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NRSG Pharm CH 13

Adrenergic / Antiadrenergic

QuestionAnswer
agents involved in neurotransmission catecholamines
natural catecholamines / synth catecholamines N: NE (main, released by most postganglionic nerves), Epi, dopamine S: isoproterenol, dobutamine
Adrenergic where? Adrenergic receptors @ end of postganglionic symp neurons
A1 adrenergic receptors, location/response In all symp target organs except heart. Vasoconstriction, pupil dilation
B2 adrenergic receptors, location/response All symp target organs except heart, INHIBIT smooth muscle
NE @ A1 All symp except heart, vasoconstriction, dilation of pupils
NE @ A2 Presynaptic adrenergic nerve terminals, inhibit release of NE
NE @ B1 Heart and kidneys - Inc HR, force of contraction (CO), renin release (BP inc)
NE @ B2 All symp except heart, inhibit smooth muscle
NE @ B3 Adipose - lipolysis, urinary bladder - relaxation of detrusor muscle
5 mechs by which Rx affect synaptic tx 1 Affect synthesis of neruotx in terminal 2 prevent storage of neruotx in vesicles in presynaptic 3 influence release 4 prevent normal destruction/reuptake 5 bind @ receptor site on postsynaptic target tissue
Prototype: Phenylephrine (Neo-Synephrine) classes, mech T: nasal decongestant; antihypotensive P: Adrenergic drug (sympathomimetic)) Mech: stimulates symp directly/indirectly - many same responses as anticholinergic
Sympathomimetics @ receptors, primary uses: A1 nasal congestion, hypotension, dilation of pupils -> eye exam A2 hypertension B1 Cardiac arrest, heart failure, shock B2 asthma, premature-labor contractions
Side/Adverse sympathomimetics tachy, hypertension, dysrhythmias, CNS excitation and seizues, dry mouth, N/V, anorexia
phenylephrine (Neo-Synephrine) actions/uses selective alpha-adrenergic agonist, reduces nasal congestion by vasoconstriction in nasal mucosa
phenylephrine (neo-Synephrine) side/adverse uncommon, irritation, rebound congestion if used for prolonged periods
Adrenergic considerations: Vitals, urinary, cardiac breathing patterns responsiveness to light (pupil dilation) Rhinorrhea and epistaxis
Adrenergic-blocking agents primary use / other therapeutic applications Primary: beta blockers for hypertension Other: Angina pectoris, migraines, heart failure
Prototype: Prazosin (MiniPress) classes, mech P: Adrenergic-blocking T: Hypertension drug M: selective A1 adrenergic antagonist - competes with NE @ receptor sites on vascular smooth muscles in arterioles and veins - blocks vasoconstriction of NE @ A1
Prazosin (MiniPress) primary uses: Hypertension, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma
Prazosin (MiniPress) adverse: dizziness, drowsiness, headache, dec energy/strength, palpitations, dry mouth
Adrenergic-blocking agents main side/adverse: Orthostatic hypotension! - rare, can cause LOC 30 min after first dose dizziness, drowsiness, light-headed, reflex tachy
adrenergic-blocking considerations first dose should be low and given at bedtime
Created by: kmulla
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