Term
| What is the action of EPI when given as a bolus? |
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Definition
| alphas are activated and you have an increased blood pressure with reflexive bradycardia. This is similar to NE given either bolus or infusion |
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Term
| Name the mixed adrenergic agonists and what receptors they bind to? |
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Definition
| NE (alpha1, alpha 2, beta 1); EPI (alpha 1, alpha 2, beta1, beta2); DA (DA, beta1, alpha1) |
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Term
|
Definition
| when you need vascular vasoconstriction like in spinal shock/spinal block or as a topical hemostatic agent |
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Term
| What can you use EPI for? |
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Definition
| asthma, cardiogenic shock, anaphylactic shock, prolong the action of local anesthetics, topical hemostatic agent |
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Term
| What would you use local anesthetic + EPI on a patient taking a beta blocker? |
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Definition
| EPI might diffuse into the vasculature and cause unopposed vasoconstriction |
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Term
| What is low dose dopamine used to treat? |
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Definition
|
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Term
| Name the alpha 1 agonists? |
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Definition
| phenylephrine, methoxamine, oxymetazoline, tetrahydrozoline, naphazoline, ephedrine/pseudoephedrine |
|
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Term
| What are teh clinical uses of alpha 1 agonists? |
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Definition
| nasal decongestants; used in eye drops to 'get the red out'; hypotensive states |
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Term
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Definition
| clonidine, guanabenz, guanfacine |
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Term
| Wha are alpha 2 agonists used for? |
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Definition
|
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Term
| What is Isoproterenol and what is it used for? |
|
Definition
| non selective beta1/beta2 agonist |
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|
Term
| Name a selective beta 1 agonist. |
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Definition
|
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Term
| What is dobutamine used for? |
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Definition
| used as an ionotropic agent; doesn't affect heart rate too much, just increases force of contraction which makes it useful for heart failure |
|
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Term
| Name the selective 2 beta agonists? |
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Definition
| albuterol, metaproterenol, terbutaline, isoetharine, bitolterol, ritodrine |
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Term
| What are the selective beta2 agonists used for? |
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Definition
albuterol, metaproterenol, isoetharine,terbutaline, bitolterol= COPD and Asthma (inhalers)
ritodrine= uterine relaxation |
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Term
| What effect does isoproterenol have on DP, SP, MAP, HR and TPR? |
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Definition
| increases HR, increases SP, decreases DP, decreases TPR. No big change in MAP |
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Term
| What receptors are activated at lower to higher doses of dopamine? |
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Definition
| lower= DA, medium= beta 1, higher= alpha 1 |
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|
Term
| By what mechanism does dopamine treat heart failure? |
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Definition
|
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Term
| Why do you not want to increase heart rate or TPR in heart failure pts? |
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Definition
| increase in TPR increases the work of the heart. Increases in heart rate could induce arrhythmias |
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|
Term
| What's another name for low dose dopamine? |
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Definition
|
|
Term
| Name a partial alpha 2 agonist? |
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Definition
|
|
Term
| How does methyldopa work? |
|
Definition
| converted into methylnorepinephrine which acts as a partial agonist at alpha 2 receptors |
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|
Term
| How do alpha 2 agonists decrease blood pressure? |
|
Definition
| works on autoreceptors, and activates alpha 2 receptors in the brain that inhibit downstream sympathetic response |
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|
Term
| Name non selective alpha 1/2 antagonists? |
|
Definition
| phenoxybenzamine, phentolamine, |
|
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Term
| Compare/contrast phenoxybenzamine and phentolamine. |
|
Definition
| phenoxybenzamine is irrefersible; phentolamine is reversible; both are antagonists at alpha 1 and alpha 2 receptors |
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|
Term
| What is phenoxybenzamine used for? |
|
Definition
|
|
Term
| What is phentolamine used for? |
|
Definition
| management of pheochromocytoma, reversal of action of local anesthetic |
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|
Term
| What are the selective alpha 1 receptor antagonists? |
|
Definition
|
|
Term
| What are selective alpha 1 antagonists used for? |
|
Definition
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Term
| Why are alpha1 antagonists preferable over alpha1/2 antagonists for treating blood pressure? |
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Definition
| allows body some control of vasoconstriciton, doesn't block autoreceptors, doesn't affect alpha 2 receptors in the brain |
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Term
| NE released from nerves acts on what lapha receptors? |
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Definition
|
|
Term
| Which alpha receptors does circulating EPI bind to? |
|
Definition
|
|
Term
| What are the nonselective beta 1, beta 2 receptor antagonists? |
|
Definition
| propranolol, nadolol, timolol, pindolol, carteolol. |
|
|
Term
| What are the beta 1 blockers? |
|
Definition
| atenolol, metropolol, esmolol, acebutolol |
|
|
Term
| What are "cardioselective" beta blockers? |
|
Definition
| those that only block beta 1s |
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|
Term
| Why is it better to block just beta 1s and leave beta 2s alone for people with HTN? |
|
Definition
| prevent precipitating an asthma attack |
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|
Term
| Name the non-selective beta 1, beta 2, alpha 1 antagonists? |
|
Definition
|
|
Term
| What are metropolol and carvedilol used for? |
|
Definition
| early stages of heart failure, possibly through a beta arrestin pathway |
|
|
Term
| What are beta blockers used for? |
|
Definition
| hypertension, angina, congestive heart failure, myocardial infarction, arrhythmias, anxiety, stage fright, migraines |
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|
Term
| How does EPI treat cardiogenic shock? |
|
Definition
| low dose infusion will activate beta 1s to increase contracility of the heart; low dose will also activate beta 2s which will decrease TPR |
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|
Term
| How does epinephrine treat anaphylactic shock? |
|
Definition
| sudden high dose EPI= 1) beta 1s- increase in CO, 2) alpha 1 and 2- vasoconstriction, 3) beta 2s bronchorelaxation |
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|
Term
| How does EPI treat neurogenic shock? |
|
Definition
| high doses activates alpha 1s increasing vascular tone |
|
|
Term
| name the indirect acting adrenergic agonists? |
|
Definition
| Tyramine, ephedrine, speudoephedrine and amphetamines |
|
|
Term
| What is the degredation pathway of NE? |
|
Definition
| reuptake 1 into the presyaptic axon terminal (there is also a reuptake 2 on the postsynaptic but its not as important) |
|
|
Term
| What compounds will reuptake 1 bind? |
|
Definition
| tyrosin, tyramine, amphetamines, ephedrine, pseudoephedrine, NE |
|
|
Term
| What's the difference between how amphetamines and cocaine work? |
|
Definition
amphetamine- taken up by reputake 1, put in vesicles with NE, triggers release of NE; at high concentrations can block reuptake 1; longer lasting than cocaine
cocaine- blocks reuptake 1 |
|
|
Term
|
Definition
| prevents uptake of dopamine into vesicles |
|
|
Term
| How does guanethadine work? |
|
Definition
|
|
Term
|
Definition
| pargyline, tranylcypromine |
|
|
Term
| Which tissues have only sympathetic control? |
|
Definition
| blood vessels, sweat glands (sympathetic cholinergic), adrenal glands, pilomotor muscles |
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|
Term
| Which tissues have only parasympathetic tone? |
|
Definition
|
|
Term
| What happens to NE taken up by reuptake 2? |
|
Definition
| it is degraded by COMT and MAO |
|
|
Term
|
Definition
| prevents conversion from tyrosine into DOPA |
|
|
Term
| What are the effects of stimulating adrenergic receptors on the eye? |
|
Definition
iris radial dilator muscle alpha 1= mydriasis
ciliary muscle beta 2 = accomodation for far vision |
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|
Term
| What adrenergic receptor is responsible for decreased urination and decreased GI motility? |
|
Definition
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