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