Term
| Intra-synaptic Adrenergic Receptors in Sympathetic Pathway |
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Definition
| alpha-1 or beta-1 receptors |
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Term
| Extra-synaptic Adrenergic Receptors in Sympathetic Pathway (usually found on end organs, obtained by systemic circulation) |
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Definition
| alpha-2 or beta-2 receptors |
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Term
| Adrenal Medulla & Pheochromocytoma cells |
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Definition
| places of NE & Epi production |
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Term
| Adrenergic Post-ganglionic Synapse Reuptake Pump |
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Definition
| removes both normally-released NE and circulating NE & Epi from synaptic cleft, requiring very high levels of each to stimulate alpha-1 & beta-1 receptors |
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Term
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Definition
| enzyme that inactivates NE & Epi, resulting in deaminated metabolites |
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Term
| Monoamine Oxidase Inhibitors (MAOIs) |
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Definition
| persons taking this type of drug will likely experience more intense effects of many sympathomimetic drugs which are otherwise inactivated by this enzyme |
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Term
| General Effect of Alpha-Adrenergic Receptors on Smooth Muscle Sites |
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Definition
| constriction of smooth muscle |
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Term
| General Effect of Beta-Adrenergic Receptors on Smooth Muscle Sites |
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Definition
| dilation or relaxation of smooth muscle |
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Term
| General Effect of Beta-Adrenergic Receptors on Production Sites |
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Definition
| production sites are stimulated, creating a response |
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Term
| Overall normal resting level of sympathetic nerve activity (SNA) |
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Definition
| activity level at 10-20% of maximum |
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Term
| Reason for raised resting level of SNA |
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Definition
| maintains certain critical body functions at optimum levels (i.e. BP & temp.); ALSO, level of activity can be rapidly adjusted up or down by centers in the brain, attempting to hold important bodily functions constant |
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Term
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Definition
| receptors in walls of carotid arteries & aortic arch that sense small, but significant changes in BP |
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Term
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Definition
| receptors in brain & skin that tell the brain to redistribute SNA going to vessels near the surface of the body & to vessels in the inner core in an attempt to shift blood one way or the other to regulate body temperature |
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Term
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Definition
| a condition that causes some areas of your body — such as your fingers, toes, tip of your nose and your ears — to feel numb and cool in response to cold temperatures or stress; the arteries that supply blood to your skin narrow, limiting blood circulation to affected areas |
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Term
| Epinephrine (Adrenalin, EpiPen, Primatene Mist) |
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Definition
| direct-acting sympathomimetic mixed agonist that stimulates all alpha & beta-receptors alike; treats circulatory shock, anaphylactic shock, bronchoconstriction & bronchospasm, cardiac arrest, bradycardia due to A-V block, mixed with local anesthetics to prolong local anesthesia (alpha-receptors) |
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Term
| Low IV rates of Epi cause |
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Definition
| drug (& amount) that causes a decrease in diastolic BP; increases systolic & pulse pressure; increases heart rate |
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Term
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Definition
| drug (& amount) that increases diastolic, mean, and systolic pressures |
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Term
| Norepinephrine (Levophed) |
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Definition
| direct-acting sympathomimetic mixed agonist that acts on alphas & beta-1 receptors much more than beta-2s; used in neurogenic & septic shock; supports BP during spinal anesthesia |
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Term
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Definition
| drug (& amount) that increases systolic, diastolic, & mean BPs |
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Term
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Definition
| drug (& amount) that increases all systolic, diastolic, & mean BPs |
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Term
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Definition
| direct-acting sympathomimetic mixed agonist that acts mainly on beta receptors; bronchodilator for asthma; treats A-V blocks along with bradyarrhythmias; used to assist in tilt-table tests for diagnosis of unexplained syncopes |
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Term
| Low & High IV Rates of Isoproterenol |
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Definition
| drug (& amount) that decreases diastolic & mean BPs while increasing pulse pressure and heart rate |
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Term
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Definition
| drug (& amount) that stimulates D receptors in GI & renal arterial smooth muscle, selectively increasing blood flow to GI & kidney |
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Term
| Intermediate Dose of Dopamine |
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Definition
| drug (& amount)that stimulates D receptors & beta-1 receptors, increasing blood flow to GI & kidney and also stimulating cardiac contractility & rate due to stimulation of cardiac beta-1 receptors |
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Term
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Definition
| drug (& amount of) stimulates D receptors in GI & kidney arterial smooth muscle, beta-1 receptors at cardiac & arterial smooth muscle cells, as well as alpha-1 receptors; alpha-1 stimulation blunts effects of lower concentrations of drug in GI & kidney and together, with stimulation of all other vascular alpha-1s, raises substantially mean arterial BP du to overall increase in total peripheral vascular resistance |
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Term
| Therapeutic Uses for Dopamine (DA, Intropin) |
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Definition
| drug used to treat cardiogenic (beta-1) shock, neurogenic (alpha-1) shock, and septic shock (beta-1, alpha-1s); treat patients with congestive heart failure who may be refractory to other therapy; treats bradycardia in non-cardiac arrest patients who are unresponsive to other treatments |
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Term
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Definition
| selective beta-1 agonist that is a mix of 2 stereoisomers; one is an alpha-1 agonist and the other a potent beta-1 agonist plus alpha-1 antagonist; net effect is a fairly selective beta-1 stimulator that increases cardiac contractility & thus increases cardiac output & pulse pressure but does not incrase diastolic or mean BP |
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Term
| Therapeutic Uses of dobutamine (Dobutrex) |
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Definition
| drug used to treat CHF & certain forms of shock (cardiogenic); sometimes used to stimulate heart during emergence from surgery |
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Term
| albuterol (Proventil), metaproterenol (Alupent), pirbuterol (Maxair), salmeterol (Serevent), terbutaline |
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Definition
| drugs that are selective beta-2 agonists with some beta-1 agonist activity; bronchodilators used as "rescue" inhalers in treatment of COPD and asthmatics and prevention of exercise-induced bronchospasms |
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Term
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Definition
| selective beta-2 agonist that is used as a bronchodilator; has the longest duration of action |
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Term
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Definition
| selective beta-2 agonist that is used as a bronchodilator; also used to manage premature labor by causing beta-2-mediated uterine relaxation |
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Term
| phenylephrine (Neo-Synephrine) |
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Definition
| drug that is a selective vascular alpha-1 agonist; when given IV, raises diastolic & mean BP but with more reflex bradycardia than NE; when used IV, used to maintain diastolic & mean BP during spinal & other anesthesia, also rarely used to treat paroxysmal supraventricular tachycardia; used topically to treat hemorrhoids; used to treat nasal congestion; a mydriatic agent (dilates pupil at dilator muscle); poor oral absorption |
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Term
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Definition
| a selective alpha-1 agonist prodrug with better oral absorption than sister drug; treats orthostatic hypotensive symptoms; being investigated for possible treatment of urinary incontinence (alpha-1 receptors on urinary sphincters, constricts sphincters keeping urine in bladder) |
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Term
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Definition
| indirect-acting sympathomimetic that inhibits NE reuptake at sympathetic nerve terminals, leaving NE available to postsynaptic receptors; a good local anesthetic that can exert its own vasoconstriction effects at site of local injection; rarely still used for pain relief & reducing epistaxis while doing intubation of trachea; topical anesthetic for mucous membranes; good absorption through nasal mucosa; very poor oral absorption due to 100% first-pass effect |
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Term
| psuedoephedrine (Sudafed) |
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Definition
| indirect acting sympathomimetic durg that stimulates release of NE from sympathetic nerve endings independent of nerve action potentials but also stimulates adrenergic receptors directly; used to treat nasal & bronchial congestion, promotes nasal & sinus drainage |
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Term
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Definition
| preferred form of taking selective alpha-1 & beta-2 direct-acting agonists & indirect-acting drugs except for cocaine; readily absorbed and has a duration of action of several hours |
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Term
| Parenteral Administration |
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Definition
| preferred form of giving cocaine & other direct-acting agonists (Epi, NE, isoproterenol, DA, dobutamine) but their actions only last a few minutes due to rapid inactivating mechanisms |
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Term
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Definition
| significant problem that occurs during long-term adminstration of any sympathomimetic drug; adrenergic receptors able to down-regulate when exposed too long to too much agonist concentration |
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Term
| "Extensions of Therapeutic Effects" |
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Definition
| side effects of sympathomimetics that involve too much stimulation of the same type of receptors intended to mediate all or part of therapeutic effect: 1) treating cardiac contractility after an acute MI may lead to more O2 deficit, tachycardia, and/or arrhythmia; 2) prevention of hypotension during surgery & ending up with severe hypertension; 3) local dermal tissue necrosis when IV alpha-agonist for systemic therapy accidentally ends up in surrounding superficial tissue |
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Term
| "Lack of Sufficient Receptor Selectivity" |
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Definition
| side effects of sympathomimetics that involves stimulation of receptors other than those that mediate therapeutic effect: 1) attempting to prevent premature labor & ending up with a tachycardia in both mother & fetus; 2) inhaling albuterol and ending up with marked tachyarrhythmias; 3) giving DA to increase renal blood flow & decreasing it instead |
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