Adrenergic Drugs Part 1 - Dr. Konorev

Question 1

3 direct acting adrenomimetic drugs

Answer 1

1. Alpha agonists
2. Mixed alpha and beta agonists
3. Beta agonists

Question 2

4 Indirect adrenomimetics

Answer 2

1. Inhibits re-uptake of DA and NE
2. Inhibits MAO
3. Reverse NE and DA uptake mechanisms and increase their release
4. Releasing agent AND a direct adrenergic R agonist

Question 3

Alpha agonists

Answer 3

1. Phenylephrine

2. Clonidine

Question 4

Mixed a and b agonists

Answer 4

1. NE

2. Epi

Question 5

B agonists

Answer 5

1. Dobutamine
2. Isoproterenol
3. Albuterol

Question 6

Inhibit is reuptake of NE and DA

Answer 6

Cocain

Question 7

Inhibits MAO

Answer 7

Selegiline

phenelzine

Question 8

Reverse NE and DA uptake mechanism and increase release of them

Answer 8

1. Amphetamines
2. Mythylphenidate
3. Tyramine

Question 9

Releasign agent AND direct adrenergic R agonist

Answer 9

Ephedrine

Question 10

Cholenergic drugs control what

Answer 10

ACh release at adrenal medulla (N), or skeletal muscles voluntary (N), preganglionic synapse (N), parasympathetic involuntary muscles (M), sympathetic only if sweat glands (M)

Question 11

Adrenergic drugs act where

Answer 11

Post synaptic ganglion at sympathetic involuntary muscles (cardiac, SM, glands, nerves ) = NE
AND
Postsynaptic ganglion at renal vascular SM = D

Question 12

a1 type R does what biochem pathway

Answer 12

Increase IP3 and DAG

= Gq

Question 13

a2 type R does what biochem pathway

Answer 13

Decrease cAMP to inhibit PKA

= Gi (so is D2)

Question 14

B type R does what biochem pathway

Answer 14

Increase cAMP to activate PKA

=Gs (so is D1)

Question 15

Direct vs indirect acting adrenergic drugs

Answer 15

1. Direct = direct action on R

2. Indirect = increase or decrease concentration of NE or D at the receptor area

Question 16

Phenylephrine R

Answer 16

A1 >a2

Question 17

Clonidine R

Answer 17

A2 >a1

Question 18

NE R

Answer 18

A1 and A2, and B1

Question 19

Epi R

Answer 19

a1 and a2 and B1 ad B2

Question 20

Dobutamine R

Answer 20

B1 > B2

Question 21

Isoproterenol R

Answer 21

B1 and B2

Question 22

Albuterol R

Answer 22

B2&raquo_space; B1

Question 23

A1 actions

4

Answer 23

1. Vascular SM = contraction **
2. Pupils = dilation by contraction of dilator muscle
3. Prostate = contraction
4. Heart = increase Contraction Force

Question 24

A2 acts where

5

Answer 24

1. Neurons = TR release
2. Platelet = aggregation
3. Adrenergic and cholinergic nerve terminals = inhibit TR release
4. Some vascular SM = contraction
5. Fat = inhibit Lypolysis

Question 25

B1 action | 1

Answer 25

Heart and juxtaglomerular cells = increase Force and Rate of contraction , increase RENIN release (higher BP)

Question 26

B2 actions | 3

Answer 26

1. Resp****, uterine, vascular SM = relaxation 2. Skeletal muscle = K+ reuptake (repolarization) 3. Liver = glycogenolysis + gluconeogenesis

Question 27

B3 actions | 2

Answer 27

1. Relax bladder detrusor muscle | 2. Active Lypolysis in fat cells

Question 28

D1 D2 actions 1 each

Answer 28

D1 : smooth muscles : dilate renal BVs | D2 : never endings : TR release

Question 29

B1 does what mostly

Answer 29

Increase heart contraction and force , HR, AV conductance

Question 30

B2 and A1 does what mostly when activated together

Answer 30

1. Increase BP, NO change in mean arterial P, decrease congestion in bronchial mucosa (A1) 2. Decrease in diastolic BP at times Muscle tremors, K+ uptake, liver metabolism, RELAX bronchial muscles ****(B2)

Question 31

More severe elevation of BP NE or Epi

Answer 31

Norepinephrine because it does not activate B2 receptors also

Question 32

More increase in HR NE or Epi

Answer 32

Epi because In NE the more severe increase in BP = BARORECEPTORS stimulated so ——> bradycardia (Epi is higher HR)

Question 33

Phenylephrine HR and BP

Answer 33

A1 : High BP and low HR as body compensates from BARORECEPTORS Mydriasis (pupil dilation)

Question 34

Clonidine BP and HR

Answer 34

Low BP and low HR, Vasoconstriction (peripheral a2 R, only not very prominent) A2

Question 35

Isoproterenol

Answer 35

``` B1 = CO increase high HR B2 = bronchodilation, vasodilation low BP ```

Question 36

Dobutamine effects

Answer 36

B1 : heart rate increase

Question 37

Albuterol effects

Answer 37

B2 : bronchodilation

Question 38

Indirect acting adrenomimetics have what properties

Answer 38

Lipophilic and cross BBB and effect CNS , unlike catacholamines, = EXCEPT tyramine ****

Question 39

Tryamine is used for

Answer 39

Evaluate peripheral adrenergic function

Question 40

TX hypotensive EM, hemorrhagic shock, overdose of antihypertensives, CNS depressants

Answer 40

NE and Phenylephrine

Question 41

TX chronic hypotension

Answer 41

Ephedrine

Question 42

TX Cardiogenic shock

Answer 42

Dobutamine

Question 43

TX Heart failure

Answer 43

Short term dobutamine in acute HF

Question 44

TX HTN

Answer 44

A2- agonists for long-term tx

Question 45

EM TX for AV block and cardiac arrest

Answer 45

Epinephrine and isoproterenol

Question 46

TX depression

Answer 46

Phenelzine and Selegiline

Question 47

TX Narcolepsy

Answer 47

Amphetamines and methylphenidate

Question 48

TX ADHD, learning problems, hyperkinetic behavior

Answer 48

Methylphenidate

Question 49

TX Obesity

Answer 49

Ephedrine (B3) and Amphetamines = to increase energy expenditure and lower appetite

Question 50

TX bronchial asthma

Answer 50

Albuterol

Question 51

TX decongestion of mucous membranes

Answer 51

Phenylephrine and ephedrine

Question 52

TX anaphylaxis

Answer 52

Epinephrine (tax cardiac depression , severe hypotension, bronchospasms)

Question 53

TX ophthalmic application : examining retina and inducing mydriasis

Answer 53

Phenylephrine

Question 54

TX glaucoma

Answer 54

A2- selective agonists

Question 55

GU : TX stress urinary incontinence

Answer 55

Ephedrine (B3)