Sympathomimetics Flashcards Preview

PLE Reviewer - PHARMACOLOGY > Sympathomimetics > Flashcards

Flashcards in Sympathomimetics Deck (14):
1

Class: non-selective, direct-acting

MOA: activates alpha and beta adrenergic receptors
a1 - vasoconstriction, increases BP
b1 - increases HR, conduction/contractility
b2 - bronchodilation

Uses: cardiac arrest, DRUG OF CHOICE for anaphylaxis, asthma, COPD, hemostasis

SE: hypertension, tachycardia, ischemia, hyperglycemia

EPINEPHRINE

2

Class: non-selective, direct-acting

MOA: activates alpha and beta adrenergic receptors
a1 - vasoconstriction, increases BP
b1 - increases HR, conduction/contractility
b2 - bronchodilation

Uses: neurogenic shock, cardiogenic shock (last resort)

SE: extreme vasospasm, tissue necrosis, excessive BP increase, arrhythmias, infarction, reflex bradycardia; compensatory vagal reflexes tend to overcome the direct positive chronotropic effects; alpha > beta activity

NOREPINEPHRINE

3

Class: non-selective, direct-acting

MOA: activates alpha, beta, and D1 adrenergic receptors
a1 - vasoconstriction, increases BP (high-dose)
b1 - increases HR, conduction/contractility (medium-dose)
d1 - vasodilation in splanchnic and renal vessels (low-dose)

Uses: cardiogenic shock, HF

SE: cardiovascular disturbance, arrhythmias

DOPAMINE

4

Class: non-selective

MOA: activates beta adrenergic receptors
b1 - increases HR, conduction/contractility
b2 - bronchodilation

Uses: asthma

SE: cardiovascular disturbance, arrhythmias

ISOPROTERENOL

5

Class: alpha-1-selective

MOA: activates alpha-1 adrenergic receptors
a1 - vasoconstriction, increases BP

Uses: nasal decongestant, mydriatic, drug-induced hypotension, orthostatic hypotension, spinal shock

SE: rebound nasal congestrion, supine hypotension, stroke, myocardial infarction, piloerection, urinary retention; mydriasis without cyclopegia (OCULAR ADMINISTRATION)

Similar:
PSEUDOEPHEDRINE
OXYMETAZOLINE (nasal decongestant)
TETRAHYDROZOLINE
MIDODRINE
NAPHAZOLINE
XYLOMETAZOLINE

PHENYLEPHRINE

6

Class: alpha-2-selective

MOA: activates alpha-2 adrenergic receptors
a2 - decreases central sympathetic outflow

Uses: hypertension, cancer pain, opioid withdrawal

SE: sedation, rebound hypertension (treated by PHENTOLAMINE), dry mouth; taper use prior to discontinuation to avoid rebound hypertension

CLONIDINE

7

Class: alpha-2-selective

MOA: activates alpha-2 adrenergic receptors
a2 - decreases central sympathetic outflow

Uses: antihypertensive rescue drug for pregnant women, pre-eclampsia, GHTN

SE: sedation, hemolytic anemia (positive-Coomb's test i idiosyncratic reaction)

Similar:
GUANFACINE
GUANABENZ
DEXMEDETOMIDINE (sedative)
TIZNIDINE (muscle relaxant)

METHYLDOPA

8

Class: alpha-2-selective

MOA: activates alpha-2 adrenergic receptors
a2 - decreases secretion of aqueous humor

Uses: gluacoma

SE: BOV, dry mouth, hyperemia, pruritis, eye discomfort

Similar:
BRIMONIDINE

APRACLONIDINE

9

Class: beta-1-selective

MOA: activates beta-1 adrenergic receptors
b1 - increases HR and contractility

Uses: acute HF, cardiogenic shock

SE: tachycardia, arrhythmias, tachyphylaxis (quick tolerance reaction); cardiac stress testing

DOBUTAMINE

10

Class: beta-2-selective

MOA: activates beta-2 adrenergic receptors (increases cAMP in lungs)
b2 - bronchodilation

Uses: DRUG OF CHOICE for acute asthma attack

SE: tachycardia, arrhythmias (in patients with concurrent COPD and heart disease or when used excessively), nervousness, restlessness, loss of responsiveness

Similar:
TERBUTALINE - preterm labor tocolysis
RITODRINE - preterm labor tocolysis

ALBUTEROL / SALBUTAMOL

11

Sympathomimetic of choice in ACUTE HF or SEPTIC SHOCK (desired INCREASE CARDIAC OUTPUT)

beta-1 & D1 agonist

12

Sympathomimetic of choice in HEMOSTASIS, DECONGESTION, and SPINAL SHOCK (desired VASOCONSTRICTION, temporary MAINTENANCE OF BP)

alpha-1 agonist

13

Sympathomimetic of choice in BRONCHOSPASM, PREMATURE LABOR (desired BRONCHODILATION, UTERINE SMOOTH MUSCLE RELAXATION)

beta-2 agonist

14

Sympathomimetic of choice in HYPERTENSION, GLAUCOMA (desired DECREASE in BP)

alpha-2 agonist