Adrenergic Drugs Flashcards Preview

Pharmacology > Adrenergic Drugs > Flashcards

Flashcards in Adrenergic Drugs Deck (45):
1

Epinephrine Uses

Anyphylactic shock, asthmatic attacks, cardiac arrest, local anesthetics

2

Norepinephrine Uses

Tx shock bc it incrases vascular resistance and increases BP
*dopa is better bc it doesn't dec blood flow to the kidney

3

Dopamine Uses

Tx severe CHF, cardiogenic and septic shock, management of shock
(Based on doses dopamine activates D1 > β1 > α1)

4

Fenoldopam

Selective D1 agonist
Use: tx HTN

5

Isoproterenol

β1 and β2-agonist
Effects: bronchodilator (β2), increased HR (β1), decreases peripheral resistance by dilating skeletal m arterioles (β2)
Use: in ED so stimulate HR in pt w/ bradycardia or heart block

6

Dobutamine

Selective β1-agonist
MOA: potent inotrope w/ mild chronotropic effects
Effects: mild vasodilation, increases myocardial O2 consumption
Use: acute heart failure, cardiogenic shock
*given for stress echo bc it increases cardiac O2 consumption

7

Albuterol and Terbutaline

Short-acting β2-agonists
Use: asthma

8

Salmeterol and Formoterol

Long-acting β2-agonist (12h)
Use: not suitable for prompt relief of breakthrough bronchospasm attacks (prophylaxis)
SE: tremor, restlessness, anxiety, tachycardia, apprehension

9

Phenylephrine

Selective α1-agonist
Effects: vasoconstriction
Use: nasal decongestant, mydriatic, increase BP in hypotension resulting form vasodilation in septic shock or anesthesia, terminates supraventricular tachycardia

10

Clonidine

Partial α2-agonist (central receptors)
Effects: reduces sympathetic outflow, reducing BP
SE: lethargy, sedation, xerostomia

11

Methyldopa

α2-agonist
MOA: converted to α-methylNE which activates central α2 receptors
Use: decrease BP, drug of choice for tx of HTN during pregnancy
SE: sedation, impaired concentration, xerostomia

12

Brimonidine

Selective α2-agonist
Effects: reduces aqueous humor production and increases outflow
Use: decrease IOP in glaucoma

13

Amphetamine

Target: α1 on vasculature and β on heart
MOA: central stimulatory action

14

Methylphenidate

Chem: analogue of amphetamine
Use: ADHD in children

15

Tyramine

Found in fermented foods (ripe cheese and chianti wine)
MOA: oxidized by MAO
Effects: precipitates vasopressor episodes if pt is taking MAOI

16

Cocaine

MOA: blocks reuptake of monoamines in cleft
Effects: potentiation and prolongation of central and peripheral actions

17

Atomoxetine

MOA: selective inhibitor of NE reuptake transporter
Use: ADHD

18

Modafinil

Chem: psychostimulant
MOA: inhibits NE and dopa transporters
Effects: increases concentration of NE/dopa/serotonin/Glu in synapse and decreases GABA levels
Use: narcolepsy

19

Ephedrine

Chem: has CNS effects
Target α and β, releasing NE from nerve endings
MOA: long duration
Effects: increases BP, bronchodilation, increases alertness, decreases fatigue
Uses: pressor agent during spinal anesthesia when hypotension occurs frequently

20

Pseudoephedrine

Chem: ephedrine enantiomer
Use: otc as decongestant

21

Phenoxybenzamine

Irreversible α-antagonist
Use: pheochromocytoma prior to surgery, or chronic management of pheochromocytoma

22

Phentolamine

Reversible α1 and α2 antagonist
Use: pheochromocytoma tx during surgery, blocking test to dx pheo, prevention of dermal necrosis after extravasation of NE, HTN crisis d/t stimulant OD, tx cocaine induced coronary syndrome, HTN crisis d/t Clonidine withdrawal or sympathomimetic amines

23

Prazosin

Selective α1-antagonist
Use: tx HTN

24

Terazosin and Doxazosin

α1-antagonists w/ longer t1/2 than Prazosin
Use: tx HTN and BPH

25

Tamsulosin

Selective α1A receptor antagonist
Use: BPH
(little effect on PB, less likely to cause orthostatic hypotension)

26

Yohimbine

α2-antagonist
Use: tx ED (in the past but replaced by phosphodiesterase type 5 inhibitors)

27

Propranolol / Nadolol

β-antagonist

28

Atenolol / Metoprolol

Selective β1-antagonist
Indication: HTN pt w/ impaired pulmonary fxn, DM HTN pt's who are receiving insulin or oral hypoglycemic agents
USE: HTN, angina pectoris, MI

29

Labetalol

α1 and β-antagonist

29

Timolol

Non-selective β-antagonist
Use: decrease IOP in glaucoma

31

Labetalol

Competitive α1 and β-antagonist (potency = β > α)
Use: HTN

32

Carvedilol

Competitive α1 and β-antagonist
Use: HTN and CHF
*has antioxidant properties

33

Pindolol

Partial agonist w/ intrinsic sympathomimetic activity (ISA)

34

α-methyltyrosine (Metyrosine)

Competitive inhibitor of Tyrosine Hydroxylase
Use: management of malignant pheo or pre-op prep for pheo resection

35

Reserpine

Irreversibly blocks VMAT
MOA: vesicles cannot store NE and dopa
Effects: gradual decrease in BP and slowing of cardiac rate
Use: tx HTN (in the past)

36

Tetrabenazine

Reversible inhibitor of VMAT
MOA: presynaptic depletion of catecholamines
Indicated: tx of chorea assoc. w/ Huntington's Dz

37

Epinephrine Cardio effects w/ high dose

β1 predominates so increased ventricular contraction, increased HR, and additionally some vasoconstriction by the α1 receptors

38

Epinephrine Cardio effects w/ low dose

β2 predominates so there is drop in diastolic pressure d/t decrease of peripheral resistance controlled by β2 receptors then HR increases d/t β1

39

Epinephrine Metabolic Effects

Increase glycogenolysis in liver (β2)
Increase lypolysis (β1 and β2)

40

NE w/ pre-tx of Atropine

Causes tachycardia when NE is given after Atropine

41

Norepinephrine

Potent agonist of α1, α2, β1 (little effect on β2)
Effects: vasoconstriction (α1), increase BP, baroreceptor reflex initiated d/t incrase in BP inducing rise in vagal activity = bradycardia

42

Dopamine @ Low Infusion Rate

Activates D1 receptors
Target: renal and coronary vessels
Effects: vasodilation in coronary arteries, increase GFR, increase renal blood flow, increase in Na+ excretion

43

Dopamine @ Intermediate Infusion Rate

Activates β1 receptors in heart increasing CO so inc SBP and increased MAP
*(preservation of flow in heart and kidneys)

44

Dopamine @ High Infusion Rate

Activates vascular α1 receptors causing vasoconstriction and a rise in BP to maintain BP in shock

45

Contraindications of β2 blockers?

Asthmatics, vasospastic dz (raynaud or Prinzmental angina), and DM pt's