Chapter 10: Adrenergic Pharmacology Flashcards Preview

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Flashcards in Chapter 10: Adrenergic Pharmacology Deck (52)
1

alpha-methyltyrosine

inhibits tyrosine hydroxylase (RL step) to prevent formation of catecholamines

Not really used clinically because there are better medications for hypertension

2

reserpine

irreversibly inhibits VMAT so that vesicles cannot store dopamine and NE

Not really used clinically since it is irreversible

But can be used to assess what concentration of a drug is needed

3

Guanethidine

acts as a "false neurotransmitter" and is transported into neurons by NET....essentially displaces NE

can lead to postural hypotension or hypotension after exercise

TX: hypertension
Don't use with MAOI

4

Guanadrel

Same as Guanethidine
Tx: hypertension

5

Amphetamine

MOA: displace catecholamines from storage, block NE reuptake by NET, weakly inhibit MAO

TX: ADHD & narcolepsy

Lots of side effects (addiction potential, loss of appetite, irritability, ED)

6

Methylphenidate

MOA: displaces catecholamines from storage vesicles, blocks NE reuptake by NET, weakly inhibit MAO

TX: ADHD

A lot of side effects

7

Pseudophedrine

MOA: inhibits catecholamine storage in vesicles
TX: allergic rhinitis & nasal decongestion
"Sudafed" - over the counter decongestant
DO NOT USE W MAOIs

8

Cocaine

MOA: inhibit NET reuptake (allows accumulation of NE in synpatic cleft)

TX: sometimes local anesthetic; drug abuse

9

Imipramine

Same as Cocaine

10

Amitriptyline

Basically same as Cocaine; used as an antidepressant

11

Phenelzine

MAOI for depression tx

12

Iproniazid

MAOI for depression tx

13

Tranylcypromine

MAOI for depression tx

14

Selegiline

MAOI used for Parkinson tx

15

Why can't you use MAOIs with SSRIs?

BAD NEWS! SEROTONIN SYNDROME! = seizures, coma, death

16

What type of foods must you avoid if taking MAOIs?

Fermented foods that contain tyrosine - think red wine or aged cheese.

Why? Risk of hypertensive crisis.

17

Nemonic for 3 major MAOIs?

When you're in the PITS, take MAOIs
P - phenelzine
I - iproniazid
T - tranylcypromise
S - selegiline

18

Alpha 1 agonist function?

increase peripheral resistance to maintain or increase blood pressure

19

Methoxamine

MOA: alpha 1 agonist
TX: hypotension, shock
Very limited clinical use for Shock

20

Phenylephrine
Oxymetazoline
Tetrahydrozoline
the "POT" triad

MOA: alpha 1 agonist
TX: nasal congestion
Use over the counter for nasal congestion, eye congestion

Rebound symptoms are common is used for over 3 days...sick. literally.

*when you smoke pot your eyes get red and runny! use POT!

21

Alpha 2 agonist function?

Inhibits sympathetic outflow from the CNS --> lowers blood pressure

22

Clonidine

MOA: alpha 2 agonist
TX: hypertension, opioid withdrawal, cancer pain

23

Dexmedetomidine

MOA: alpha 2 agonist
TX: sedation of surgical and ICU patients
ANESTHESTIC - LIKE!

24

Methyldopa

MOA: alpha 2 agonist
TX: hypertension in Preggo Ladies

25

Beta 1 agonist function?

stimulates heart and raises BP via renin

26

Beta 2 agonist function?

relaxes smooth muscle and increases gluceoneogenesis

Think of bronchodilation for ASTHMA

27

Isoprotenol

Non-selective B1 B2 agonist, meaning it can help with asthma buttt
you will also have adverse heart effects

- increased HR, irregular respirations, etc.

28

Dobutamine

This is the dude with the weird racemic mixture crap! Basically A1 agonist/antagonist actions cancel each other out so you're left with:

B1 agonist behavior
TX: IV for urgent & severe heart failure

29

Metaproterenol

MOA: B2 selective agonist
Asthma

30

Terbutaline

MOA: B2 selective agonist
Asthma

31

Albuterol

MOA: B2 selective agonist
Asthma

32

Salmeterol

MOA: B2 selective agonist
Asthma

33

Phenoxybenzamine

MOA: irreversibly BLOCKS a1 and a2 (antagonist)
TX: hypertension and sweating

34

Prazosin
Terazosin
Doxazosin

MOA: a1 antagonist (blocks 'em up)
TX: hypertension, benign prostatic hyperplaisa
Because postural hypotension is big risk, small doses given at first.

35

Which has the shortest half life? Prazosin, terazosin, or doxazosin?

prazosin

36

Tamsulosin

MOA: a1 antagonist
TX: benign prostatic hyperplasia

* has specificity for genitourinary tract

37

Drugs used to treat benign prostatic hyperplasia?

SINS!
Prazosin, terazosin, doxazosin, tamsulosin

38

Yohimbine

MOA: a2 antagonist (binds to self receptor to increase release of neurotransmitters)
TX: Impotence/ED
Do not use with psych patients, mind altering drugs, ulcers, preggos...

"Yo, Him, get it up!"

39

Nemonic for B adrenergic antagonists? Major use?

LOLs (the beta blockers!) for hypertension

40

Propanolol

MOA: B1 B2 blocker
TX: hypertension
May result in decrease libido

41

Serious or common side effects of beta blockers? Don't want to use these if you have ____?

Bronchospasm and wheezing - so you don't want to use these if you have asthma or heart issues!!!

42

Which beta blocker would you avoid with a patient with liver issues? Why?

labetalol - can cause hepatotxicity/liver damage.

43

Which beta blocker would you use to treat hypertension if the patient has bradycardia or limited cardiac reserve?

Pindolol

44

What beta blocker would you use for emergency B blockage, thyroid storm? Hint: very very short half life

Esmolol (half life of only 3-4 minutes)

45

Which drug used to treat hypertension has a high risk of postural hypotension, or hypotension following exercise?

Guanethidine or guandrel

46

What drug would you use to assess whether the effect of a drug requires concentraion at presynaptic terminals?

Reserpine

47

Typical type of drugs to treat depression? Name 3 specifically

PITS -
phenelzine
iproniazid
tranylcypromine

48

What drug can be used to both treat hypertension and symptoms of opioid withdrawal?

Clonidine

49

What drug would you use to treat hypertension in a pregnant female?

Methyldopa

50

What beta agonist can be used to treat urgent heart failure?

dobutamine

51

What alpha antagonist would you use to treat ED?

Yohimbine

52

What beta blocker may cause decreased libido and sedation?

Propanolol