Shared Flashcard Set

Details

Pharm-Adrenomimetics
as
38
Pharmacology
Professional
02/17/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
epinephrine
Definition
-direct acting adrenomimetic
-low oral bioavailability and short half life
-EPi can be used for hemorrhage from minor cuts by binding to alpha 1
-Epi used for combination with local anesthetics
-used for AV block; V-fib
Term
Dipivefrin
Definition
direct acting adrenomimetic
prodrug converted into epinephrine
topical, ophthalmic agent
Term
dopamine
Definition
direct acting adrenomimetic
activates dopamine, B1, alpha receptors

use in distributive shock
Term
phenylephrine
Definition
alpha one selective agonist
direct acting adrenomimetic

nasal decongestant
short duration of action

used for PSVT (paroxysmal supraventricular tachycardia)
-used for dilation pupil without cycloplegia (paralysis ciliary m.)
Term
xylometazoline
Definition
alpha one selective agonist
direct acting adrenomimetic

nasal decongestant
long duration of action
Term
oxymetazoline
Definition
alpha one selective agonist
direct acting adrenomimetic

nasal decongestant
long duration of action
Term
midodrine
Definition
alpha one selective agonist
direct acting adrenomimetic
Term
brimonidine
Definition
alpha two selective agonist
direct acting adrenomimetic
topical-eye
Term
apraclonidine
Definition
alpha two selective agonist
direct acting adrenomimetic
topical-eye
Term
isoproterenol
Definition
non-selective beta agonist

Better than dobutamine for decreasing PVR
used for AV block
Term
dobutamine
Definition
B1 agonist; can also activate B2 to a lesser degree

used in cardiogenic shock
Term
which drug will have a greater effect on lowering PVR (isoproterenol or dobutamine)?
Definition
isoproternol; more activity on B2 receptors-->vasodilation
Term
MOA of direct acting adrenomimetics?
Definition
directly activate adrenergic receptors
Term
what would be the advantage of vasoconstricting blood vessels in the area where a local anesthetic is applied?
Definition
to keep anesthetic local
Term
what's the problem with chronic use of alpha agonists?
Definition
rebound nasal congestion

chronic activation of alpha1 receptor on the nasal mucosa causes down regulation of the receptor; when the drug is stopped, there is insufficient endogenous NE to activate the few receptors that remain; this causes rebound nasal congestion
Term
what's effect of Epi on angioedema (swelling in SubQ tissue cuases non-piting edema)

anaphylaxis
Definition
alpha1-constricts capillary beds; counteracts the dilation and increased vascular permeability of capillaries
Term
what's epi effect on bronchoconstriction (in relation to anaphylaxis)?
Definition
Beta2-bronchodilation
Term
what's epi effect on pruritis, urticaria (from anaphylaxis)?
Definition
beta-suppress release of mediators from mast cells
Term
what's epi effect on hypotension (from anaphylaxis)?
Definition
alpha1, beta1-raise BP
Term
Why is NE not the drug of choice for anaphylaxis?
Definition
little effect on bronchoconstriction

NE doesn't bind to Beta2 very well
Term
why does standing on your head cardiovert SVT?
Definition
increases vagal outflow and slows down AV nod to break the circle to get normal sinus rhythm
Term
PSVT treatment with alpha1 agonist summary
Definition
main form PSVT is AV nodeal reentry; blocking or slowingdown the AV node will stop this arrhythmia; PE will cause vasoconstriction and increase bp, which is sensed by the baroreceptors, which increase PS activity to the heart; activation of M recpetors on the AV node, slows the AV node, thereby stopping the arrhythmia; this effect (increasing PS stimulation to the heart and stopping PSVT) can be mimicked by vagal maneuvers
Term
what's the problem with using PE (phenylephrine)to treat PSVT?
Definition
SIDE EFFECTS
Term
norepinephrine
Definition
-direct acting adrenomimetic
-low oral bioavailability and short half life
-NE used for hypovolemic and distributive (e.g. septic) shock
Term
albuterol
Definition
direct activating adrenomimetic
Beta2 selective agonist
-used for asthma/COPD
-short duration of action
Term
terbutaline
Definition
direct activating adrenomimetic
Beta2 selective agonist
-used for asthma/COPD
-used for premature labor (activates uterine smooth muscle relaxtion and stops uterine contractions)

don't use:
-parenteral form for prevention of preterm labor or treatment of preterm labor beyond 48-72 hour
-oral form for preterm labor
-short duration of action
MI, arrhythmia, tachcardia/death
Term
salmeterol
Definition
direct activating adrenomimetic
Beta2 selective agonist
-used for asthma/COPD
-long duration of action
Term
formoterol
Definition
Beta2 selective agonist
-used for asthma/COPD
-long duration of action
Term
what's the advantage of giving albuterol vs. epi/isoproterenol to treat asthma?
Definition
less B1 side effects
Term
what are the contraindications for direct acting adrenomimetics?
Definition
CV disease, hyperthyroidism, diabetes
Term
what's the MOA for diret acting adrenomimetics?
Definition
directly activate adrenergic receptors
Term
Tyramine
Definition
indirect acting adrenomimetics
-NOT A DRUG
-comes from gut bacteria and fermented food
metabolized by MAO
-promotes release of NE from sympathetic nerve terminal
Term
what happens if pereson is takin a drug that inhibits the activity of MAO ahd eats a lot of cheese and drinks a lot of beer?
Definition
BP increases and go into hypertensive crisis
Term
Ephedrine
Definition
mixed acting adrenomimetic

-releases NE from nerve terminal
-activates alpha and beta receptors
-crosses BBB

-used fpr asthma, COPD, nasal congestion
-adverse effects: excessive simtulation B1 results in stroke, MI, sudden death; CNS-insomnia, nervousness, anxiety
Term
what classes of drugs are used for nasal congestion?
Definition
alpha agonists; ephedrine (mixed acting adrenomimetic)
Term
ephedrine seldom used to treat asthma; why?
Definition
side effects and development of B2 agonists
Term
FDA ban on ephedrine alkaloids doesn't contain?
Definition
OTC or prescriptoin drugs that contain ephedrine alkaloids or synthetic ephedrine (mild asthma, nasal decongestant)
-doesn't include use ephedra in traditional asian medicine
Term
Psuedoephedrine
Definition
mixed acting adrenomimetics
-directly activates alpha and to lesser extent B
-release NE from nerve terminal
-less CNS effectts than ephedrine
-used as nasal decongestant
Supporting users have an ad free experience!