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Block 2 Week 3 > CV Autonomic Pharmacology > Flashcards

CV Autonomic Pharmacology Flashcards

1
Q 
What do these do?
Propranolol
Metoprolol
Phentolamine
Prazosin
Carvadilol
A

sympatholytics (block)

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2
Q 
What do these do?
Norepinephrine
Epinephrine
Isoproterenol
Dobutamine
Dopamine
Phenylephrine
Clonidine
Tyramine
A

sympathomimetics

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3
Q

What do these do?
Acetycholine
Digoxin?

A

cholinomimetics (parasympathetic agonists)

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4
Q

What do these do?
Atropine
Trimethaphan

A

cholinolytics (block)

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5
Q

What type of receptors are found in smooth muscle (blood vessels, eye, gut, bladder)?

A

alpha 1

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6
Q

What type of receptors cause Formation of IP3 (increase intracellular Ca2+), DAG (activate PKC)?

A

alpha 1

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7
Q

What type of receptors are found in presynaptic nerve terminals, smooth muscle (blood vessels)

A

alpha 2

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8
Q

What type of receptors cause inhibition of neuronal Ca2+ channels; inhibition of adenylyl cyclase (decrease cAMP)

A

alpha 2

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9
Q

What type of receptors are found in cardiac myocytes, juxtaglomerular cells (kidney)

A

beta 1

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10
Q

What type of receptors cause Stimulation of adenylyl cyclase, increased cAMP

A

beta 1, beta 2, beta 3

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11
Q

What type of receptors are found in smooth muscle (airways, blood vessels), ciliary body epithelium (eye), cardiac muscle

A

Beta 2

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12
Q

What type of receptors are found in adipocytes?

A

beta 3

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13
Q

What type of muscarininc receptors are found in cardiac muscle?

A

M2

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14
Q

What type of muscarinic receptor Activate K+ channels (hyperpolarization), inhibit adenylyl cyclase (decrease cAMP)?

A

M2

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15
Q

*Sinoatrial node
Sympathetic activation of β1 adrenergic receptors has a (blank) effect

Parasympathetic activation of M2 muscarinic receptors has a (blank) effect

A

positive chronotropic effect (increases heart rate) negative chronotropic effect (decreases heart rate)

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16
Q

*Atrioventricular node
Sympathetic activation of β1 adrenergic receptors has a (blank) effect.
Parasympathetic activation of M2 muscarinic receptors has a (blank) effect

A

positive dromotropic effect (increases conduction velocity)

negative dromotropic effect (decreases conduction velocity)

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17
Q

*Ventricular muscle
Sympathetic activation of β1 adrenergic receptors has a (blank) effect

Parasympathetic activation of M2 muscarinic receptors (blank) sympathetic responses. In the absence of sympathetic tone, parasympathetic activation has little or no effect on the ventricles.

A

positive inotropic effect (increases contractility)

antagonizes

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18
Q

*Blood Vessels

Sympathetic activation

α1 adrenergic receptors cause (blank)

β2 adrenergic receptors cause (blank)

A

vascular smooth muscle contraction and constriction of blood vessels.

relaxation of vascular smooth muscle and dilation of blood vessels.

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19
Q

(blank) activation has little or no effect on most blood vessels. Exceptions include blood vessels of the face, tongue, genitals and urinary tract, where (blank) stimulation causes relaxation of the vascular smooth muscle and vasodilation.

A

Parasympathetic

Parasympathetic

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20
Q

(blank) mostly just helps with total peripheral resistance with blood vessels.

A

parasympathetics

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21
Q

What is a non-selective antagonist for A1, A2, B1, B2, D1?

A

carvedilol

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22
Q

What is a selective antagonist for alpha 1 receptors?

A

prazosin

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23
Q

What is a selective antagonist for alpha 2 receptors?

A

yohimbine

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24
Q

What is nonselective agonist of alpha receptors?

A

oxymetazoline

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25
Q

What is a selective agonist for alpha 1 receptors?

A

phenylephrine

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26
Q

What is a selective agonist for alpha 2 receptors?

A

clonidine

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27
Q

What is a nonselective agonist for beta receptors?

A

isoproterenol

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28
Q

What is a selective agonist for beta 1 receptors?

A

dobutamine

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29
Q

What is a selective agonist for beta 2 receptors?

A

terbutaline

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30
Q

What is a selective agonist for D1 receptors?

A

fenoldopam

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31
Q

B2 receptors are more susceptible to (blank)

A

epinephrine

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32
Q

Norepinephrine is more susceptible to (blank)

A

beta 1 and alpha 1 receptors

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33
Q

Which would you want to utilize more for vasoconstrction and dilation; epinephrine or norepinephrine?

A

epinephrine

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34
Q

Norepinephrine likes the 1 receptors or the 2’s?

A

the 1’s

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35
Q

Does epinephrine have a higher affinity for betas or alphas?

A

betas

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36
Q

Does isoproterenol have more of an affinity for alphas or betas?

A

betas

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37
Q

Does phenylephrine have more of an affinity for a’s or b’s and 1 or 2?

A

alpha 1 then alpha 2

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38
Q

Does clonidine like alpha or betas better and 1 or 2?

A

alpha 2 then alpha 1

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39
Q

What do you use for:

severe hypotension; septic shock

A

norepinephrine

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40
Q

What do you use for:

anaphylactic shock; cardiogenic shock; cardiac arrest; local vasoconstriction

A

Epinephrine

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41
Q

What do you use for:

cardiogenic shock; bradycardia; atrioventricular block

A

isoproterenol

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42
Q

What do you use for:

acute heart failure; cardiogenic shock

A

dobutamine

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43
Q

What do you use for:

acute heart failure; cardiogenic shock; acute renal failure

A

dopamine

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44
Q

What do you use for:

topical vasoconstriction; shock; autonomic testing

A

phenylephrine

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45
Q

What do you use for:

hypertension

A

clonidine

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46
Q

(blank) is a life-threatening condition that occurs when the body is not getting enough blood flow.

A

shock

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47
Q

What are the major classes of shock?

A

hypovolemic, cardiogenic,vasodilatory

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48
Q

What is shock due to weakened heart?

A

cardiogenic

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49
Q

What is shock do to lack of blood?

A

hypovolemic

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50
Q

What is shock such as septic or anaphylaxic due to vasodilation?

A

vasodilatory shock

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51
Q

(blank) causes an increase in diastolic and systolic pressure, increase in MAP, increase in SV, PP but decrease in heart rate, increase TPR.

A

norepinephrine

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52
Q

What is the equation for CO?

A

Co=MAP/TPR

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53
Q

What s the equation for SV?

A

SV=CO/HR

54
Q

MAP= (blank) X SV X (Blank)

A

HR X SV X TPR

55
Q

What will affect pacemaker activity?

A

B1

56
Q

What will effect SV and ventricular contraction?

A

B1

57
Q

What will effect TPR and vascular tone?

A

A1 and B2

58
Q

What will effect systolic pressure?

A

A1 and B2

59
Q

Whats going to affect diastolic pressure?

A

A1 and B2

60
Q

Whats going to affect pulse pressure?

A

B1 receptors

61
Q

What does isproterenol do?

A

it lowers diastolic pressure, decrease of TPR, Increased heart rate, systolic is variable, increase in stroke volume, decrease in MAP

62
Q

What does norepinephrine do?

A

Systolic and diastolic increase, increased peripheral resistance, decrease heart rate

63
Q

Epinephrine acts like isoproterenol when it has (blank) dose due to its higher affinity for beta receptors

A

low

64
Q

What does epinephrine act like at high doses?

A

like norepinephrine

65
Q

What does epinephrine do?

A

decreases in diastolic pressure and reduction in TPR, increase heart rate

66
Q

Low dose epinephrine exhibits greater (blank)(isoproterenol-like) effects.

A

beta-adrenergic

67
Q

High dose epinephrine exhibits greater (blank) (norepinephrine-like) effects

A

alpha-adrenergic

68
Q

phenylephrine is a selective (blank)

A

alpha 1 agonist

69
Q

What do beta receptors do?

A

decease diastolic pressure and increase heart rate

70
Q

What do alpha receptors do?

A

increase systolic pressure

71
Q

How can you tell the difference between EPI and Phenylephrine?

A

Epinephrine will have beta effects so you will get a decrease in diastolic pressure

72
Q

If you have a decrease in heart rate what can you expect the drug to be?

A

norepinephrine

73
Q

If you have an increase in heart rate, an increase in systolic but a decrease in diastolic pressure what can you assume the drug is?

A

epinephrine

74
Q

If you have an increase in heart rate, a decrease in diastolic and systolic pressure then what drug is at work?

A

Isoproterenol

75
Q

What drug will give you an increase in systolic, diastolic, pulse pressure, MAP, and a derease in heart rate?

A

norepinephrine

76
Q

What drug will give you an increase in systolic, decrease in diastolic, increase in pulse pressure, increase in MAP, increase in HR

A

Epi (low dose)

77
Q

What drug will give you an increase in systolic, diastolic, pulse pressure, MAP

A

Epi (high dose)

78
Q

What drug will give you a decrease in diastolic, increase in pulse pressure, decrease in MAP, and increase in HR?

A

Isoproterenol

79
Q

What drug will give you increase in systolic, diastolic, MAP and decrease in HR?

A

phenylephrine

80
Q

What determines diastolic pressure?

A

TPR

81
Q

(blank) produces dose dependent effects

A

Dopamine

82
Q

Low doses of (blank) activate D1 receptors, increasing renal blood flow

A

dopamine

83
Q

Intermediate doses of (blank) can activate beta receptors increasing cardiac output

A

dopamine

84
Q

What will high doses of dopamine do?

A

activate alpha receptores (increase TPR and MAP)

85
Q

Contractile forces is indicative of (blank)

A

Beta 1 receptors

86
Q

When you go into hypovolemic shock what do you want to do?

A

utilize sympathetic reflex to increase vasoconstriction to attempt to maintain BP

87
Q

In vasodilatory shock what happens?

A

you get dilation of blood vessels which decrease TPR which decreases MAP, poor perfusion to organs

88
Q

When you have cardiogenic shock what happens?

A

sympathetic response increase and leads to vasoconstriction to try and restore BP, but has low CO-> elevated Venous pressure which leads to edema

89
Q

When you have cardiogenic shock do you want a vasodilatory or vasoconstriction?

A

vasodilator and increased contractility (dobutamine)

90
Q

Why is clonidine used to treat hypertension?

A

alpha 2 regulate exocytosis so they can inhibit release of norepinephrine and decreases sympathetic tone.

91
Q

(blank) can activate presynpatic α2 receptors

inhibiting sympathetic neurotransmitter release

A

Clonidine

92
Q

(blank) effects in the central nervous system also decrease sympathetic tone

A

Clonidine

93
Q

What is an indirect acting sympathomimetic that is taken up into postganglionic sympathetic nerve terminals by NET and when combined with MAO inhibitors can cause hypertensive crisis?

A

Tyramine

94
Q

What is used for severe hypertension and pheochromocytoma?

A

phentolamine

95
Q

What is used for hypertension?

A

prazosin

96
Q

What is used for hypertension, angina, cadiac arrhythmias?

A

propranolol

97
Q

What is used for hypertension, angina, congestive heart failure?

A

metoprolol

98
Q

What is used for hypertension and heart failure?

A

carvadilol

99
Q

What is an antagonist for alpha receptors?

A

phentolamine

100
Q

What is a antagonist for Alpha 1 receptors (most) and alpha 2?

A

prazosin

101
Q

What is a beta antagonist and likes beta ones the most?

A

metoprolol

102
Q

What is an alpha 1 antagonist> beta 1 antagonist >beta 2 antagonist

A

carvadilol

103
Q

What happens to epinephrine after it is given an alpha blocker?

A

it will exhibit reversal of the mean blood pressure to a net decrease due to the beta response

104
Q

What happens to phenylephrine after it is given an alpha blocker

A

The response is suppressed but not reversed

105
Q

(blank) enhances alpha-adrenergic response to high dose epinephrine

A

Beta blockade

106
Q

If you add an alpha blocker to epinephrine what happens?

A

systolic pressure drops

107
Q

When blood pressure falls in the kidney what happens?

A

renin is released which turns into angiotensinogen then to angiotensin I then Angiotensin II which causes vasoconstriction and aldosterone secretion which causes increased blood volume

108
Q

(blank) antagonists can reduce blood pressure by inhibiting renin secretion.

A

β1 receptor

109
Q

(blank) can also reduce blood pressure by decreasing HR and SV

A

β1 receptor antagonists

110
Q

(blank) = HR x SV x TPR

A

MAP

111
Q

(blank) contribute to a decrease in myocardial work and oxygen consumption,
which makes these compounds effective in treating angina.

A

Beta 1 receptor antagonists

112
Q

β1 receptor antagonists (metoprolol) and non-selective α1/β1 antagonists (carvedilol)
are also effective in treating (blank) by mechanisms that are not entirely clear.

A

heart failure

113
Q

What is a Nm antagonist?

A

d-tubocurarine

114
Q

What is a Nn antagonist?

A

trimethaphan

115
Q

What is a M antagonist?

A

atropine

116
Q

What is a Nm and Nn agonist?

A

nicotine

117
Q

What is a M agonist?

A

bethanechol

118
Q

What is an endogenous neutrotransmitter of cholinergic receptors?

A

acetylcholine

119
Q

When do you use digoxin?

A

in atrial fibrillation

120
Q

Even though most blood vessels do not receive (blank) input, acetylcholine can cause vasodilation

A

parasympathetic

121
Q

Why isnt Ach used to regulate vascular tone and cause vasodilation?

A

Cuz it doesnt live long in the blood stream and has a lot of nonspecific effects

122
Q

What does this:
Inhibits NA K Atpase so you wont rid the cell of calcium so you will get more calcium in the cells and get greater force of contraction. Used in A fib.

A

digoxin/digitalis

123
Q

(blank) can act centrally to increase parasympathetic tone.

A

Digoxin

124
Q

(blank) reduces AV conduction to make sure that this doesn’t occur by increasing parasympathetic tone to reduce ventricular rate.

A

digoxin

125
Q

What cholinolytic is used in bradycardia and heart block?

A

atropine

126
Q

What cholinolytic is used in hypertensive crisis?

A

trimethaphan

127
Q

(blank) will increase heart rate and increase AV nodal conduction by blocking parasympathetic stimulation of the heart but it will also block basal parasympathetic effects on all other organ systems producing a significant number of unwanted side effects.

A

Atropine

128
Q

What are the only 2 organs that have predominant sympathetic tone?

A

blood vessels, sweat glands

129
Q

(blank) blocks Nn which will block predominate resting tone of organs i.e block vasosympathetic tone to blood vessels to create vasodiliation to help with hypertensive crisis but has a lot of bad side effects.

A

Trimethaphan

130
Q

(blank) can reduce blood pressure by blocking sympathetic effects on blood vessels but it will also block basal parasympathetic effects on all other organ systems producing a significant number of unwanted side effects

A

Trimethaphan

Block 2 Week 3 (9 decks)

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