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TL Catecholamines
Catecholamines
| Question | Answer |
|---|---|
| Why are andrenergic drugs called sympathomimetic? | their actions are similar to those produced by the sympathetic nervous system |
| How are andrenergic drugs classified? | into 2 group based on chemical structure: catecholamines, and noncatecholamines or by action: direct-acting drugs act on the organ/tissue innervated, indirect cause the release or neurotransmitters, dual work both ways |
| What kind of receptors are activated by andrenergic drugs? | alpha, beta, and/or dopamine |
| If an andrenergic drug mimics norepinephrine or epinephrine what kind of receptors will be activated? | Alpha and Beta |
| What is the andrenergic drug called if it activates dopamine receptors? | dopaminergic |
| Name the common actions that can be expected from andrenergic drugs. | stimulate the sympathetic nervous system, constrict peripheral blood vessels, increase heart rate, and dilate the bronchi |
| Name five common catecholamines. | dobutamine, dopamine, epinephrine, norepinephrine, isoproterenol |
| What happens to catecholamines when given orally? | They are quickly broken down by enzymes – too quickly to be therapeutic as PO drugs. (Sublingual preparations work because absorption is through the mucous membranes.) |
| Why is administration of catecholamines by subcutaneous injection slower than IM injection? | Sub Q absorption is slowed because of blood vessel constriction around the injection site – less local blood vessel constriction in IM injection |
| How are catecholamines distributed in the body and where are the metabolized? | They are widely distributed, mostly metabolized in the liver but also in the GI tract, lungs, kidneys, plasma, and other tissues |
| How are catecholamines eliminated from the body? | mostly in urine, but small amounts of isoproterenol are excreted in feces, and some epinephrine can get into breast milk |
| Why is the hearts workload increased by catecholamines? | They are strong inotropes – increasing the force of contraction |
| What is a positive chronotropic effect? | causes the heart rate to increase |
| How can the administration of catecholamines result in bradycardia even though they are positive chronotrops? | They cause the heart rate to increase, stronger contraction increases the amount of blood pumped out into vessels that are constricted due to alpha activation resulting in high BP. The hear may slow to compensate. |
| Explain the connection between epinephrine and dysrrhythmias. | catecholamines, especially epinephrine, can cause the purkinje fibers to fire spontaneously possibly causing PVCs or fibrillation |
| What receptors are stimulated by norepinephrine? | Alpha receptors almost exclusively |
| What receptors are stimulated by dobutamine and isoproterenol? | Beta receptors |
| What receptors are stimulated by epinephrine? | both alpha and beta |
| What receptors are stimulated by dopamine? | dopamine receptors primarily |
| What kind of catecholamines would be best for hypotension caused by loss of vasomotor tone or blood loss? | those that activate alpha receptors such as norepinephrine and epinephrine |
| What kind of catecholamines would be useful for the treatment of bradycardia, heart block, or low cardiac output? | Those that activate beta receptors such as dobutamine and isoproterenol |
| What kind of catecholamines are used to treat ventricular fibrillation, asystole, and cardiac arrest? Why? | Beta andrenergic drugs because they are believed to make the heart more responsive to defibrillation |
| Name four conditions that beta 2 andrenergic drugs would be useful for. | asthma, emphysema, bronchitis, hypersensitivity reactions |
| What is the main therapeutic action of dopamine? | restore blood flow to the kidneys by dilating the renal blood vessels |
| What is the difference between manufactured and natural catecholamines in duration of action? | Manufactured catecholamines have short duration of action |
| What can happen when alpha andrenergic blockers are combined with catecholamines? | hypotension |
| What drug interaction could result from the combination of a beta blocker and a catecholamine? | bronchoconstriction |
| What is the concern with diabetic patients and epinephrine? | Epinephrine causes the release of stored sugar for the body’s emergency response system which may lead to hyperglycemia for the diabetic – may need more insulin |
| What adverse effect could result from the combination of a tricyclic antidepressant and a catecholamine? | hypertension |
| List the possible adverse effects associated with catecholamines (RADHPCHHSAHN). | Restlessness, asthmatic episode, dizziness, headache, plapitations, cardiac arrhythmias, hypotension, hypertension, stroke, angina, hyperglycemia, tissue necrosis (extravasation) |
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Perseverandovercome
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