58

B blockers (antidote)

Glucagon

59

B blockers (side effect)

Blunted response to hypoglycemia (dangerous in diabetics bc mask sx of hypoglycemia) -> selective B1 blockers preferable in DM over nonselective
Don't use in suspected cocaine users (unopposed a-adrenergic activity)
Hyperkalemia w/ nonselective b blockers (interferes w/ B2 mediated intracellular K+ uptake)

60

Partial B agonists

Pindolol
Acebutolol

61

Partial B agonists (contraindication)

Angina

62

Metoprolol (side effect)

Dyslipidemia

63

Propanolol (side effect)

Exacerbate vasospasm in Prinzmetal angina

64

Pseudoephedrine (mechanism)

a agonist

65

Pseudoephedrine (3 uses)

Reduces secretions (hyperemia, edema, nasal congestion)
Open obstructed eustachian tubes
Illicitly used to make methamphetamine

66

Pseudoephedrine (2 side effects)

HTN
CNS stimulation/anxiety

67

Carteolol (mechanism and use)

B blocker -> decreases aq humor synthesis
For glaucoma (no pupillary/vision changes)

68

Brimonidine (mechanism)

a2 agonist -> decreases aq humor synthesis

69

Brimonidine (use)

Glaucoma

70

Brimonidine (side effects)

Eyes stuff: blurry vision, hyperemia, foreign body sensation/pruritus, allergic rxn

71

Betaxolol (mechanism and use)

B blocker -> decreases aq humor synthesis
For glaucoma (no pupillary/vision changes)

72

Propanolol (3 uses)

Essential/familial tremors
Migraine prophylaxis
Reduction of portal venous pressure (to prevent variceal bleed)
Other more obvious things