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Sympathomimetic Agon

Pharm Y2B2

QuestionAnswer
alpha 1 radial m. contracts - mydriasis
alpha 2 trabecular network - increase outflow of aqueous humor
beta 2 ciliary process - increase synthesis of aqueous humor
alpha 2 ciliary process - decrease synthesis of aqueous humor
beta 2 lungs - dilate
beta 1 heart rate increase
beta 1 heart force increase
alpha 1 arteries - constrict
beta 2 skeletal muscles - dilate
beta 2 skeletal muslce increase contractility
alpha 1 spleen - contract
alpha 2 platelet aggregation - increase
alpha 1 apocrine glands - increase
alpha 1, beta 2 glycogenolysis - increase
beta 3 increase lipolysis
alpha 2 insulin decrease
beta 2 insulin increase
beta glucagon increase
alpha 2, beta 2 GI tract - relax wall
beta 1 renin secretion - increase
alpha 1 nasal, salivary, gastric - decrease secretion
beta 2 bladder wall - relax
alpha 1 contract internal sphincter
alpha 1 contract ureter
alpha 1 contract prostate capsule
beta 2 uterus pregnant relax
alpha 1 contract - detumescence penile arteries
alpha 2 SNS post.gan. nerve terminal (decrease)
epinephrine DOC for asthma (beta 2) and anaphylactic shock
epinephrine increase duration of local anesthesia b/c alpha 1 receptors induce vasoconstriction
epinephrine ADR: tachycardia, hemorrhage, adverse CNS effects, pulmonary edema
epinephrine increase HR, increase systolic BP, dilate blood vessels in skeletal muscle (antogonize induced by histamines and leukotrienes)
epinephrine topically used to vasoconstrict blood vessels (alpha 1)
norepinephrine rise in peripheral resistance due to intense vasoconstriction (alpha 1)
norepinephrine ARD: bradycardia: due to baroreceptor vagal reflex; increase BP
norepinephrine used to treat shock b/c it increases vascular resistance
metaraminol use for shock Tx over norepi. b/c it does not reduce blood flow to the kidneys
alpha and beta non-selective epinephrine and norepinephrine
alpha-methyldopa alpha 2 agonist; DOC in Tx hypertension in pts w/ renal insufficiency
alpha-methyldopa DOC for hypertension in pregnancy
alpha-methyldopa ADR: hepatotoxic, hemolytic anemia
dobutamine 2 isomers, w/ net result being selective beta 1 agonist
dobutamine increase contractility and cardiac output in CHF pts; good over sympathomimetic drugs b/c no effect on beta 2 receptors in myocardium
dobutamine tolerance w/ prolonged use; use w/ caution in A-fib pts
selective beta 2 agonists albuterol, bitolterol, salmeterol, ritodrine
albuterol used for acute bronchospasm (bronchodilate), prevent exercise-induced asthma
albuterol bronchodilation, anti-inflammatory, inhibit release of inflammatory mediators from mast cells; increase mucous clearance by cilia
albuterol ADR: tremor, tachycardia, arrhythymias, death?
ritodrine arrest premature labor (relax uterus)
ritodrine ARD: cardiac stim., hypotension, neonatal hypoglycemia
dopamine DOC for shock; increases BP by alpha 1 receptors, and increases blood flow to splanchnic areas and kidneys
dopamine "renal dose" <2ug/kg/min - dilate renal, mesenteric, coronary vessels (stimulates D1 and D2 receptors)
dopamine medium dose (2-10) - beta 1 agonist: positive inotropic effect
dopamine high dose (10 +) - alpha 1 agonist: vasoconstriction
fenoldopam D1 agonist, IV admin. for severe hypertension (vasodilates)
fenoldopam ADR: dose-related hypotension, tacy, headache, flushing
MAO-A I role in adrenergic nerve terminals, metabolizes NE, EPI, and serotonin; inhibited by clorgyline
MAO-B found in serotonin and histaminergic nerve terminal, metabolizes dopamine (phenethylamine)
selegiline used in Parkinson's; inhibits MAO-B; less risk for "cheese rxn"
MAO inhibitors inhibition occurs w/in a few days, but drugs take a couple of wks to kick in
MAO-A Tx for resistant depression
MAO inhibitors fatal intracranial bleed; mc: postural hypotension; anti-ACH, sexual dysfxn
serotonin syndrome HT, shivering, diaphoresis, muscle rigidity, fever, agitation, hallucinations
Created by: fl_sun80
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