Lecture 14/15 - Adrenergic Stimulants Flashcards Preview

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Flashcards in Lecture 14/15 - Adrenergic Stimulants Deck (99):
1

What are the catecholamines? (three)

Epinepherine
Norepinephrine
Isoproterenol

2

What is the beta1 agonist?

Dobutamine

3

What is the beta2 agonist?

Albuterol

4

What is the alpha agonist?

Phenylphrine

5

What are the alpha2 agonists? (four)

Xylazine
Detomidine
Medetomidine
Dexmedetomidine

6

What are three other adrenergic stimulants that aren't really receptor related?

Amphetamine
Cocaine
Tyramine

7

Where is NE released from?

Nerves + Adrenal medulla

8

What does NE stimulate?

Alpha + B1

9

Where is EPI released from?

Adrenal medulla

10

What does EPI stimulate?

Alpha + Beta

11

What inhibits tyrosine hydroxylase?

Metyrosine

12

What is the basic progression of Tyrosine to Epi?

Tyrosine - L-DOPA - Dopamine - NE - EPI

13

What are the two way that NE/EPI/ISO are metabolized?

MAO - in nerve
COMT - in circulation

14

What two drugs stimulate NE release?

Amphetamines + Tyramine

15

What does cocaine do in the adrenergic terminal?

Inhibit NE reuptake

16

What compound would you test to test NE levels in the body?

VMA levels in urine

17

What does SNS stimulation of Alpha1 do?

Vasoconstriction

18

What does SNS stimulation of Beta1 do?

Increase heart rate + contractility
Renin secretion

19

What does SNS stimulation of Beta2 do?

Vasodilation of skeletal muscle BV
Glycogenolysis

20

What does SNS stimulation of Beta3 do?

Lipolysis

21

What does SNS stimulation of Alpha2 do?

Inhibit NE release (or any NT)

22

What occurs with indirect acting drug when denervation happens?

No longer work

23

What occurs with direct acting drugs when denervation occurs?

Increase activity possible

24

What makes up NE?

Dopamine + hydroxyl group

25

What does NE stimulate?

Alpha + B1

26

What makes up EPI?

NE + Methyl group

27

What does EPI stimulate?

Alpha + Beta

28

What makes up Isoproterenol?

EPI + 2 methyl groups

29

What does isoproterenol stimulate?

Betas

30

Where is isoproterenol found in the body?

Not, synthetically made drug

31

What is the ranking of sensitivity to alpha receptors?

EPI > or = NE >>>>>>> ISO

32

What is the most basic characteristic of alpha1?

Excitatory

33

What stimulates alpha1?

Phenylephrine

34

What is the activity of alpha2?

Inhibitory, pre-synaptically

35

What activates alpha2?

Clonidine

36

What are the results of Phenylephrine administration?

Vasoconstriction = Increased resistance
Mydrasis
Prostate + bladder base + urtheral spincter = contract
Pilomotor SM stimulation

37

What are the results of Xylazine administration?

Decreased NE release = Decreased BP
Inhibit ACh release = Decreased secretions
CNS depression

38

What happens with general alpha agonists in the cardiovascular system?

Increased arterial resistance (Diastolic)
Increased BP = Baroreceptors = Decreased HR

39

What happens with general alpha agonists in the eye?

Mydriasis (no effect of accommodation)
Decreased production of Aqueous humor
Increased outflow of aqueous humor

40

What happens with respiration in the presence of alpha agonists?

Constrict nasal + upper airway BV

41

What happens in the genitourinary tract in the presence of an alpha agonist?

Increase continence
Ejaculation

42

What is the compound preference in Beta1?

ISO> EPI = NE

43

What is the compound preference in Beta2?

ISO>EPI>>NE

44

What is the compound preference in Beta 3?

Iso = NE > EPI

45

What type of receptors are betas?

Gs

46

What is the effect of Dobutamine adminstration?

Increased HR + Force
Increase automaticity
Increased Renin secretion

47

What is the effect of Albuterol adminstration?

Bronchodilation = relax bronchial SM
BV to skeletal muscles dilate
Glucogenolysis + Gluconeogenesis
K+ uptake into muscle

48

What is the general affects of beta receptor activation in the cardiovascular system?

Increased HR + Force
Ca+ influx
AV/SA node conduction increases = automaticity
Ventricular conduction increase
Increased O2 consumption
Increased CO = Increased systolic

49

What is the general effects of beta receptor activation in the eye?

increase aqueous humor production
increase ocular pressure
Slight relaxation of ciliary muscle

50

What occurs in the respiratory system with beta receptor activation?

Bronchial SM relaxation

51

What does beta receptor activation do in the gentiourinary system?

Decrease contractions of uterus
Relax bladder wall

52

What does beta receptor activation do in regards to metabolism?

Increase Renin secretion (1)
Glycogenolysis + K+ uptake into cells + Inc. insulin (2)
Lipolysis (3)

53

What happens with NE administration with BP and HR?

HR increases, with decrease from baroreceptor reflex
D/S Pressure increase

54

What happens with phenylephrine administration with BP and HR?

Vasoconstriction = Increased BP
Baroreceptor reflex = decreased HR

55

What is phenylephrine used for/

Hypotensive emergencies

56

Whats the upside to using phenylephrine in a clincal emergency situation?

Can increase BP without affecting HR

57

What is an important thing you must watch out for with stopping phenylephrine termination?

Rebound effect

58

What fungus produces ergot alkaloids?

Claviceps purpurea

59

What are the symptoms or ergotism?

dementia + hallucinations + stimulation of uterine SM
Vasoconstriction = gangrene

60

What receptors does ergotamine activate?

Partial agonist for Alpha + Serotonin

61

What does medetomidine activate?

Alpha 2

62

What occurs with medetomidine activation?

Inhibit NE release in brain = Sedation + Analgesia
Decrease SNS output
Decrease BP + HR + RR

63

What is the general characteristic of Detomidine?

Long duration of action

64

What is the general characteristic of Romifidine?

less ataxia than others

65

What is the general characteristic of Xylazine?

Increased risk of vomiting

66

What is clonidine used for?

Decrease BP in humans

67

What are the peripheral side effects of alpha2 agonist administration?

Vomiting in small animals
Decreased GI motility + acid
Hypertension followed by Hypo + Brady
Reduced RR

68

What is important to know about sheep and goats in regards to alpha 2 agonists?

increase resipratory rate + airway pressure

69

What does isoproterenol stimulate?

B1 + 2

70

What are the effects of isoproterenol on BP and HR?

Increase rate + force of heart
Vasodilation (B2) = decreased BP (Diastolic + MAP)
Baroreceptor reflex further increases HR

71

What is isoproterenol used for?

Cardiac arrest + Heart block

72

What can an overdose of isoproterenol cause?

palpitations + sinus tachycardia + arrhythmia

73

What does dobutamine activate?

beta1

74

What happens with dobutamine administration?

Increase force and rate of heart
Short duration

75

What are the uses for dobutamine?

Increase CO in shock or CHF

76

What is terbutaline used for?

Oral treatment of bronchospasms
RAO/heaves in horses

77

What are the side effects of terbutaline?

Tremors + Tachycardia + Headache

78

What is albuterol used for?

Rapid bronchodilation

79

What is clenbuterol used for?

RAO in horses
Uterine relaxation in cattle

80

What are the affects of NE administration on the cardiovascular system?

Increase BP (PP unchanged)
Decreased BF to kidneys + spleen + liver
HR increases but then decreases
Increased peripheral resistance

81

When is NE used clinically?

Hypotensive crisis

82

What happens if NE + atropine given together?

Vagal reflex blocked = Increased HR

83

What is a really bad side effect of NE adminstration?

Necrosis if gets into area with poor circulation

84

What happens with a low dose of EPI?

B2 mostly stimulated
Vasodilation = Decrease Diastolic
MAP same

85

What happens with high dose of EPI?

Alpha activated as well
Vasocontriction
BP increases

86

What are the four big reasons for epinephrine use?

Vasoconstriction
Anaphylactic shock
Cardiac arrest + complete heart block
Bronchodilation

87

What are the side effects of EPI administration?

Throbbing headache
Palpitations + angina
Restlessness + tremors

88

What is dopamine used for clinically?

Treat cardiogenic shock
Increase BF + CO w/o vasoconstriction

89

Why does a High dose of Dopamine increase heart rate?

NE is made from this

90

What occurs with amphetamine administration?

NE + DA release
DA = indirect

91

What symptoms are seen with amphetamine adminstration?

Tremor + Tachycardia + Hypertension
Agitation + Insomina + increase motor activity

92

What is horner's syndrome?

SNS denervation to one eye

93

What occurs with Horner's syndrome?

Miosis

94

With Horner's syndrome what is the response to a indirect agonist?

No change

95

With Horner's syndrome what is the response to a direct agonist?

Increased response

96

How does Tyramine work, in a general sense?

Indirectly

97

What does tyramine do?

Gets into vesicles and displaces NE

98

What is a major symptom with tyramine?

Tachyphylaxis w/ repeated application
Severe hypertension

99

When does someone come into contact with tyramine?

Found in food
Normally broken down by MAO's in GI, unless patient is on MAO inhibitor