Chapter 30 - Adrenergic Agonists Flashcards Preview

Nur 30 Pharmacology > Chapter 30 - Adrenergic Agonists > Flashcards

Flashcards in Chapter 30 - Adrenergic Agonists Deck (40):
1

What are the Indications and Actions of Dopamine?

Indications: Correction of hemodynamic imbalances present in shock.

Actions: Acts directly and by the release of norepinephrine from sympathetic nerve terminals. Mediates dilation of vessels to maintain renal perfusion while stimulating sympathetic response.

2

What are some adverse effects of dopamine?

Tachycardia
Ectopic beats (skipping)
Anginal pain (chest)
Hypotension
Dyspnea
Nausea & vomiting
Headache

3

What are some indications of Phenylephrine?

1)Treatment of vascular failure in shock or drug induced hypertension
2)Overcome paroxysmal SVT
3) Symptomatic relief of nasal congestion
4) Therapy for middle ear infections
5) Pupil dilation

4

What are the actions and adverse effects of Phenylephrine?

Actions: powerful post synaptic alpha adrenergic receptor stimulant causing vasoconstriction. Raising systolic & diastolic BP with little effect on beta receptors in the heart.

Adverse: fear, anxiety, restlessness, headache, nausea, decreased urine formation, pallor

5

What are some indications of isoproterenol? (Isuprel)

Treatment of shock, cardiac arrest, and certain ventricular arrhythmias; treatment of heartblock in transplanted hearts; treatment of bronchospasm during anesthesia. (P.497)

6

What are some actions and adverse effects of isoproterenol? (Isuprel)

Acts on beta-adrenergic receptors to produce increased heart rate, positive inotropic effect, bronchodilation, and vasodilation.

Adverse: restlessness, apprehension, anxiety, fear, cardiac arrhythmias, tachycardia, nausea, vomiting. (P.498 for more)

7

What is a sympathomimetic and how do they produce effects?

A drug that mimics the effects of the sympathetic nervous system (SNS).

The drugs produce therapeutic and adverse effects by their stimulation of adrenergic receptor sites either direct (occupation of receptor) or indirect (neurotransmitter) stimulation. p. 486

8

Sympathomimetic drugs can be divided into which categories?

Alpha agonists:

a1 = blood vessels
a2= nerves

Beta agonists;

b1= cardiac
b2= lungs/"everything else"

9

What are the actions and indications of a/b adrenergic agonists?

1) Heart rate increases with increased myocardial contractility.
2) bronchi dilate
3) respiration a increase in rate and depth
4) blood vessels constrict increases BP
5) intraocular pressure decreases
6) pupils dilate

10

What are indications of labetalol?

1) Hypertension
Off label:
Control of BP in pheochromocytoma
Clonidine withdrawal hypertension

11

What are the actions of labetalol

Competitively blocks alpha and beta receptor sites in the in the SNS leading to lower BP without reflex tachycardia and decreased renin levels.

12

Adverse effects of labetalol?

Dizziness, vertigo, fatigue, gastric pain, flatulence, impotence, bronchospasm, dyspnea, cough, decrease exercise tolerance

13

What are indications of phentolamine?

Prevention or control of hypertensive episodes associated with pheochromocytoma; test for diagnosis; prevention and treatment of dermal necrosis and sloughing with IV extravasation of norepinephrine or dopamine.

14

What are the actions of phentolamine?

Competitively blocks postsynaptic alpha 1 and presynaptic alpha 2 receptors, causing a vasodilation and lowering BP, accompanied by increased reflex tachycardia.

15

Adverse effects of phentolamine?

Acute and prolonged hypotensive episodes, MI tachycardia, arrhythmias, nausea, flushing

16

What are indications of doxazosin?

Treatment of hypertension as monotherapy or in combo antihypertensive drugs;

Treatment of benign prostatic hypertrophy

17

Effects of Doxazosin?

Reduces total peripheral resistance through alpha blockade

Does not affect HR or CO

Increase high density lipoproteins while lowering total cholesterol levels

18

Adverse effects of doxazosin?

Headache
Dyspepsia
Fatigue
Dizziness
Postural
Dizziness
Vertigo
Tachycardia (p 509)

19

Propranolol indications?

Treatment of hypotension
Angina pectoris
Idiopathic hypertrophic subaortic stenosis
SVA
Prevention of heart attack after already having one
Adjunctive therapy in pheochromocytoma

20

Actions of Propranolol?

Competitively blocks beta adrenergic receptors in the heart and juxtaglomerular apparatus; reduces vascular tone in CNS

21

Adverse effects of propranolol

Allergic reaction
Bronchospasm
Bradycardia
Heart failure
Cardiac arrhythmias
CVA
Pulmonary edema
Gastric pain

22

What are some indications of atenolol?

Treatment of angina
Hypertension
MI
Off label:
Prevention of migraines
Alcohol withdrawals
SVT

23

Actions of atenolol?

Blocks beta 1 adrenergic receptors
Decreasing the excitability of the heart
Cardiac output and O2 consumption

Decreases renin release

24

Adverse effects of atenolol??

Allergic reaction
Dizziness
Bradycardia
Heart failure
Arrhythmias
Gastric pain
Flatulence
Impotence
Bronchospasm
Decreased exercise tolerance

25

Bethanechol? (I)

Acute postoperative and postpartum nonobstructive urinary retention
Neurogenic agony of the bladder with retention

26

Bethanechol (A)

Acts directly on cholinergic receptors to mimic the effects of ACh
increases tone of detrusor muscles
Causes emptying of bladder

27

Bethanechol (AE)

Abdominal discomfort
Salivation
Nausea
Vomiting
Sweating
Flushing

28

Pyridostigmine (I)

Treatment of myasthenia gravis
Antidote for nondepolarizing neuromuscular junction blockers
Increased survival after exposure to nerve gas

29

Pyridostigmine (A)

Reversible cholinesterase inhibitor that increases the level of ACh

Facilitating transmission at the neuromuscular junction

30

Pyridostigmine AE

Bradycardia
Cardiac arrest
Tearing
Miosis
Salivation
Increased bronchial secretions
Incontinence
Nausea
Vomiting

31

Donepezil I&A

Treatment of mild to moderate to mild Alzheimer's

Reversible cholinesterase inhibitor that causes elevated ACh levels in the cortex, which slows neuronal degradation of Alzheimer's disease

32

Donpezil AE

Insomnia Diarrhea
Fatigue
Rash. Muscle cramps
Nausea
Vomiting

33

Atropine indications?

To decrease secretions before surgery
Treatment of Parkinsonism
Restoration of cardiac rate and arterial pressure
Relief of bradycardia
Control of rhinorrhea associated with hay fever
Antidote for cholinergic overdose and mushroom poisoning

34

Atropine actions?

Competitively blocks ACh muscarinic receptor sites, blocking the effects of the PNS

35

Atropine AE

Blurred vision
Mydriasis
Cycloplegia
Photophobia
Palpitations
Dry mouth
Bradycardia
Decreased sweating

36

Dopamine is a?

a&b adrenergic agonist

37

a specific adrenergic agonists include...

Phenylephrine

38

Isoproterenol is a

B specific adrenergic agonist

39

Bethanechol is a

Direct acting cholingeric agonist

40

Indirect acting cholinergic agonists are

Pyridostigmine
Donepezil