Adrenergics

Question 1

What is the signal transduction pathway for beta receptors

Answer 1

Accumulate cAMP and activate PKA

Question 2

What is the signal transduction pathway for alpha 2 receptors

Answer 2

Decrease cAMP and inhibit PKA

Question 3

What are the three mechanisms of action for indirect acting adrenergic drugs?

Answer 3

Reuptake blocker (cocaine), MAO inhibitor (selegine, phenelzine), and releasing agents (Amphetamines, methylphenidate)

Question 4

What alpha adrenergic agonists prefer a1>a2?

Answer 4

phenylephrine, methoxamine

Question 5

What alpha adrenergic agonists prefer a2>a1

Answer 5

Clonidine, methyNE

Question 6

What is the receptor selectivity for NE

Answer 6

a1=a2; B1>B2

Question 7

What is the receptor selectivity for epinephrine?

Answer 7

a1=a2; B1=B2

Question 8

What beta adrenergic agonists prefer B1>B2

Answer 8

Dobutamine

Question 9

What Beta adrenergic agonists select both B R equally

Answer 9

isoproterenol

Question 10

What Beta adrenergic agonists prefer B2»B1

Answer 10

Albuterol, terbutaline, ritodrine

Question 11

What Dopamine agonists prefer D1 & D2 equally

Answer 11

dopamine

Question 12

What dopamine receptor agonists prefer D1»D2

Answer 12

Fenoldopam

Question 13

What are the effects of epinephrine and the corresponding receptor?

Answer 13

Cardiac function - B1 - increase HR, contractility
Vascular tone - B2, a1 - inc systolic BP, same MAP
Respiratory - B2 - relax s. m. - a1 - dec secretion, congestion
skeletal m - B2 - tremor, inc K uptake
Elevate Blood Glucose - B2- inc liver glycogenolysis - a2/B2 - inhibit insulin release
Increase blood FFA - B
Increase renin release - B1

Question 14

What are the effects of NE and the corresponding receptor

Answer 14

Cardiac stimulation - B1 - pump harder but dec HR

Potent vasoconstriction - a1

Question 15

Why does NE decrease HR

Answer 15

The rise in BP is detected by the baroreceptors, which tell the hard to pump slower

Question 16

What are the effects of dopamine and what are the corresponding receptors

Answer 16

vasodilation of the renal, cerebral, mesenteric, coronary a. - D1
Activation presynaptic D2 - suppress NE release

Question 17

What is the signal transduction pathway for alpha 1 R

Answer 17

IP3, DAG, MAPK, PI3K,

These stimulate cell growth

Question 18

What is the effects of phenylephrine

Answer 18

a1>a2. mydriasis (pupillary dilation), decongestion, severe vasoconstriction (inc BP)

Question 19

What happens to phenylephrine is you block the baroreflex

Answer 19

The drug is 10x more potent on vasoconstriction

Question 20

What are the effects of clonidine

Answer 20

a2>a1. Central effect on the a2 receptors in the brainstem, which decreases NE output –> lower BP and HR

Question 21

What are the effects of isoproterenol

Answer 21

B1=B2. Increase cardiac output (B1), vasodilation / bronchodilation (B2). Therefore keeping BP about the same

Question 22

What are the effects of dobutamine

Answer 22

B1>B2. Increase cardiac output

Question 23

What are the effects of terbutaline, albuterol

Answer 23

B2>B1. Bronchodilation, relax uterus

Question 24

Are indirect adreneric agonists polar or nonpolar

Answer 24

nonpolar

Question 25

What adrenergic agonist should be used to treat hypotensive emergencies?

Answer 25

Ne, phenylephrine, methoxamine

Question 26

What adrenergive agonist should be used to treat chronic HTN

Answer 26

ephedrine

Question 27

What adrenergic agonist should be used to treat cardiogenic shock (massive acute MI)

Answer 27

dopamine, dobutamine

Question 28

What adrenergic agonist should be used to treat CHF

Answer 28

dopamine

Question 29

What adrenergic agonist should be used to manage HTN

Answer 29

any a2 agonist

Question 30

What adrenergic agonist should be used to treat HTN emergencies

Answer 30

fenoldopam

Question 31

What adrenergic agonist should be used to treat complete AV block and cardiac arrest

Answer 31

Epinephrine, isoproterenol

Question 32

What adrenergic agonist should be used to treat decongestion

Answer 32

Phenylephrine, ephedrine, pseudoephedrine

Question 33

What adrenergic agonists should be used to treat bronchial asthma

Answer 33

albuterol, terbutaline

Question 34

What adrenergic agonist should be used to treat anaphylaxis

Answer 34

epinephrine

Question 35

What adrenergic agonist should be used to induce mydriasis

Answer 35

phenylephrine

Question 36

What adrenergic agonist should be used to treat glaucoma

Answer 36

apraclonidine, brimonidine

Question 37

What adrenergic agonist should be used to suppress premature labor

Answer 37

terbutaline

Question 38

What adrenergic agonist should be sued to treat stress incontinence

Answer 38

Ephedrine

Question 39

What adrenergic agonist should be used to Tx priapism

Answer 39

phenylephrine

Question 40

What adrenergic agonist should be used to tx narcolepsy

Answer 40

amphetamines, methylphenidate

Question 41

What adrenergic agonist should be used to treat ADHD

Answer 41

methylphenidate

Question 42

What adrenergic agonist should be used to tx obesity

Answer 42

Phentermine, ephedrine, amphetamines

Question 43

What are the CV adverse effects of adrenergic agonists

Answer 43

Inc BP, Inc cardiac work, sinus tachycardia

Question 44

What are the CNS adverse effects of adrenergic agonists

Answer 44

Amphetamines - insomnia, dec appetite, anxiety, psychoses | cocaine - convulsions, arrhythmias, hemorrhagic stroke

Question 45

What indirect antiandrenergics deplete NE

Answer 45

reserpine, guanethidine

Question 46

What indirect antiadrenergics inhibit NE synthesis

Answer 46

metyrosine

Question 47

What indirect antiadrenergics activate inhibitory a2 Receptors

Answer 47

Clonidine

Question 48

What indirect antiadrenergics are used to treat chronic HTN

Answer 48

guanethidine, clonidine

Question 49

What indirect antiadrenergic is used to treat a pheochromocytoma

Answer 49

metyrosine

Question 50

What are the nonselective alpha R antagonists

Answer 50

Phentolamine (competitive), phenoxybenzamine (noncompetitive)

Question 51

What are the alpha 1 receptor specific antagonists

Answer 51

-osin's

Question 52

what are the mixed alpha receptor antagonists

Answer 52

labetalol, carvedilol

Question 53

What are the non selective B antagonists

Answer 53

propanolol (A), pindolol (pa), nadolol (a), penbutolol (pa)

Question 54

What are the B1 selective antagonists

Answer 54

metoprolol (ia), betaxolol (a), acebutolol (pa), atenolol (a)

Question 55

What is the difference when using phentolamine and prazosin to cause cardiac stimulation

Answer 55

Phentolamine (nonselective a) will cause a larger increase in B1 effect because there is no negative feedback on NE release (a2 job) Prazosin has no tachycardia

Question 56

What alpha antagonists are used to treat pheochromocytoma

Answer 56

phentolamine, phenoxybenzamine

Question 57

What alpha antagonists are used to treat chronic HTN

Answer 57

-osin

Question 58

What alpha antagonists are used to treat ED

Answer 58

phentolamine, papverine

Question 59

What alpha antagonists are used to treat BPH

Answer 59

tamsulin, silodosin | these specifically target a1a R

Question 60

What are the adverse effects of alpha R antagonists

Answer 60

postural Hypotension, increase HR, salt/water retention, impaired ejaculation, nasal stuffiness

Question 61

What are the effects of B blockers

Answer 61

inhibit renin release, inc respiratory secretion, decrease intraocular pressure, tx hyperthyroidism, tx HTN, tx angina pectoris, MI, arrhythmias, HF

Question 62

What are the adverse effects of B blockers

Answer 62

CNS - sedation, depression, sleep disturbances Resp - inc resistance, can trigger bronchospasm dec HDL/LDL ration May delay recovery from insulin induced hypoglycemia