Pharm: Adrenergics Flashcards Preview

Step 1 > Pharm: Adrenergics > Flashcards

Flashcards in Pharm: Adrenergics Deck (17):
1

Epinephrine

Mechanism: alpha1 agonism (vasoconstriction) at high doses, beta1 agonism (increased HR and contractility) at low doses, beta2 agonism (bronchodilation, mild decrease in BP)
Use: cardiac arrest, severe HTN, bronchospasm in asthma and anaphylaxis
SE: HTN, arrhythmia, MI, pulmonary edema, headache, anxiety

2

Norepinephrine

Mechanism: alpha1 agonism (vasoconstriction), beta1 agonism (increased contractility)
Use: increases BP in treatment of severe hypotension and shock
SE: angina, MI, arrhythmia, decrease RPF

3

Dopamine

Mechanism: alpha1 agonism (vasoconstriction) at high doses, beta agonism (increased HR and contractility) and D1 (increased renal perfusion) agonism at low doses
Use: increases BP in treatment of severe hypotension and shock
SE: angina, arrhythmia, HTN, nausea

4

Dobutamine

Mechanism: beta1 agonism > increases HR and contractility > increases CO; alpha1 and beta2 effects are weak and produce mild vasodilation
Use: cardiogenic shock (pressor), cardiac stress testing
SE: arrhythmia, angina, hypotension, headache

5

Ephedrine, pseudoephedrine

Mechanism: stimulates release of NE and epinephrine > increases BP, increases CO, induces bronchodilation, stimulates CNS (amphetamine effects)
Use: nasal decongestant
SE: HTN, tremor, anxiety, arrhythmia

6

Cocaine

Mechanism: blocks Na/K ATPase, blocks presynaptic monoamine reuptake pumps (like DAT1) responsible for reuptake of NE, serotonin, and dopamine, thereby potentiating their effects
Use: local anesthesia
SE: HTN, paranoia, seizures, cardiac ischemia and infarction, arrythmia, addiction

7

Phenylephrine

Mechanism: alpha1 agonism > vasoconstriction (decreased mucosal secretions) and pupil dilation
Use: severe hypotension and shock, nasal congestion, mydriasis in eye exam
SE: arrhythmia, headache

8

Clonidine

Mechanism: alpha2 agonism in the vasomotor centers of the medulla > decreased release of NE and other NTs > decreased central adrenergic activity > decreased vasoconstriction, HR, CO
Use: HTN; useful in pts with renal disease because it does not decrease RPF
SE: rebound HTN, bradycardia, sedation

9

Isoproterenol

Mechanism: beta1 and beta2 agonism > increases HR and contractility, causes vasodilation and bronchodilation
Use: torsades de pointes (co-administer Mg), cardiac arrest, heart block
SE: tachyarrhythmias, anxiety, pulmonary edema

10

Albuterol, pirbuterol, bitolterol

Mechanism: beta2 agonism > bronchodilation; can also cause intracellular movement of K
Use: asthma, hyperkalemia (in high doses)
SE: tachycardia, tremor, aniety

11

Metoprolol, atenolol, esmolol, acebutolol

Mechanism: selective beta1 antagonism > decreases HR and contractility; minimal beta2 antagonism
Use: HTN, tachycardia, CAD
SE: mild bronchoconstriction (avoid in asthmatics), bradycardia, impotence, hypotension

12

Carvedilol, labetalol

Mechanism: alpha1 receptor blocker + beta blocker > decreases HR and contractility, vasodilation, bronchoconstriction
Use: CHF, HTN
SE: dizziness, hypotension, bradycardia

13

Propanolol, nadolol, pindolol, timolol

Mechanism: nonselective beta antagonism > decreased HR and contractility, decreased BP, bronchoconstriction
Use: HTN, CAD, hyperthyroidism-induced tachycardia, chronic migraines
SE: bronchoconstriction, arrhythmia, impotence, fasting hypoglycemia, hypotension

14

Prazosin, terazosin, doxazosin, tamsulosin, alfuzosin

Mechanism: selective alpha1 antagonist > vasodilation and decreased BP; decreases prostatic neck contraction to improve urinary flow
Use: HTN, BPH
SE: first-dose syncope, orthostatic hypotension, dizziness, nasal congestion

15

Phenoxybenzamine

Mechanism: irreversible alpha antagonist > decreases BP
Use: pheochromocytoma (esp. prior to surgical resection)
SE: orthostatic hypotension, tachycardia, nasal congestion

16

Methyldopa

Mechanism: alpha2 agonist that acts in the vasomotor centers of the medulla > decreases release of NE and other NTs > decreases vasoconstriction
Use: moderate HTN; useful in pts with renal disease because it does not decrease RPF
SE: sedation, dizziness, positive Coombs test, orthostatic hypotension

17

Terbutaline, ritodrine

Mechanism: beta2 agonist > relaxation of smooth muscle in lungs (bronchodilation) and uterus (reduces contractions)
Use: delay preterm labor, status asthmaticus
SE: dizziness, tachycardia, anxiety, chest pain, tremor