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NURS 472 Adrenergic

Pharm - adrenergic drugs

properties of catechols have neighboring -OH --> not orally absorbed (IV admin), do not cross BBB so no CNS effects
properties on non-catechols non-neighboring -OH --> oral absorption, cross BBB to exert CNS effects
Alpha-1 receptor normal functions vasoCon, mydriasis, bladder/prostrate sphincter contraction
Alpha-1 therapeutic uses to increase BP, hemostasis, releive nasal congestion, local anesthesia adjunct, mydriasis
ADRs of Alpha-1 activation HTN (too much of good thing), brady compensatory, necrosis extravasation
Beta-1 normal functions cardiac stimulation (force, frequency, AV conduction), kidney --> renin
Beta-1 therapeutic uses tx of cardiac arrest, HF, AV heart block, shock
Beta-1 ADRs tachy overshoot, dysrhythmias, angina pectoris (bwo increased heart activity exceeding what coronary artery can provide)
Beta-2 normal functions bronchoDIL, uterine relaxation, vasoDIL-essential, glycogenolysis, skeletal muscle contraction, HYPERkalemia
Beta-2 therapeutic uses asthma, delay tocolysis
Beta-2 ADRs hyperglycemia, tremor, HYPOkalemia (intracellular K shunting)
Dopamine receptor blurb PNS only in kidney vasculature -->increase RBF--> increase urine output
All Adrenergic agonists are catechols EXCEPT terbutaline, ephedrine
how must chatechols be administered must be IV admin, not absorbed orally, SHORT ACTING due to peripheral COMT, do NOT pass BBB, no CNS effect
What catechol activates all 4 receptor types epinephrine
epinephrine indications cardiac stimulation, anaphylactic shock(slanted towards Alpha-1, Beta-1)
epinephrine ADRs HTN overshoot, dysrhythmias, angina, necrosis extravasation, HYPERglycemia
What endogenous substance and 2 drugs activate Alpha-1, Alpha-2 and Beta-1 Norepinephrine, levarterenol, levophed
Norepinephrine activates these receptors with this indication Alpha-1,2 and Beta-1. Indicated for cardiac. CANNOT tx asthma or tocolysis because no Beta-2
What is the only drug that acts on Beta-1, Beta-2 nonselectively isoproterenol
What is isoproterenol indicated for cardiac stimulation, bronchoDIL
ADRs of Isoproterenol (B-1, B-2) B-1: tachy, dysrhythmias, angina. B-2: hyperglycemia, hypokalemia
what is therapeutically relevant about norepinephrine, levarterenol and levophed this class can treat both cardiac and blood pressure bwo A-1, A-2 and B-1 stimulation
In what order does dopamine 'step up' with increased dosage dopa receptors, B-1 receptors, A-1 receptors, with respective ADRs at each receptor
what drug activates Beta-1 selectively dobutamine
what is indication of dobutamine to stimulate heart in CHF
major ADRs of dobutamine B-1 ADRs of tachy, dysrhythmias, angina
what drug activates Beta-2 selectively terbutaline, which is a NON-catechol, so it can be given oral and it DOES cross BBB
terbutaline indicated for asthma, tocolysis
what NONcatechol activates all 4 receptors ephedrine - like an oral epinephrine
what little use does ephedrine have today pre-tx IV contrast, nasal decongestant, asthma, allergy, postural orthostasis
besides usual ADRs relevant to receptor type, what other ADR does ephedrine have because it is a NONcatechol, it can cross BBB and stimulate CNS-->insomnia
epinephrine catecholamine activates all 4 receptors
norepinephrine catecholamine activates A-1,A-2, B-1
levarterenol catecholamine activates A-1, A-2, B-1
levophed catecholamine activates A-1, A-2, B-1
dopamine activates dopa first, B-1 second, A-1 third
dobutamine selective B-1
terbutamine selective B-2 NONCATECHOLAMINE
ephedrine activates all 4, NONCATECHOLAMINE
Created by: lorrelaws