Adrenergic's

Question 1

Metyrosine:

MOA, Therapeutic use?

Answer 1

Tyrosine Hydroxylase Inhibitor
(STOP! TyrosineDOPA)

Pheochromocytoma : Decrease NE, Epi

Question 2

Tyramine:

MOA, where is it found, ADR?

Answer 2

Enters neuron via amine pump
Increase NE, Epi release
Dietary constituent, wine/ cheese

HTN crisis if combined with MAOi

Question 3

Amphetamine:
MOA
Therapeutic uses

Answer 3

Increase NE/ epi release

ADHD, narcolepsy
^ TPR/ HR
CNS stimulation

Question 4

Cocaine:

MOA

Answer 4

Decreases NE reuptake at synaptic cleft

Question 5

Tranylcycloprine:
MOA
Therapeutic Use
ADR

Answer 5

MAOi
Anti-depressant

HTN Crisis (increase circulating dietary amines)

Question 6

Phenelzine:
MOA
Therapeutic Use
ADR

Answer 6

MAOi
Anti-depressant

HTN Crisis (increase circulating dietary amines)

Question 7

Entacapone:
MOA
Therapeutic use

Answer 7

COMTi
Adjunct to Parkinsonism therapy
(give with levo/carbidopa)

Question 8

Phenylephrine:
MOA + Effects
Therapeutic Use
Adverse effects

Answer 8

A1 agonist
^TPR/ BP
Decreased HR (reflex)

Ophtho, decongestant, ^ duration local anesthesia (vasoconstrxn.)

Question 9

Clonidine:
MOA
Therapeutic Use
Adverse Effects

Answer 9

A2 agonist; sympatholytic
Decrease TPR/ BP, ^ HR (reflex)

HTN
ADHD
Drug addiction

Sedation, sexual dysfunction, HTN with sudden w/draw

Question 10

Albuterol:
MOA
Therapeutic Use
Adverse Effects

Answer 10

B2 agonist
Reflex ^ HR
Asthma

High dose = Loss of selectivity–> B1 Activity–> cardiac stimulation
Tremor

Question 11

Isoproterenol:
MOA
Therapeutic Use
Adverse effects

Answer 11

B1/2 agonist 
Decreased TPR/ BP, ^ HR 
- Bronchospasm
- Heart block
- Cardiac arrest 

ADR: Tremor

Question 12

Epinephrine:
MOA
Therapeutic Use
Adverse effects

Answer 12

A1-2; B1-2 agonist
LOW DOSE: B2+1»>
Decrease TPR/ BP; ^HR

HIGH DOSE: A1»>
^TPR/BP/HR

Anaphylaxis
Cardiac Arrest
Bronchospasm
Glaucoma 
^ Duration local anesthesia 

ADR: Hyperglycemia, CNS stimulation, etc. (too much of any receptor)

Question 13

Norepinephrine:
MOA
Therapeutic Use
Adverse Effects

Answer 13

A1-2, B1 Agonist
^TPR/ BP, +/-HR

Septic/ cardiogenic shock

ADR: Hyperglycemia, CNS stimulation, etc. (too much of any receptor)

Question 14

Dobutamine:
MOA
Therapeutic Use
Adverse Effects

Answer 14

A1, B1-2 agonist
Increased CO

Acute CHF

ADR: Arrhythmia, ^myocardial O2; ^ AV nodal conduction

Question 15

Which Drugs are Catecholamines and what do they have in common?

Answer 15

DINED: 
Dopamine
Isoproterenol
Norepinephrine
Epinephrine
Dobutamine 

IV/ subQ only; rapidly metabolized

Question 16

A1 Receptor (3)

Answer 16

• mydriasis
• GI/GU sphincter contraction + orgasm
• vasoconstriction

Question 17

B1 Receptor (3)

Answer 17

• Increase renin
• Increase cardiac fxn
• Increase lipolysis

Question 18

B2 Receptor (4)

Answer 18

• Dilate uterus
• Dilate bronchi
• Dilate vasculature
• Increase insulin, gluconeogenesis, glycogenolysis

Question 19

A2 Receptor (3)

Answer 19

Sympatholytic:

• Decrease NE/ Epi
• Decrease CNS sympathetic output
• Decrease Insulin

Question 20

Dopamine:
MOA
Therapeutic Uses
ADR

Answer 20

D1, B1, A1-2 agonist + NE/ epi release
Cerebral, coronal, splanchnic, renal, vasodilation

Low: vasodilation only
Mod: Lower TPR, ^ HR/CO +/- BP
High: ^TPR/ HR/ BP

Shock or acute CHF

ADR: Hyperglycemia, CNS stimulation etc

Question 21

Pseudophedrine:
MOA
Therapeutic Use
ADR

Answer 21

Direct agonist + NE release
Nasal decongestant
HTN/ insomnia

Question 22

Phenoxybenzamine:
MOA
Therapeutic Use
ADR

Answer 22

A1/2 antagonist- noncompetitive
Decreased TPR/ ^HR
Pheochromocytoma

ADR: Angina

Question 23

Phentolamine:
MOA
Therapeutic Use
How is it administered?

Answer 23

A1/2 antagonist- competitive
HTN crisis, vasospasm (frostbite),
Pheochromocytoma

*IV ONLY
Faster onset and shorter duration of action than phenoxylbenzamine

Question 24

Doxazosin:
MOA
Therapeutic Use
ADR

Answer 24

A1 antagonist
BPH/ HTN

ADR: First dose syncope; start regimen at night

Question 25

Tamsulosin: MOA Therapeutic Use ADR

Answer 25

A1a antagonist - selective for sphincter; BPH ADR: Orthostatic HTN

Question 26

Propanolol: MOA Therapeutic Use ADR/Contraindicaitons

Answer 26

B1/2 competitive antagonist Decreased cardiac function, blood flow, BP etc. ``` Tx: HTN angina arrhythmia post MI pheo migraine idiopathic hypertrophic subarortic stenosis stage fright, tremors ``` ``` ADR/ Contraindications: AV block Raynauds Variant angina DM- inhibits tacky in response to hypoglycemia; increases insulin induced hypoglycemia ```

Question 27

Timolol: MOA Therapeutic Use ADR/ Contraindications

Answer 27

B1/2 competitive antagonist Same as propranolol- better for glaucoma ``` ADR/ Contraindications: AV block Raynauds Variant angina DM- inhibits tacky in response to hypoglycemia; increases insulin induced hypoglycemia ```

Question 28

Carvedilol: MOA Therapeutic use

Answer 28

A1, B1-2 antagonist Decreased TPR, BP, HR, CO ^ HDL Tx: HTN, CHF

Question 29

Metoprolol: MOA Therapeutic Use ADR

Answer 29

B1 antagonist Propranolol uses + CHF DOC for DM, Raynauds, and COPD

Question 30

Esmolol: MOA Therapeutic Use Metabolism*?

Answer 30

B1 antagonist IV antiarrythmic *Metabolized by red cell esterase; very short t 1/2

Question 31

Nebivolol: MOA Therapeutic Use

Answer 31

B1 antagonist + NO release | HTN