First Aid - Pharm 5
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| selectivity for Sympathomimetics - Phenylephrine | α1 >α2
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| selectivity for Sympathomimetics - Albuterol | β2 >β1
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| Mechanism/selectivity for Sympathomimetics - terbutaline | β2 >β1
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| name the Sympathomimetic - α1, α2, β1, β2, low doses selective for β1 | Epinephrine
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| name the Sympathomimetic - α1, α2 >β1 | NE
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| name the Sympathomimetic - β1 =β2 | Isoproterenol
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| name the Sympathomimetic - β1 >β2 | Dobutamine
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| name the Sympathomimetic - D1 = D2 >β >α | Dopamine
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| name the Sympathomimetic - Indirect general agonist, releases stored catecholamines | Amphetamine - and - Ephedrine
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| name the Sympathomimetic - α1 >α2 | Phenylephrine
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| name the Sympathomimetic - β2 >β1 | Albuterol, - terbutaline
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| name the Sympathomimetic - Indirect general agonist, uptake inhibitor | Cocaine
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| name the Sympathomimetic - Centrally acting α-agonist, ↓ central adrenergic outflow | Clonidine, α-methyldopa
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| effect on BP and HR of - Norepinephrine | (α > β), ↑ BP, ↓ HR (reflex bradycardia)
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| effect on BP and HR of - Epinephrine | nonselective - NC BP( increases systolic, but decreases diastolic)
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| effect on BP and HR of - Isoproterenol | (β > α), ↓ BP, ↑ HR
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| Applications of Sympathomimetics - Epinephrine | Anaphylaxis, glaucoma (open;angle), asthma, hypotension
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| Applications of Sympathomimetics - NE | Hypotension (but ↓ renal ;perfusion)
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| Applications of Sympathomimetics - Isoproterenol | AV block (rare)
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| Applications of Sympathomimetics - Dopamine | Shock (↑ renal perfusion), heart failure
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| Applications of Sympathomimetics - Dobutamine | Shock, heart failure cardiac ;stress testing
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| Applications of Sympathomimetics - Amphetamine | Narcolepsy, obesity, ADHD
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| Applications of Sympathomimetics - Ephedrine | Nasal decongestion, urinary incontinence, hypotension
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| Applications of Sympathomimetics - Phenylephrine | Pupil dilator, vasoconstriction, nasal decongestion
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| Applications of Sympathomimetics - Albuterol, terbutaline | Asthma
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| Applications of Sympathomimetics - Cocaine | Causes vasoconstriction and ;local anesthesia
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| Applications of Sympathomimetics - Clonidine, α-methyldopa | Hypertension, especially with;renal disease (no ↓ in blood ;flow to kidney)
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| name the Nonselective α-blockers | Phenoxybenzamine - phentolamine
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| name the α1 selective α-blockers | Prazosin, terazosin, doxazosin
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| name the α2 selective α-blockers | Mirtazapine
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| Nonselective α-blockers - Application and Toxicity | Pheochromocytoma - Orthostatic hypotension, reflex tachycardia
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| α1 selective α-blockers - Application and Toxicity | Hypertension, urinary retention in BPH - -1st-dose orthostatic hypotension, dizziness, headache
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| α2 selective α-blockers - Application and Toxicity | Depression - Sedation, ↑ serum cholesterol, ↑ appetite
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| Nonselective α-blockers - names and differences | Phenoxybenzamine (irreversible) - phentolamine (reversible)
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| 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
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| 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)
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| β-blockers - selective ones | Before N - β1 selective (β1 > β2)–– Betaxolol, Esmolol (short acting), Atenolol, Metoprolol - Acebutolol (partial agonist hes and Ass),
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| β-blocker effect WRT - Hypertension | ↓ cardiac output, ↓ renin secretion
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| β-blocker effect WRT - Angina pectoris | ↓ heart rate and contractility, resulting in ↓ O2 consumption
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| β-blocker effect WRT - MI | β-blockers ↓ mortality
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| β-blocker effect WRT - SVT | ↓ AV conduction velocity
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| β-blocker effect WRT - CHF | Slows progression of chronic failure
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| β-blocker effect WRT Glaucoma | ↓ secretion of aqueous humor
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| which β-blockers - Tx for Glaucoma | timolol
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| which β-blockers - Tx for SVT | propranolol, esmolol
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| 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
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| β-blockers - Toxicity (cardiac) | -bradycardia, -AV block, -CHF
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