| Flap 1 |
Flap 2 |
| selectivity for Sympathomimetics - Phenylephrine |
α1 >α2 |
| selectivity for Sympathomimetics - Albuterol |
β2 >β1 |
| Mechanism/selectivity for Sympathomimetics - terbutaline |
β2 >β1 |
| name the Sympathomimetic - α1, α2, β1, β2, low doses selective for β1 |
Epinephrine |
| name the Sympathomimetic - α1, α2 >β1 |
NE |
| name the Sympathomimetic - β1 =β2 |
Isoproterenol |
| name the Sympathomimetic - β1 >β2 |
Dobutamine |
| name the Sympathomimetic - D1 = D2 >β >α |
Dopamine |
| name the Sympathomimetic - Indirect general agonist, releases stored catecholamines |
Amphetamine - and - Ephedrine |
| name the Sympathomimetic - α1 >α2 |
Phenylephrine |
| name the Sympathomimetic - β2 >β1 |
Albuterol, - terbutaline |
| name the Sympathomimetic - Indirect general agonist, uptake inhibitor |
Cocaine |
| name the Sympathomimetic - Centrally acting α-agonist, ↓ central adrenergic outflow |
Clonidine, α-methyldopa |
| effect on BP and HR of - Norepinephrine |
(α > β), ↑ BP, ↓ HR (reflex bradycardia) |
| effect on BP and HR of - Epinephrine |
nonselective - NC BP( increases systolic, but decreases diastolic) |
| effect on BP and HR of - Isoproterenol |
(β > α), ↓ BP, ↑ HR |
| Applications of Sympathomimetics - Epinephrine |
Anaphylaxis, glaucoma (open;angle), asthma, hypotension |
| Applications of Sympathomimetics - NE |
Hypotension (but ↓ renal ;perfusion) |
| Applications of Sympathomimetics - Isoproterenol |
AV block (rare) |
| Applications of Sympathomimetics - Dopamine |
Shock (↑ renal perfusion), heart failure |
| Applications of Sympathomimetics - Dobutamine |
Shock, heart failure cardiac ;stress testing |
| Applications of Sympathomimetics - Amphetamine |
Narcolepsy, obesity, ADHD |
| Applications of Sympathomimetics - Ephedrine |
Nasal decongestion, urinary incontinence, hypotension |
| Applications of Sympathomimetics - Phenylephrine |
Pupil dilator, vasoconstriction, nasal decongestion |
| Applications of Sympathomimetics - Albuterol, terbutaline |
Asthma |
| Applications of Sympathomimetics - Cocaine |
Causes vasoconstriction and ;local anesthesia |
| Applications of Sympathomimetics - Clonidine, α-methyldopa |
Hypertension, especially with;renal disease (no ↓ in blood ;flow to kidney) |
| name the Nonselective α-blockers |
Phenoxybenzamine - phentolamine |
| name the α1 selective α-blockers |
Prazosin, terazosin, doxazosin |
| name the α2 selective α-blockers |
Mirtazapine |
| Nonselective α-blockers - Application and Toxicity |
Pheochromocytoma - Orthostatic hypotension, reflex tachycardia |
| α1 selective α-blockers - Application and Toxicity |
Hypertension, urinary retention in BPH - -1st-dose orthostatic hypotension, dizziness, headache |
| α2 selective α-blockers - Application and Toxicity |
Depression - Sedation, ↑ serum cholesterol, ↑ appetite |
| Nonselective α-blockers - names and differences |
Phenoxybenzamine (irreversible) - phentolamine (reversible) |
| effects of an α-blocker (e.g., phentolamine) on BP responses to epinephrine and phenylephrine. |
The epinephrine response exhibits reversal of the mean blood pressure change, from a net increase (the α response) to a net decrease (the β2 response). The response to phenylephrine is suppressed but not reversed because phenylephrine is a “pure” α-agonis |
| β-blockers - non selective ones |
Nonselective (N or later)(β1 = β2)––propranolol, timolol, nadolol, pindolol (partial agonist), and - labetalol (partial agonist, and exception to the after N rule and the olol rule) |
| β-blockers - selective ones |
Before N - β1 selective (β1 > β2)–– Betaxolol, Esmolol (short acting), Atenolol, Metoprolol - Acebutolol (partial agonist hes and Ass), |
| β-blocker effect WRT - Hypertension |
↓ cardiac output, ↓ renin secretion |
| β-blocker effect WRT - Angina pectoris |
↓ heart rate and contractility, resulting in ↓ O2 consumption |
| β-blocker effect WRT - MI |
β-blockers ↓ mortality |
| β-blocker effect WRT - SVT |
↓ AV conduction velocity |
| β-blocker effect WRT - CHF |
Slows progression of chronic failure |
| β-blocker effect WRT Glaucoma |
↓ secretion of aqueous humor |
| which β-blockers - Tx for Glaucoma |
timolol |
| which β-blockers - Tx for SVT |
propranolol, esmolol |
| β-blockers - Toxicity (non cardiac) |
1. Impotence, 2. exacerbation of asthma, 3. CNS adverse effects (sedation, sleep alterations), 4. diabetics can't feel low sugar |
| β-blockers - Toxicity (cardiac) |
-bradycardia, -AV block, -CHF |
