ANS Pharm

Question 1

NE

Answer 1

Sympathomimetics (agonists)
a1=a2 B1»B2
increases contractility (force) and decreases heart rate (reflex)
VC of blood vessels—>inc BP (pressor)

Question 2

Epi

Answer 2

Sympathomimetics (agonists)

a1=a2 B1=B2

Question 3

Isoproterenol

Answer 3

Sympathomimetics (agonists)

B1=B2»»»»a (pure beta agonist)

Question 4

Phenylephrine

Answer 4

a selective agonist
pressor agent—>increase TPR,—>inc BP—>reflex decrease in HR
a1>a2»»»»>.B

Question 5

Albuterol

Answer 5

B2 selective agonist
used to treat asthma, bronchodilation
B2»>B1»»»>a

Question 6

Dobutamine

Answer 6

B1 selective agonist
used in MI, CHF, cardiogenic shock to increase CO
B1>B2»a

Question 7

DA

Answer 7

DA agonist

D1=D2»B»>a

Question 8

Propranolol

Answer 8

Nonselective B antagonist
dec HR and CO—>dec work of heart and O2 demand
**blocks SNS BD—>contraindicated in asthma and COPD
may mask signs of hypoglycemia(contraindicated in diabetics)
B1=B2»>a

Question 9

Atenolol and Metoprolol

Answer 9

B1 selective B antagonist
B1»>B2

lessens risk for bronchospasm (comp to propanolol)

has been shown to improve outcomes in CHF patients

Question 10

Phentolamine

Answer 10

Non selective a antagonist

a1=a2

Question 11

Prazosin

Answer 11

a1 selective a antagonist
a1»»»»>a2

Higher risk for syncope events
used to lower BP (HTN)

Question 12

Carvedilol

Answer 12

Mixed antagonist
can be used to treat HTN
B1-B2>_a1>_a2

Question 13

Acetylcholine

Answer 13

muscarinic and nicotinic agonist

Question 14

Bethanechol

Answer 14

Muscarininc cholinergic agonist

M1-5»»»NmNN

Question 15

Atropine

Answer 15

Muscarinic receptor antagonists
reverses reflex bradycardia
can also be used in COPD and asthma to improve BD

M1-4»»>NmNn

Question 16

a1 receptors

Answer 16

agonism causes contraction of vascular smooth muscle
vasoconstriction
—>main regulator of blood pressure
pupil, spleen, uterus, errector pili etc
stimulates glycogenolysis

EPI>NE»ISO

Question 17

a2 receptors

Answer 17

agonism cause vasoconstriction (just at different places than a1)

minor physiological role

may stimulate autoreceptors that decrease NE release from neurons
EPI>NE»ISO

Question 18

B1 receptors

Answer 18

found in the heart stimulates increased HR
increases contractility
ISO>EPI»NE

Question 19

B2 receptors

Answer 19

agonism causes smooth muscle relaxation
**think bronchioles, and certain vascular beds
stimulate skeletal muscle K uptake
also has metabolic (glycogenolysis) and humoral (insulin) affects
ISO>EPI»>NE

Question 20

DA receptors

Answer 20

renal afferent blood vessels
D1—>Dilation
increase blood flow to the kidney

used in cardiogenic shock (heart is not delivering enough O2 to tissues—> dec flow to kidneys) give IV DA—>improve renal blood flow and at high enough doses you can activate B1 (good) or a1 (bad)

at high enough doses it can bind B1 and a1

Question 21

EPI and the heart

Answer 21

inc HR, inotropy—>inc work by heart—>inc O2 demand***

Question 22

Epi in the blood vessels

Answer 22

can stimulate a1 and B2
B2>a1
***different distribution and density of receptors in different receptor beds
skeletal muscle (both B2 and a1, dose dependent vasodilation-B2 first, the a1)

Question 23

Ipratropium bromide

Tiotropium

Answer 23

inhalation only
Muscarinic receptor antagonist—>decreases BC
use with albuterol to open up airway in pt with COPD