Chapter 18/19

Question 1

Alpha 1 Adrenergic Function

Answer 1

• Increase cardiac contractility and vasoconstriction
• Dilate Pupils, decrease salivary gland secretion
• Increase bladder and prostate contraction

Question 2

Alpha 2 Adrenergic Function

Answer 2

• Inhibit norepinephrine release

- Decrease GI motility and tone

Question 3

Beta 1 Adrenergic Function

Answer 3

• Increase Cardiac contractility

- Increase renin secretion

Question 4

Beta 2 Adrenergic function

Answer 4

• Decreases GI tone and motility
• Activates liver glycogenolysis
• Bronchodilation
• Increases blood flow in skeletal muscles
• decreases uterine tone

Question 5

Inactivation of Neurotransmitters

Answer 5

1. reuptake of the transmitter back into the neuron
2. enzymatic transformation or degradation
3. diffusion away from the receptor

Question 6

2 Enzymes that inactivate the metabolism of norepinephrine

Answer 6

1. Monoamine oxidase (MAO)

2. Catechol-O-methyltransferase (COMT)

Question 7

How do drugs stop the termination of the neurotransmitter?

Answer 7

1. By inhibiting the norepinephrine reuptake, which prolongs the action of the transmitters
2. inhibiting the degradation of norepinephrine by enzyme action

Question 8

Adrenergic agonists

Answer 8

sympathomimetics or adrenomimetics

Question 9

adrenergic blockers

Answer 9

sympatholytics or adrenolytics

Question 10

Where are adrenergic receptor sites?

Answer 10

cells of muscles such as heart, bronchiole walls, GI tract, urinary bladder, and ciliary muscle

Question 11

Categories of sympathomimetics

Answer 11

1. direct-acting (directly stimulate: epinephrine/norepinephrine)
2. indirect-acting (stimulate the release of norepinephrine from terminal nerve endings: amphetamine)
3. mixed-acting (both direct and direct which stimulate the adrenergic receptor sites and stimulate release of norepinephrine from terminal nerve endings: ephedrine)

Question 12

Epinephrine

Answer 12

• Nonselective
• Action: Alpha 1, Beta 1 and 2
• Contraindications: dysrhythmias, cerebral arteriosclerosis, pregnancy, narrow angle-glaucoma, cardiogenic shock.
• PK: subq/im/iv
• Quick onset–> lasts 1 to 3 hrs
• Action: inotropic, vasoconstrictor, bronchodilator

Question 13

Albuterol

Answer 13

Selective: B2 adrenergic

• treat bronchospasm, asthma, bronchitis, COPD
• Side effects: tremors, dizziness, hallucinations, cardia dysrhythmias
• Increase effect with other sympathomimetics,MAO inhib, TCAs

Question 14

Adrenergic blockers OR sympatholytics

Answer 14

• Block by occupying receptors (Directly)

- By inhibiting the release of norep/epi (indirectly)

Question 15

Alpha-Adrenergic blockers

Answer 15

• Selective: block A1

- Nonselective: block A1/A2

Question 16

Alpha-Adrenergic blocker function

Answer 16

-vasodilation
-decrease BP
-Reflex tachycardia
-Decrease symptoms of BPH and PVD
(cardura, regitine, minipress, hytrin)

Question 17

Beta-Adrenergic Blockers

Answer 17

• Block beta 1: decrease BP and P

- Block beta 2: uterine contraction, bronchoconstriction

Question 18

Non-selective Beta-Adrenergic

Answer 18

Inderal

• used for angina, cardiac dysrhythmias, hypertension, heart failure
• Side effects: weight gain, impotence, decreased libido, alopecia

Question 19

Selective beta-adrenergic blocker

Answer 19

metopropol, atenolol
-side effects: bradycardia, hypotension, dysrhythmias, headaches, dizziness, fainting, fatigue, mental depression, nausea, vomiting, diarrhea, blood dyscrasias, hypoglycemia

Question 20

Adrenergic neuron blockers

Answer 20

Drugs that block the release of norepinephrine from sympathetic terminal neurons
-used to decrease blood pressure
(reserpine, guanethinidine, guanadrel)

Question 21

Cholinergics/ Parasympathomimetics

Answer 21

mimic acetylcholine

Question 22

Cholinergic Receptors

Answer 22

1. muscarinic: stimulate smooth muscle and slow heart rate

2. nicotinic receptors: affect skeletal muscles

Question 23

Cholinergic Agonists

Answer 23

1. Direct: act on the receptors to activate tissue response

2. indirect: inhibit acetylcholinesterase

Question 24

Cholinergic action in cardiovascular

Answer 24

decrease P and BP, vasodilation, slows conduction of AV node

Question 25

Cholinergic action in GI

Answer 25

increase tone and motility, increase peristalsis, relax sphincter muscles

Question 26

Cholinergic action in GU

Answer 26

contract bladder, increase ureter tone, relax sphincter muscles, stimulate urination

Question 27

Cholinergic action in eye

Answer 27

pupil constriction, increase accomodation

Question 28

Cholinergic action in lungs

Answer 28

bronchial constriction, increase secretions

Question 29

Cholinergic action in striated muscle

Answer 29

increase neuromuscular transmission

Question 30

Direct acting cholinergics

Answer 30

selective to muscarinic receptors - located in smooth muscles - Side effects: hypotension, bradycardia, blurred vision, miosis, excessive salivation, sweating, increased gastric acid, nausea, vomiting, diarrhea, bronchoconstriction

Question 31

Indirect acting cholinergics

Answer 31

- function: break down cholinesterase enxyme into choline and acetic acid - function: allow ach to activate receptors - Effects: stimulate skeletal muscles, increase tone, GI motility, bradycardia, bronchial constriction

Question 32

Antiocholinergics

Answer 32

- heart: large doses increase P, small decrease P - lungs: bronchodilation, decrease secretions - GI: relax smooth muscle tone, decrease peristalsis, decrease secretions - GU: relax destrusor muscle, increase sphincter constriction - Eye: dilate pupils, decrease accomodation - Glands: decrease salivation, perspiration - CNS: Decrease tremors and rigidity

Question 33

Alpha 1 Receptor

Answer 33

- Vascular smooth muscle | - vasoconstriction

Question 34

Alpha 2 Receptor

Answer 34

Adrenergic and cholinergic nerve terminals | -decrease neurotransmitter release

Question 35

Beta 1 receptor

Answer 35

heart | increase in rate and force of contraction

Question 36

Beta 2 receptor

Answer 36

Broncial smooth muscle | Bronchodilation