Adrenergic Drugs Flashcards
(118 cards)
1
Q
what produces a physiological response as that of endogenous mediators
A
adrenergic agonist
2
Q
which adrenergic agonist acts through stimulation of adrenergic receptors
A
direct action
3
Q
which adrenergic agonist produces a response through the release of catecholamines from adrenergic neurons
A
indirect action
4
Q
what are the 3 receptors of the adrenergic neurotransmission pathway
A
alpha
beta
alpha-2
5
Q
what is the purpose of the alpha-2 adrenergic receptors in the adrenergic neurotransmission pathway
A
provide negative feedback to control the release of norepinephrine
6
Q
what neurotransmitter is released in the adrenergic neurotransmission pathway
A
norepinephrine
7
Q
what does the norepinephrine of the adrenergic neurotransmission pathway originate from (think neurotransmitter)
A
dopamine
8
Q
what process is used to change dopamine into norepinephrine
A
hydrolyzation
9
Q
what triggers the release of the norepinephrine from the neuron in the adrenergic neurotransmission pathway
A
change in cell membrane potential (action potentials) / influx of Ca++
10
Q
which neurotransmitters are involved with adrenergic receptors
A
norepinephrine & epinephrine
11
Q
what types of receptors are associated with adrenergic receptors
A
alpha & beta
12
Q
which adrenergic receptors have a slightly higher affinity for epinephrine over norepinephrine
A
beta 2 and alpha receptors
13
Q
which adrenergic receptor has an equal affinity for epinephrine and norepinephrine
A
beta 1
14
Q
where are alpha-1 receptors found
A
post synaptic membrane of effector organs
15
Q
where can alpha-2 receptors be found
A
- pre-synaptic
- post synaptic in beta cells of pancreas and blood vessels
16
Q
what G protein is associated with alpha 1 receptors
A
Gq
17
Q
what G protein is associated with alpha-2 receptors
A
Gi
18
Q
which G protein is associated with beta receptors
A
Gs
19
Q
what enzyme is used in addition to G protein Gq
A
Phospholipase C
20
Q
what is the result of Gq acting on an alpha-1 receptor
A
smooth muscle contraction
21
Q
what is the result of the activation of Phospholipase C
A
IP3 –> Ca++ release
22
Q
what is the result of Gi acting on the Alpha-2 receptor
A
decrease adenylyl cyclase
decrease cAMP
23
Q
if there is an inhibitory effect on alpha-2 receptor, what is the outcome
A
smooth muscle contraction / vasoconstriction
24
Q
what is the result of the activation of beta receptor with Gs
A
heart muscle contraction
smooth muscle contraction
glycogenolysis
25
what stops the functions of the alpha-2 receptor
dephosphorylation
26
what adrenergic receptor is critical in controlling blood pressure
Beta-1
27
which beta receptor has a higher affinity for epinephrine
beta-2
28
where are beta-1 receptors often found
heart
kidney
fat cells
29
True or False:
Beta-1 receptors have an equal affinity for epinephrine and norepinephrine
true
30
where are Beta-2 receptors mostly found
blood vessels of skeletal muscle
liver
smooth muscles of bronchus
IG tract
uterus
31
what tissue/ organ does B1 receptors affect
cardiac
32
if there is an increase of epinephrine on a B1 receptor in the cardiac tissue, what is the result
increased HR
increased contractibility
increased cardiac output
33
what is the effect of norepinephrine on a B1 receptor in cardiac tissue
increased HR followed by a decrease in HR caused by vagal stimulation
34
True or False:
There will be an increase in heart contractibility in the presence of norepinephrine in the cardiac tissue
true
35
what receptor is mainly in charge of blood pressure
B1
36
why does diastolic pressure see little to no change in the presence of epinephrine on B1 receptors in cardiac tissue
B2 receptors = relaxation
norepinephrine has a greater affinity on B2 receptors
36
why does diastolic pressure see little to no change in the presence of epinephrine on B1 receptors in cardiac tissue
B2 receptors = relaxation
norepinephrine has a greater affinity on B2 receptors
37
what receptors create constriction of the blood vessels in the presence of epinephrine
alpha 1
alpha 2
38
what receptors cause dilatation of the blood vessels in splanchic and skeletal muscles in the presence of epinephrine
alpha 1
alpha 2
beta 2
39
what is the response of alpha 1 & 2 receptors of the blood vessels in the presence of norepinephrine
constriction
40
what receptor is caused bronchial dilation / relaxation in the presence of epinephrine
beta 2
41
how does beta 2 receptors in the respiratory tract response to norepinephrine
no response
42
what is the function of alpha 1, alpha 2, and beta 2 receptors in the GIT with epinephrine
relaxation
43
with the GI tract, what receptor is responsible for contraction of the sphincter muscle with epinephrine
alpha 1
44
True or False:
both epinephrine and norepinephrine cause constriction of the sphincter muscles of the GI tract with an A1 receptor present
true
45
what receptors are found in the urinary bladder
Beta 2
Alpha 1
46
where is the beta 2 receptor found in the urinary bladder
detrusor muscle
47
where is the alpha 1 receptor found in the urinary bladder
sphincter
48
what is the result of epinephrine acting on the detrusor muscle
relaxation via beta 2 receptor
49
what receptors are found in the uterus
alpha 1
alpha 2
beta 2
50
what is the result of the presence of epinephrine on the uterus
relaxation and contraction due to the mix of receptors
51
which receptor is most used for relaxation of smooth muscles
beta 2
52
what receptor is found within the male sex organs
alpha 1
(constriction functions)
53
what receptor's primary job is constriction
alpha 1
54
what receptor is found in relation to "goose bumps"
alpha 1
55
what receptors are found within the eye structures
alpha 1
beta 2
56
what receptor is found within the iris/ radial muscle of the eye
alpha 1
57
what is the result of alpha 1 receptors under epinephrine and norepinephrine in the eye
contraction for pupil dilation
58
what is the result of epinephrine acting on the beta 2 receptor in the eye
relaxation for far vision
59
where in the eye are the beta 2 receptors found
ciliary muscle
60
what receptors are used for metabolic effects
alpha 2
alpha 1
beta 1
beta 2
61
what receptors are found in the liver
alpha 1
beta 2
62
what process is triggered by the increase of epinephrine or norepinephrine in the liver
glycogenolysis
63
what receptors are found associated with fat cells/ tissue
alpha 2
beta 1
64
what process is associated with the increase of epinephrine or norepinephrine in the fat cells/ tissue
lipolysis
65
what receptors are found in associated with the pancreas
alpha 2
beta 2
66
what is the function of the alpha 2 receptor in the pancreas in the presence of epinephrine
decreased insulin secretion
67
what is the function of the beta 2 receptor in the pancreas in the presence of epinephrine
increased insulin secretion
68
True or False:
the pancreas receptors respond to both epinephrine and norepinephrine
FALSE
they respond the most to epinephrine increases
69
what receptor has mostly inhibitory effects because of its presynaptic location
alpha 2
70
what is the biotransformation route of catecholamines in the oral route
metabolism by conjugation and oxidation
71
which administration route is not effective with catecholamines
oral route
72
why is the SubQ administration not a great route for catecholamines
needs good perfusion / slow absorption
73
how are catecholamines metabolized
COMT & MAO
74
how are catecholamines excreted from the system
in urine
(renal system)
75
how should an epinephrine solution be administered
IM only
76
what kind of epinephrine is used as an aerosol and ophthalmic solution
epinephrine bitartrate
77
what route / mix of epinephrine can give a slow consistent release from 2 mg/ml
epinephrine suspension
78
if using epinephrine to relieve respiratory distress due to bronchospasm, what receptor would be affected
beta 2
79
what receptors would be affected in cases of inducing bronchodilation with epinephrine
beta 2
80
in cases of hypotension, what receptors would be affected
alpha 1
beta 1
81
in a case of cardiac arrest, what receptors are acted on with epinephrine
all of them
82
why are all receptors activated in a case of hypersensitivity reactions
multiple systems are failing and there are several correcting factors
83
what neurotransmitter can be used to prolong the action of local anaesthetic drugs
epinephrine
84
how can epinephrine be used as a topical haemostatic agent
alpha 1 receptors constrict peripheral vessels
85
what are the adverse effects of epinephrine uses
- fear, anxiety, weakness, dizziness, tremors and respiratory difficulty and palpitations
86
what are some adverse effects of using epinephrine in a hypertensive patient
- cerebral vascular haemorrhage
-ruptured aneurysms
87
what pre-existing conditions could possibly lead to an increase of myocardial toxicity if given epinephrine
1. hyperthyroid
2. halogenated hydrocarbon anaesthetics
3. hypertensive
88
what are some major adverse effects to look out for in the case of administering epinephrine
cardiac arrhythmia & necrosis/ sloughing tissue at injection site
89
why is epinephrine considered contraindicated in pregnancies
induces contraction of the uterus
90
what is the immediate metabolic precursor of norepinephrine and epinephrine
dopamine
91
what does dopamine effect
motor activity
92
what is dopamine (class)
central neurotransmitter
93
how is dopamine metabolized
MAO
COMT
94
at low concentrations, what receptor is involved with dopamine
D1
95
what is the result of a low dopamine dosage
increased renal blood flow and urine production
96
in what cases could epinephrine be used but should be used with caution
cardiogenic
hypovolemic shock
97
at higher doses of dopamine, what receptors are affected
B1 receptors
98
what type of reaction is caused from a high dosage of dopamine
positive inotropic action
99
what is the physiological result of the high doses of dopamine
releases NE from nerve terminals
100
at maximal concentrations of dopamine, what receptor is being affected
alpha 1
101
what is the physiological result of a maximal dose of dopamine
vasoconstriction
102
how would you administer dopamine hydrochloride
IV route
administered @ 2-5 ug/kg/min
gradually increase to 20-50 ug/kg/min
103
how does the use of dopamine affect cats
delayed diuresis in cats
104
how is delayed diuresis caused in cats from the administration of dopamine
reduced number of dopaminergic receptors
105
what is the synthetic analogue of dopamine
dopexamine
106
how does dopexamine affect cardiac output
activates B-receptors to increase cardiac output
107
what is the effect of neuronal reuptake from the administration of dopexamine
inhibits neuronal reuptake (inotropic effect)
108
what is the D1 selective agonist derivative of dopamine
fenoldopam
109
what is fenoldopam used to treat
hypertensive crisis
110
what G protein in affected by Fenoldopam
Gs proteins
111
what precaution should be used when treating hypovolemic shock with dopamine
fluids should be administered first
(hypovolemia corrected first)
112
what is the possible adverse reactions caused by dopamine
1. extravasation of dopamine
2. ischaemic necrosis and sloughing
113
when should dopamine administration be avoided
patients receiving MAO inhibitors or taking tricyclic antidepressants
114
what are the direct-acting agonists
-epinephrine
-norepinephrine
-dopamine
-phenylephrine
-clonidine
115
what is the impact of using indirect acting agonists on the body
release NE from the storage vesicles
116
what are the indirect-acting agonists
amphetamine
tyramine
117
what is an example of a mixed-action agonist
ephedrine
