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Flashcards in SNS drugs Deck (34):
1

where are andrenergic receptors found

1. CNS and SNS
2. presynaptically on neuron or post-synaptically on effector organ

2

where do catecholamines come from

synthesized from tyrosine in sympathetic nerve endings

3

what are drugs that turn on SNS

1. sympathicomimetics
2. a or B angonists

4

what are drugs that turn off SNS

1. sympatholytics
2. a or B blockers

5

what are receptor types for each SNSr

a1 - Gq and i/o
a2 - Gi/o
B - Gs

6

tissues for a1

1. vascular smooth muscle
2. GU and GI smooth muscle
3. heart
4. liver

7

tissues for a2

1. pancreatic B cells
2. platelets
3. nerve
4. vascular smooth muscles

8

actions of a1 agonists

1. vasoconstriction
2. increased vascular resistance
3. enlarged pupils
4. sphincter closure

9

actions of a2 agonists

inhibit cAMP
- inhibits Ca channels , NE release, Ach release, insulin release

10

tissues for B1

1. heart
2. juxtaglomerular cells

11

tissues for B2

1. bronchi
2. skeletal muscle
3. liver

12

tissues for B3

1. adipose

13

actions of B1 agonists

Gs > cAMP> opening of Ca channel - contractions
1. tachycardia
2. myocardial contraction
3. lipolysis
4. renin release

14

actions of B2 agonists

Gs > cAMP > PKA phosphoylate MLCK > inactive > relax
1. vasodilation
2. decrease peripheral resistance
3. bronchodilation
4. glycogenolysis
5. release of glucagon

15

3 potential actions of sympathomimetics

1. direct action - stim G receptor
2. indirect - affect synthesis, storage, release of actitivy
3. mixed

16

what are direct acting sympathomimetics (2)

catechoamines
1. rapid onset
2. breif action
3. paraenterally
non - catecholamines

17

5 important catecholamines

1. NE
2. E
3. dopa
4. isoproterenol
5. dobutamine

18

where does NE act and what does it do (2)

1. a>B1>>B2,3
2. increase MAP and PVR
3. increase HR but reflex bradycardia

19

where does E act and what does it do (2)

1. low dose mostly B and high dose mostly a
2. increase inotropy and chronotropy (B1), bronchodilates (B2), hyperglycemia, drops peripheral resistance (B2)

20

what does dopamine do

1. vasodilates peripheral renal, mesenteric, coronary vascular beds via D1
2. inhibs NE release
3. at high does B1 effects the biggest
4. at higher dose a1 is most - good for treatment of shock

21

what are a1 agonists (phenyephrine) used for

treatment of shock, nasal decongestants

22

what are a2 agonists (clonadine) used for

hypertension by acting on CNS to inhibit sympathetic output
1. CNS - inhibits excitatory outflow
2. peripheral - inhibits release of catecholamines

23

what are B1 agonists (dobutamine) used for

increase cardiac output - ionotropic effects more significant

24

what are B2 agonists (salbutamol) used for

aerosols for bronchodilation

25

what is a non-seletive B agonist

isoproterenol
- most prominent effects are B, but rarely used because of lack of selectivity

26

what does and indirect andrenergic agonist (amphetamine) do

reverses the vesicular monoamine transporter > more NE and dopa
- vasoconstriction, MAP, ionotropy
- wakefulness, euphoria, anxiety, hypertension

27

what are mixed sympathomimetics

ephedrine and pseudoephedrine
- increase release of NE and stim a1, B1, B2

28

2 classes of sympatholytics and examples

1. direct - a and B blockers
2. indirect - decrease release, change storage, decrease synthesis

29

2 types of a blockers

1. reversible - can be displaced by agonists - phenotolamine, prazolin
2. irreversible - covalent bond - phenoxybenzamine

30

what do non-selective a blockers do

- both a1 and a2
- lower PVR and reflex tachycardia
- more profound effects when standing
- more NE released because of a2 blockade

31

what do a1 selective blockers do

- good for hypertension
- lower PVR
- fewer adverse effects
- lower lipid levels
- ___-zosins

32

what do a1A selective blockers do

- tamulosin
- treatment of BPH by causing vasodilation of the prostate vascular smooth muscle

33

what are effects of non-selective B-blockers (propranolol)

- lower ionotropy, chronotropy, CO, SA and AV activity
- brochoconstrict problematically

34

what are B1 blockers good for

avoid bronchoconstriction
- metoprolol, atenolol, bisprolol

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