Endogenous Catecholamines and D1 Agonists

Question 1

What binds alpha and beta 2

Answer 1

Epinephrine

Question 2

What binds alpha and beta 1 > 2

Answer 2

Norepinephrine

Question 3

What binds D, alpha and beta

Answer 3

Dopamine

Question 4

What binds D1

Answer 4

Fenoldopam

Question 5

DOC for patients in anaphylactic

Answer 5

Epi

Question 6

Potent vasopressor at high doses

Answer 6

Epi

Question 7

Cause bradycardia

Answer 7

Norepi (indirect M2)

Question 8

Limited therapeutic value, but can treat shock

Answer 8

Norepi

Question 9

DOC for cardiogenic and hypovolemic shock

Answer 9

Dopamine

Question 10

Why is dopamine better than norepi for shock

Answer 10

DA preserves renal blood flow

Question 11

Effects of high dose epi

Answer 11

Increase BP
+ve chronotropic/ionotropic (beta 1)
Vasoconstriction (alpha 1)
Increase CO and O2

Question 12

Effects of low dose epi

Answer 12

Decrease PVR
Increase systolic, decrease diastolic
No change in MAP
Tachycardia (beta 1)

Question 13

SM effects of epi

Answer 13

Bronchodilation (beta 2)
Relax GI with contracted sphincters
Relax detrusor (beta 2), contract sphincter (alpha 1)
Prostate SM contraction

Question 14

Metabolic effects of epi

Answer 14

Hyperglycemia

Lypolysis (beta 3)

Question 15

How does epi cause hyperglycemia

Answer 15

Increase glycogenolysis and glucagon release (beta 2)

Net inhibition of insulin secretion (alpha 2 inhibits, beta 2 enhances)

Question 16

What effect does epi have in glaucoma

Answer 16

Decrease aqueous humor production

Question 17

How do you treat asthma attacks with epi

Answer 17

Combine with local anesthetics to increase duration

Question 18

Causes Vasoconstriction

Answer 18

Epi (alpha 1)

Norepi (alpha 1)

Question 19

Effects of norepi vasoconstriction

Answer 19

Increased PVR

Increased SBP/DBP and MAP

Question 20

Induces hyperglycemia less potent than epi

Answer 20

Norepi

Question 21

Function of DA

Answer 21

Central regulator of movement

Question 22

CVS effects of DA

Answer 22

Low dose - vasodilate (D1): renal, mesenteric, coronary

Question 23

How does DA treat shock

Answer 23

Increase GFR, RBF, Na+ excretion

Ie. preserves renal function

Question 24

What is the inotropic effect of DA

Answer 24

Intermediate contraction (beta 1)
Increasing NE release

Question 25

Effect of DA on BP

Answer 25

Increase SBP

Question 26

Effect of high concentration DA

Answer 26

Alpha 1 vasoconstriction

Question 27

Effect of Fenoldopam

Answer 27

Peripheral vasodilation

Question 28

What is used for short term management of inpatient HTN

Answer 28

Fenoldopam

Question 29

Administration of Epinephrine

Answer 29

IV emergency | SC, ET tube, inhalation, topical eye

Question 30

Why don't you give epi orally

Answer 30

Inactivation in gut

Question 31

Why is DA ineffective orally

Answer 31

Metabolized by MAO and COMT

Question 32

How is Fenoldopam administered

Answer 32

IV

Question 33

Does DA cross BBB

Answer 33

No

Question 34

Notable AE of epi

Answer 34

Tremor ICH due to increased BP Arrhythmias - Digitalis pts Pulm edema

Question 35

What causes kidney shutdown

Answer 35

Norepi

Question 36

DA overdose

Answer 36

Sympathomimetic Sx

Question 37

Why is DA nausea, HTN and arrhythmia short-lived

Answer 37

Rapid metab to HVA

Question 38

Does Epi enter CNS

Answer 38

No, polar

Question 39

How is epi metabolized

Answer 39

COMT and MAO | Makes VMA and metanephrine

Question 40

How does hyperthyroid affect epi

Answer 40

Enhance CV actions

Question 41

How does cocaine affect epi

Answer 41

Prevent reuptake

Question 42

How do beta blockers affect epi

Answer 42

Cause predominate alpha effects - increase TPR and BP

Question 43

What counteracts local action of norepi

Answer 43

Baroreceptor reflex

Question 44

How do you block baroreceptor counteraction of norepi

Answer 44

Atropine