Sympathetic Depressants

Question 1

Non-selective α & β agonists:

Answer 1

Adrenalin
Dopamine
Ephedrine
Amphetamine

Question 2

α1 selective agonists:

Answer 2

Phenylephrine
Methoxamine
Mephenteramine
Metaraminol
Oxymetazoline
Xylometazoline

Question 3

α2 selective agonists:

Answer 3

Clonidine
Methyldopa
Guanfacine

Question 4

β1 agonists:

Answer 4

Dobutamine

Question 5

β2 agonists:

Answer 5

Salbutamol
Terbutaline
Salmeterol
Formoterol

Question 6

Non-selective α blockers:

Answer 6

Phenoxybenzamine
Phentolamine
Ergotamine

Question 7

α1 selective blockers:

Answer 7

Prazosin
Terazosin
Tamsulosin
Alfuzosin
Doxazosin

Question 8

α2 selective blockers:

Answer 8

Yohimbine

Question 9

Non-selective β blockers:

Answer 9

Propranolol
Pindolol
Timolol

Question 10

α & β blockers:

Answer 10

Labetalol

Carvedilol

Question 11

β1 blockers:

Answer 11

Atenolol
Metoprolol
Esmolol

Question 12

Adrenergic neuron blockers:

Answer 12

Reserpine
Guanethidine
Methyldopa
Bethanidine

Question 13

Ganglionic blockers:

Answer 13

Trimetaphan

Mecamylamine

Question 14

Side effects associated with interference in sympathetic neuron function:

Answer 14

Postural hypotension (GGb)
Sedation or depression
Increase GI motility and diarrhea
Sexual dysfunction
Increase blood volume and Na retention
Nasal stuffiness
Extrapyramidal syndrome

Question 15

α2 agonists have an ___ effect on sympathetic discharge from the ___ in the brainstem:

Answer 15

inhibitory; VMC

Question 16

Adverse effects of α2 agonists:

Answer 16

Drowsiness or sedation
Dry mouth (xerostomia)
Decrease in BP
Bradycardia
Rebound hypertension (acute withdrawal)

Question 17

When given ___, postsynaptic α2 receptors result in a transient ___:

Answer 17

parenterally; rise in BP

Question 18

These drugs block the antihypertensive effect of clonidine:

Answer 18

Tri-cyclic antidepressants

Question 19

Guanfacine has ___ effects similar to Clonidine but is slower to enter the __:

Answer 19

hemodynamic; CNS

Question 20

α2 agonists undergoing extensive 1st pass metabolism:

Answer 20

Methyldopa

Guanabenz

Question 21

α2 agonist which gives a (+) Coombs test:

Answer 21

Methyldopa

Question 22

α2 agonist that may activate imidazoline receptors:

Answer 22

Clonidine

Question 23

Therapeutic uses of clonidine:

Answer 23

HTN
Reduce diarrhea in diabetics
Treatment for withdrawal
Menopausal hot flashes
Diagnosis of pheochromocytoma

Question 24

Usual half-life of α2 agonists:

Answer 24

6-24 hours

Question 25

Advantages of Guanfacine over Clonidine

Answer 25

More selective for α2 receptors Adverse effects milder Withdrawal symptom milder

Question 26

These drugs should never be given alone when treating α2 agonist withdrawal:

Answer 26

β-blockers

Question 27

Used in the treatment of ADHD in children 16-17:

Answer 27

Guanfacine

Question 28

Drugs causing extrapyramidal symptoms:

Answer 28

Methyldopa | Reserpine

Question 29

α2 agonist used for ocular hypertension and open-angle glaucoma:

Answer 29

Apraclonidine | Brimonidine

Question 30

Glaucoma therapy drug the crosses the BBB and is more selective for α2:

Answer 30

Brimonidine

Question 31

Blockade of presynaptic α2 receptors leads to enhanced release of ___ and stimulation of ___ receptors and ____:

Answer 31

norepinephrine; postsynaptic β1; JG cells

Question 32

Blockade of α1 receptors inhibits vasoconstriction, leading to:

Answer 32

``` Decreased blood pressure (orthostatic hypertension) Fluid retention (RAA activation) ```

Question 33

Therapeutic uses of phenoxybenzamine:

Answer 33

``` Pheochromocytoma Reverse local anesthesia Prevent dermal necrosis Treat rebound hypertension Sexual dysfunction Peripheral vascular disease ```

Question 34

Phenoxybenzamine generally has a ___ onset and ___ duration:

Answer 34

slow (1 hr); long (12-14 hrs)

Question 35

Phenoxybenzamine exhibits a 100:1 selectivity for __ receptors vs. __ receptors:

Answer 35

α1; α2 SNS excitation and increased motor activity)

Question 36

CNS effects of phenoxybenzamine depend on:

Answer 36

``` Slow IV administration (sedation, fatigue, nausea) Rapid IV (SNS excitation and increased motor activity) ```

Question 37

α1a (uroselective) blockers:

Answer 37

Tamsulosin Silodosin Afluzosin

Question 38

Nonselective α1 blockers are more prone to:

Answer 38

1st dose effect

Question 39

Phentolamine has a ___ onset and ___ duration:

Answer 39

rapid (1 hr); short

Question 40

Contraindications of phentolamine:

Answer 40

Coronary Artery Disease | History of peptic ulcer

Question 41

Other receptors stimulated by phentolamine:

Answer 41

Muscarinic, H1, H2 (increased gastric acid secretion)

Question 42

Phenoxybenzamine and Phentolamine are both used to treat:

Answer 42

Pheochromocytoma

Question 43

Blockade of __ receptors are responsible for reflex tachycardia:

Answer 43

α2

Question 44

Therapeutic uses of Prazosin:

Answer 44

Mild to moderate HTN Congestive heart failure Impaired bladder emptying

Question 45

α1 blockers from longest to shortest half-life:

Answer 45

Terazosin (12) > Tamsulosin > Alfuzosin > Prazosin (2-3)

Question 46

α1a selection blockers exhibit no ___ and are metabolized by ___:

Answer 46

1st dose effect; CYP450

Question 47

α1 blockers with apoptotic effects on prostrate smooth muscle:

Answer 47

Terazosin | Doxazosin

Question 48

Ergot preparation with greatest α blocking property:

Answer 48

Ergotoxine

Question 49

Ergot preparation with highest selectivity for dopamine receptors

Answer 49

Cabergoline Pergolide Bromocriptine (suppress prolactin)

Question 50

Ergot preparations with agonist effects at α receptors:

Answer 50

Ergotamine Ergonovine Methysergide

Question 51

Ergot derivatives with increased α blocking action:

Answer 51

Dihydro

Question 52

Ergot DOC in preventing postpartum bleeding:

Answer 52

Ergonovine

Question 53

Ergot alkaloids are combined with __ to facilitate absorption when used to treat ___:

Answer 53

Caffeine; migraines

Question 54

Ergot used for senile cerebral insufficiency:

Answer 54

Dihydroergotoxine

Question 55

Erogt used to treat parkinsonism:

Answer 55

Bromocriptine

Question 56

Depressants that will cause hypotension:

Answer 56

``` Ganglionic blockers Guanethidine Methyldopa Reserpine Clonidine Conventional α blockers ```