Chapter 9: Sympathomimetics

Question 1

A drug that decreases appetite

Answer 1

Anorexiant

Question 2

A synthetic sympathomimetic with isopropylamine in its structure (eg, amphetamine, ephedrine). Unlike catecholamines, these usually have oral activity, a long half-life, CNS activity, and cause release of stored catecholamines

Answer 2

Phenylisopropylamine

Question 3

Type of adrenoceptors outside the CNS found in adipocytes, which stimulates lipolysis

Answer 3

Beta 3

Question 4

Type of adrenoceptors outside the CNS found in adipocytes, which inhibits lipolysis

Answer 4

Alpha 2

Question 5

Type of adrenoceptors outside the CNS found in most vascular smooth muscle responsible for contraction

Answer 5

Alpha 1

Question 6

Type of adrenoceptors in the heart (stimulates rate and force) and the juxtaglomerular cells of kidney (stimulates renin release)

Answer 6

Beta 1

Question 7

What is the drug of choice for the immediate treatment of anaphylactic shock (hypotension, bronchospasm, angioedema) because it is an effective physiologic antagonist of many of the mediators of anaphylaxis?

Answer 7

Epinephrine

Question 8

Noncatecholamine alpha-selective sympathomimetic used as decongestant, mydriatic, neurogenic hypotension

Answer 8

Phenylephrine

Question 9

Noncatecholamines beta 2-selective agonist used for acute bronchospasm

Answer 9

Albuterol, metaproterenol, terbutaline

Question 10

What is the primary transmitter at the sympathetic postganglionic neuron-effector cell synapses in most tissues? (except: eccrine sweat glands and vasodilator sympathetic fibers in skeletal muscle)

Answer 10

Norepinephrine

Question 11

Inhibits synthesis of dopamine by inhibiting hydroxylation of tyrosine to DOPA (enzyme: tyrosine hydroxylase)

Answer 11

Metyrosine

Question 12

Blocks the transfer of DOPA into vesicles

Answer 12

Reserpine

Question 13

Inhibits entry of calcium triggers interaction among SNARE proteins (VAMPs and SNAPs)

Answer 13

Guanethidine

Question 14

Promotes entry of calcium triggers interaction among SNARE proteins (VAMPs and SNAPs)

Answer 14

Amphetamines and Tyramine

Question 15

Inhibits diffusion and reuptake of Dopa via NET and DAT in synaptic cleft

Answer 15

Cocaine and TCAs

Question 16

Adrenoceptor that stimulates platelet aggregation

Answer 16

Alpha 2 adrenergic agonist

Question 17

Sympathomimetic (non-selective, direct-acting)
b1 = b2 > a
Used for severe Asthma, COPD, hemostasis

Answer 17

Epinephrine

Question 18

Sympathomimetic (non-selective, direct-acting)
a > b1&raquo_space; b2 (almost negligible)
First line treatment for refractory hypotension in severe sepsis

Answer 18

Norepinephrine

Question 19

Dose-dependent actions of dopamine:

Answer 19

LOW DOSE (0.5 to 3 mcg/kg/min)

• D1 and D2 receptors
• Vasodilation, decreased arterial BP and increased renal and splanchnic blood flow

MEDIUM DOSE (3-10 mcg/kg/min)

• β1 receptors
• Increased CO (chronotropy and contractility)

HIGH DOSE (>10 mcg/kg/min)

• α1 receptors
• Leads to arterial and venous vasoconstriction, increased SVR, increased BP and increased CO

Question 20

A non-selective beta adrenergic receptor agonist

used in asthma and for sustained increases in HR (during pacemaker insertion for bradydysrhythmia)

Answer 20

Isoproterenol

albuterol or salbutamol is beta-2 selective

Question 21

Drug of choice for Alpha-1 agonist overdose

Answer 21

Phentolamine

Question 22

Pseudoephedrine is avoided in the 1st trimester because it may be associated with possible risk of:

Answer 22

Gastroschisis

Question 23

A unilateral condition that results from interruption of sympathetic nerves to the face. Symptoms include vasodilation, ptosis, miosis and loss of sweating on the affected side.

Answer 23

Horner’s syndrome

Question 24

Activates a2 adrenergic receptors by decreasing central sympathetic outflow (lowering peripheral vascular resistance), used in preeclampsia and gestational HPN

Answer 24

Methyldopa

Question 25

Sympathomimetic of choice for:
Acute heart failure, septic shock

Goal:
Increased cardiac output

Answer 25

Beta 1 and D1 agonists

Question 26

Sympathomimetic of choice for:
Hemostasis, decongestion, and spinal shock

Goal:
Vasoconstriction and temporary maintenance of BP

Answer 26

Alpha 1 agonist

Question 27

Sympathomimetic of choice for:
Bronchospasm, premature labor

Goal:
Bronchodilation, uterine SmM relaxation

Answer 27

Beta 2 agonist

Question 28

Sympathomimetic of choice for:
Hypertension, glaucoma

Goal:
Decrease BP

Answer 28

Alpha 2 agonist