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Pharmacology > L2: Adrenergic Pharmacology > Flashcards

L2: Adrenergic Pharmacology Flashcards

(56 cards)

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1
Q

What are the ligands for adrenergic receptors?

A

NE and Epi

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2
Q

What is the Gq adrenergic response?

A

Increased Ca 2+

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3
Q

What is the Gi adrenergic response?

A

Decreased cAMP

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4
Q

What is the Gs adrenergic response?

A

Increase cAMP

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5
Q

What physiological response is alpha 1 responsible for?

A

Vasoconstriction: contraction of vascular smooth muscle.

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6
Q

What physiological response is alpha 2 responsible for?

A

Decreased sympathetic tone: increased parasympathetic response.

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7
Q

What physiological response is beta 1 responsible for?

A

Increased contractile force, increased HR, Increased renin

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8
Q

What physiological response is beta 2 responsible for?

A

Decreased bronchial contraction, decreased skeletal muscle blood vessel constriction, increased gluconeogenesis

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9
Q

What physiological response is beta 3 responsible for?

A

Increased lipolysis

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10
Q

What drug class is Phenylephrine?

A

Alpha 1 agonist

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11
Q

What drug class is clonidine?

A

Alpha 2 agonist?

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12
Q

What drug class is methyldopa?

A

Alpha 2 agonist

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13
Q

What drug class is isoproterenol?

A

non-selective beta agonist

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14
Q

What drug class is dobutamine?

A

Non selective beta agonist.

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15
Q

What drug class is Albuterol?

A

Beta 2 agonist

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16
Q

What drug class is phentolamine?

A

Non selective alpha antagonist

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17
Q

What drug class is Prazosin?

A

Alpha 1 antagonist

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18
Q

What drug class is Propranolol?

A

Non selective beta blocker

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19
Q

What drug class is Atenolol?

A

Beta 1 blocker

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20
Q

What drug class is Metoprolol?

A

Beta 1 blocker

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21
Q

What drug class is Carvedilol?

A

Mixed alpha 1/ beta blocker

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22
Q

What drug class is labetalol?

A

Mixed alpha 1/beta blocker

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23
Q

What is the difference between epinephrine and Phenylephrine?

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A

Phenylephrine is missing an OH group on the catechol which makes it less sensitive to COMT, less polar, and more sensitive to alpha-1 receptors. In short, it lasts longer.

24
Q

What are the clinical uses of Alpha-1 agonists?

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A

Nasal congestion
Hypotension
Hemorrhoids

25
What drug is a first-line tx for hypertension during pregnancy?
Methyldopa
26
Why do Alpha-2 agonists not cause reflex tachycardia?
Stimulation of alpha-2 receptors in the medulla has sympatholytic effects
27
Which alpha-2 agonist is more potent and why?
Clonidine bc it is active in the brain and periphery.
28
Why is methyldopa safe for pregnancy?
It is a prodrug that is only active in the brain when it is transformed to alpha-methyl-NE
29
Why can't you stop clonidine cold turkey?
Bc, you'll enter a hypertensive crisis.
30
What are the characteristics of isoproteronol?
Potent vasodilator Bronchodilator Positive Inotropic Positive Chronotropic
31
How is isoproterenol metabolized?
By COMT and MAO
32
What happens to pusle, BP and TPR on isoproterenol?
Increased pulse: Increased beta 1 Decreased BP: Decreased resistance Decreased resistance: Beta 2 *no alpha stim so there is dramatic TPR decrease
33
What are the characteristics of Dobutamine?
Greater inotropic than chronotropic effect with no net change in TRP.
34
What is albuterol used for?
Short-action acute bronchospasm
35
What patient would you not give a beta-2 agonist to?
Diabetic because increased glycogenolysis leads to hyperglycemia.
36
What are the clinical uses of beta-2 agonists?
Asthma Acute bronchospasm Bronchospasm prophylaxis Premature labor
37
What are the side effects of beta 2 angonsts?
Tremors Palpitations CNS stimulation Reflex tachycardia
38
What is reflex tachycardia?
Dec in BP so HR increases
39
What does alpha-1 antagonist-induced vasodilation trigger?q
Reflex tachycardia (even more pronounced in mixed alpha-1 and 2)
40
Why does HR increase more with alpha-1 and 2 antagonists?
Bc alpha-2 inhibitory reflux is also blocked.
41
What is the clinical use of phentolamine?
Anesthesia reversal
42
What is the clinical use of Prazosin?
Benign prostatic hyperplasia.
43
What is beta blocker withdrawal?
When taking Beta-blockers, more beta receptors appear to try and become unblocked so, when you immediately stop beta blockers, you have too many active receptors that are trying to bring you into hypertension.
44
What are the characteristics of beta blockers?
Negative inotropic, Dromotropic, Chronotropic Decreased renin release Anxiolytic
45
Which beta blockers are more likely to bronchoconstrict?
Nonselective beta blockers
45
Which beta blockers are more likely to increase metabolism?
Nonselective beta blockers
46
What are the clinial uses of propranolol?
HTN After heart attack (post myocardial infarction)
47
What are the first-line treatment drugs for systolic/diastolic HTN in adults over 60 without other problems?
Calcium channel blockers Thiazides
48
What are the first-line treatment drugs for systolic/diastolic HTN in adults under 60 without other problems?
ACEI and ARB
49
What antihypertensive drug can you not give someone over 60?
Beta blocker
50
When are beta blockers a first line tx for hypertension?
Ischemic heart disease Recent ST-elevation myocardial infarction (recent heart attack) Left ventricular systolic dysfunction Some arrhythmias
51
What beta-blockers are preferred in patients with bronchospasms, diabetes, and peripheral vascular disease?
Beta 1 agonists
52
Which beta-1 antagonist has a longer half life?
Metoprolol
53
Which beta blocker is recomended for patients with heart failure?
Carvedilol
54
Which beta blocker has the least reflex tachycardia?
Mixed alpha-1/beta blocker
55
In what patient would propranolol be contraindicated?
Asthma

Pharmacology (8 decks)

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