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Pharm - Autonomics 2

Autonomic Drugs (Part 2) from First Aid 2013

Epinephrine: receptor binding, uses All adrenergic receptors (a1,2, b1,2). Treats anaphylaxis, glaucoma, asthma, and hypertension.
Norepinephrine: binding, uses Alpha-1 and alpha-2 receptors. Treats hypotension (but still decreases renal perfusion).
Isoproterenol: binding, uses Beta-1 and beta-2 receptors. Treats Torsades (inc HR decreases QT) and bradyarrhythmias.
Norepinephrine vs. Isoproterenol Norepi: inc BP via vasoconstriction, leading to bradycardia. Isopro: dec BP via vasodilation, leading to tachycardia.
Dopamine: binding, uses Low dose -> D1 receptors Med dose -> beta-1 & 2 Hi dose -> alpha-1 & 2 Treats shock (inc renal perfusion), HF (inotropic, chronotropic)
Dobutamine: binding, uses Beta-1 receptors. For HF and cardiac stress testing.
Phenylephrine: binding, uses Alpha-1,2 receptors. For hypoTN (vasoconstrictor), ocular procedures (mydriatic), and rhinitis (decongestant).
Albuterol, salmeterol, terbutaline: binding, uses Beta-2 > beta-1. Albuterol - acute asthma Salmeterol - long-term asthma, COPD Terbutaline- reduce uterine contractions
Indirect sympathomimetics Amphetamines (releases stores) Ephedrine (releases stores) Cocaine (re-uptake inhibitor)
Ephedrine uses Treats nasal congestion, urinary incontinence, hypotension
Cocaine uses, warnings Causes vasoconstriction and local anesthesia. Never give beta-blockers if cocaine use is expected. -> unopposed a1-activation -> HTN
Clonidine, methyldopa: MOA, Use Act as alpha-2 agonists, which actually decrease sympathetic outflow by negative feedback. AKA "sympathoplegics," they are used in pregnant HTN or in HTN with renal disease (preserve blood flow).
Nonselective alpha-blockers Phenoxybenzamine - use before removing a pheochromocytoma Phentolamine - give with local Epi injection to prevent local vasocronstriction, necrosis Also an antidote for MAO-I patients who ingest tyramine.
Alpha-1 selective alpha-blockers: naming, Use, Tox End in "-osin". Use: HTN or urinary retention in BPH Tox: orthostatic hypoTN, dizziness
Alpha-2 selective alpha-blocker: naming, Use, Tox Mirtazapine Use: Depression Tox: Sedation, inc. cholesterol and appetite
Beta blockers: naming, Uses Naming: end in -"lol" Angina: dec HR/cont, decreasing O2 need MI: dec mortality SVT: dec AV conduction (Class II AA) HTN: dec CO, dec renin (b1 blockade on JGA) CHF: slows progression Glaucoma: dec secretion of aq humor
Beta blockers: toxicities Impotence, asthma, CV adverse effects, CNS effects (seizures, sedation, sleep alterations), use cautiously with diabetics
Beta-1 selective beta-blockers A BEAM of blockers: Acebutolol Betaxolol Esmolol - Class II AA / SVT Atenolol Metoprolol - Class II AA / SVT Use in patients with lung disease.
Non-selective beta blockers (beta-1,2 only) Please Try Not Being Picky: Propanolol Timolol Nadolol Pindolol
Non-selective beta blockers (with anti-alpha vasodilatory effects, too) Carvedilol, labetalol
Partial beta agonists PAPA: Partial Agonists: Pindolol Acebutolol
Created by: wmwebb89