Adrenergic Pharmacology

Question 1

Which part of the body has no sympathetic postganglionic neuron-effector cell synapses in most tissues?

Answer 1

1. eccrine sweat glands

2. vasodilator sympathetic fibers in skeletal muscles

Question 2

What drug inhibits the conversion of tyrosine to DOPA?

tyrosine hydroxylase

Answer 2

metyrosine

Question 3

what drug inhibits the transfer of DOPA into vesicles?

Answer 3

Reserpine

Question 4

what enzyme inactivates norepinephrine and dopamine in the cytoplasm?

Answer 4

monoamine oxidase

Question 5

what drug class increases the stores of NE and dopamine by inhibiting its breakdown in the cytoplasm?

Answer 5

monoamine oxidase inhibitors

Question 6

what dug inhibits the fusion of the the NE vesicles to the terminal membrane?

Answer 6

guanethedine

Question 7

what drug promotes the fusion of the the NE vesicles to the terminal membrane?

Answer 7

amphetamine

tyramine

Question 8

what drug inhibits the diffusion and reuptake of NE and Dopa via NET and DAT in synaptic cleft?

Answer 8

Cocaine

TCAs

Question 9

What drug class inhibits the metabolism of metanephrines and VMA?

Answer 9

MAOi

COMi

Question 10

[adrenoceptor]

causes smooth muscle contraction via increase in IP3, DAG

Answer 10

alpha 1, Gq

Question 11

[adrenoceptor]

causes smooth muscle contraction via decrease in cAMP

Answer 11

alpha 2

Question 12

[adrenoceptor]

increases heart rate by increasing cAMP

Answer 12

beta 1

Question 13

[adrenoceptor]

relax smooth muscle, by increasing cAMP, lungs

Answer 13

beta 2

Question 14

[adrenoceptor]

increase lipolysis, by increasing cAMP, seen in adipose cells

Answer 14

beta 3

Question 15

[adrenoceptor]

relax renal vascular smooth muscle by increasing cAMP

Answer 15

dopamine 1

Question 16

What adrenergic receptor causes contraction of the pupillary dilator muscle, and pilomotor smooth muscle

Answer 16

alpha 1

alpha 1 always contracts

Question 17

what adrenergic receptor stimulates platelet aggregation?

Answer 17

alpha 2

Question 18

What is the effect of alpha 2 receptors in the eyes?

Answer 18

it increases the outflow of aqueous humor

Question 19

What is the effect if you stimulate beta 1 adrenergic receptors in the kidneys?

Answer 19

stimulation of renin release in the juxtaglomerular cells of the kidney

Question 20

norepinephrine has no effect in beta 2 adrenoceptor in this part of the body

Answer 20

blood vessels

Question 21

[sympathomimetics]

drug added to local anesthetic solution to decrease systemic absorption, and contributes to bloodless surgical field

Answer 21

epinephrine

beta 1 = beta 2 > alpha

Question 22

[sympathomimetics]

epinephrine increases the HR by accelerating what phase of depolarization?

Answer 22

phase 4

Question 23

[sympathomimetics]

can cross the placenta causing fetal anoxia

Answer 23

epipnephrine

Question 24

[sympathomimetic]

first line treatment for refractory hypotension in severe sepsis

Answer 24

norepinephrine

has minimal metabolic effects

Question 25

[sympathomimetics] last resort drug in cardiogenic shock

Answer 25

norepinephrine alpha 1 > beta 1 negligible beta 2

Question 26

[sympathomimetics] drug of choice in patients with cardiogenic shock

Answer 26

dopamine

Question 27

[sympathomimetics] drug of choice in acute heart failure accompanied with severe hypotension

Answer 27

dopamine

Question 28

[sympathomimetic] best used for patients with decreased contractility, low systemic blood pressure and low urine output

Answer 28

dopamine

Question 29

[sympathomimetics] unique among catecholamines since it can simultaneously increase myocardial contractility, GFR, excretion of Na and UO

Answer 29

dopamine

Question 30

[sympathomimetics] inactive per orem; does not enter CNS significantly; very effective in renal failure associated with shock

Answer 30

dopamine

Question 31

[sympathomimetics] What dopamine dose will lead to vasodilation D1 and D2 receptors?

Answer 31

0.5 to 3 mcg/kg/min - Low dose

Question 32

[sympathomimetics] What dopamine dose will lead to stimulation of beta 1 receptors leading to increased CO (increases chronotropy and contractility)

Answer 32

3-10 mcg/kg/min - medium dose

Question 33

[sympathomimetics] what dose of dopamine will lead to stimulation of alpha 1 receptors resulting to vasoconstriction, increased SVR, increased BP

Answer 33

>10mcg/kg/min - high dose

Question 34

[sympathomimetics] used as an adjunct to beta 2 agonist in asthma treatment

Answer 34

isoproterenol

Question 35

[sympathomimetics] drug used during pacemaker insertion for bradyarrhythmia

Answer 35

isoproterenol

Question 36

[sympathomimetics] avoided in patient with CAD since it wont induce a compensatory decrease in HR.

Answer 36

isoproterenol this drug is not readily taken up by the nerve endings also

Question 37

[selective alpha 1 agonists] drug that cause rebound nasal congestion

Answer 37

phenylephrine

Question 38

[selective alpha 1 agonists] ocular administration causes mydriasis WITHOUT cyclopegia

Answer 38

phenylephrine

Question 39

What is the drug of choice for alpha 1 agonist overdose?

Answer 39

phentolamine

Question 40

[selective alpha 1 agonists] drug that is avoided in the first trimester because it is associated with gastroschisis

Answer 40

Pseudoephedrine

Question 41

[selective alpha 1 agonists] drug for orthostatic hypotension

Answer 41

midodrine

Question 42

[selective alpha 1 agonists] drug of choice for patients with CAD and aortic stenosis experiencing hypotension

Answer 42

phenylephrine since it increases coronary perfusion pressure without chronotropic side effects (tachycardia)

Question 43

[diagnose] Ptosis Anhidrosis Miosis

Answer 43

Horner Syndrome

Question 44

[diagnose: horners syndrome] indirect acting sympathomimetics is unable to dilate the pupil but phenylephrine will

Answer 44

Postganglionic

Question 45

[diagnose: horners syndrome] indirect acting sympathomimetics and phenylephrine is able to dilate the constricted pupil

Answer 45

preganglionic

Question 46

[selective alpha 2 agonist] used in cancer pain and opioid withdrawal

Answer 46

clonidine

Question 47

[selective alpha 2 agonist] causes rebound hypertension due to abrupt discontinuation

Answer 47

clonidine

Question 48

[selective alpha 2 agonist] reduces CO due to decreased HR and relaxation of vascular resistance

Answer 48

clonidine

Question 49

what is the drug of choice to reverse rebound hypertension due to clonidine?

Answer 49

phentolamine

Question 50

Giving clonidine with pure autonomic failure cause ___ (increase/decrease)

Answer 50

increase

Question 51

TCAs can reduce the antihypertensive effect of clonidine due to

Answer 51

alpha blocking effects of TCA

Question 52

[selective alpha 2 agonist] drug of choice for pre-eclampsia and gestational hypertension

Answer 52

methyldopa

Question 53

[selective alpha 2 agonist] this drug can cause hemolytic anemia, mental depression, vertigo, nightmares, impaired concentration

Answer 53

methyldopa

Question 54

[selective alpha 2 agonist] drug used for glaucoma since it activates alpha 2 adrenergic receptor; decreases secretion of aqueous humor

Answer 54

apraclonidine

Question 55

[selective beta 1 agonist] drug used to induce ischemia in the myocardium for cardiac stress testing

Answer 55

dobutamine

Question 56

[selective beta 1 agonist] may cause arrythmias, tachyplaxis, eosinophilic myocarditis

Answer 56

dobutamine

Question 57

what is the enantiomer of dobutamine that cause alpha-1 agonist?

Answer 57

negative enantiomer

Question 58

what is the enantiomer of dobutamine that is a competitive antagonist at alpha 1 and a strong agonist at beta 1

Answer 58

positive enantiomer

Question 59

[Selective beta 2 agonist] drug used for tocolysis for preterm labor

Answer 59

terbutaline

Question 60

[Selective beta 2 agonist] used as a vasodilator in Raynaud's phenomenon

Answer 60

isoxuprine

Question 61

[Selective beta 2 agonist] this drug can cause maternal pulmonary edema

Answer 61

isoxuprine

Question 62

___ is an alpha 1, direct sympathomimetic drug that is not a catechol derivative and not activated by COMT

Answer 62

phenylephrine