Adrenergics

Question 1

Alpha 1 agonism

Answer 1

vasoconstriction, possible reflex bradycardia (due to PANS action independent of drug agonist)

Question 2

Alpha 1 agonist drugs

Answer 2

phenylephrine, methoxamine, oxymethazoline, tetrahydrozoline

Question 3

Main uses for Alpha 1 agonists

Answer 3

cold medication, phenylephrine can be used for shock along with methoxamine (has SE of vagal reflex)

Question 4

Alpha 2 agonism

Answer 4

causes decrease in sympathetic outflow from nerve terminals

Question 5

Alpha 2 agonist uses

Answer 5

mainly for HTN

Question 6

Alpha 2 agonist drugs

Answer 6

clonidine, dexmedetomidine, guanabenz, guanfacine, methyldopa

Question 7

Beta 1 agonism

Answer 7

increase HR, increase contractility, inc. SV, inc. CO

Question 8

Beta 2 agonism

Answer 8

Vasodilate (lower BP),

Question 9

Isoproterenol MOA

Answer 9

act on beta 1 and beta 2

Question 10

Isoproterenol uses

Answer 10

Tx for bronchospasm (thru B2 action), heart block (due to B1 action), bradyarrhytmias (due to B1 action)

Question 11

Isoproterenol SE

Answer 11

flushing, angina, arrythmias

Question 12

Dobutamine MOA

Answer 12

B1 more than B2 action

Question 13

Dobutamine uses

Answer 13

CHF

Question 14

Selective B2 agonists

Answer 14

Salmeterol, Albuterol, Terbutaline

Question 15

Salmetrol uses

Answer 15

prophylaxis to asthma attack due to slow action

Question 16

Albuterol, Terbutaline use

Answer 16

immediate use for asthma

Question 17

B2 selectives SE

Answer 17

palpitations due to the vasodilation

Question 18

way to distinguish Nor-epi from Epi

Answer 18

nor-epi does not affect B2 (therefore can NEVER lower BP) while epi does, also EPI is released from the adrenals

Question 19

Dosing changes in receptors with Epi

Answer 19

low dose: B1, B2 action
medium dose: B1, B2, A1
High dose: B1, B2, more predominant A1 action w/ reflex bradycardia chance increasing

Question 20

Alpha antagonist actions

Answer 20

low total peri. resistance, lower mean BP

Question 21

selective alpha 1 blockers

Answer 21

OSIN enders, prazosin, doxazosin, terazosin, tamsulosin

Question 22

non selective alpha blockers

Answer 22

phentolamine (competitive), phenoxybenzamine (non-competitive)

Question 23

selective alpha 2 blockers

Answer 23

yohimbine, mirtazapine

Question 24

major SE from alpha blockade

Answer 24

possible reflex tachy, and renin-angiotensin activation (to inc. BP)

Question 25

which class are used in pheochromocytoma?

Answer 25

non-selective alpha blockers, phenoxybenzamine is the DOC

Question 26

selective alpha 1 blocker uses

Answer 26

BPH (only relaxes trigone to help bladder empty), HTN

Question 27

Mirtazipine other uses

Answer 27

depression and helps stim lbs gain

Question 28

B1 blockade effects

Answer 28

dec. HR, dec SV, dec. CO, decrease renin release, dec. aqueous humor production

Question 29

B2 blockade effects

Answer 29

precipitate bronchospasm in asthmatics, vasospasm in pt with vasospastic disorders, metabolic effects (decrease gluconeogenesis and glycogenolysis) can result in hypoglycemia, can mask hypoglycemia episode due to stopping the hypoglycemia indced tachycardia

Question 30

names A-M means?

Answer 30

B1 selective

Question 31

olol means?

Answer 31

beta blocker of some kind

Question 32

beta blockers that increase blood lipids

Answer 32

atenolol, metoprolol, propranolol, timolol

Question 33

beta 1 selective makes drug safer for...

Answer 33

asthmatics, diabetics, people with peri vascular diseases

Question 34

beta blockers with intrinsic sympathomimetic activity..

Answer 34

acebutolol (agonist slight to B1), pindolol (agonist slightly to B1, B2)

Question 35

what does intrinsic sympathomimetic mean

Answer 35

act as partial agonist to other receptors, allowing for less bradycardia (thru B1), slight vaso or broncho dilation (thru B2), minimal change in plasma lipids (thru B2)

Question 36

which beta blockers don't have increase lipids associated with it

Answer 36

acebutolol, pindolol

Question 37

which beta blockers are sedative

Answer 37

ALL except atenolol; Propranolol is most sedative

Question 38

general uses of beta blockers

Answer 38

angina, HTN, post-MI Antiarrhymatics: propranolol, acebutolol, esmolol Glaucoma: timolol Migraine, thyrotoxicosis, performance anxiety, essential tremor---Propranolol

Question 39

drugs with alpha 1 and beta blocker activity

Answer 39

labetalol, carvedilol; use in CHF

Question 40

K channel block and Beta blocking activity

Answer 40

Sotalol (class III antiarrhymatic)