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103 Cards in this Set
- Front
- Back
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Name 2 places NE/E is released from
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Adrenal medulla
Nerve Endings |
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Describe in general the funtion of a1 receptors
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Inc BP, vasoconstriction, mydriasis, contration of urinary trigone and pilimotor muscles
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Describe in general the funtion of a2 receptors (really only 2 main functions)
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Autoreceptor (feed back inhibition)+ vasoconstriction
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Describe in general the funtion of b1 receptors
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Tachycardia, increased force and conduction velocity of heart
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Describe in general the funtion of b2 receptors
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Relax bronail sm, dilate skeletal and cardiac SM
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Primary receptor in:
Radial m. |
a1
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Primary receptor in:
Skeletal/coronary bv's |
a1 but b2 also present--VIP
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Primary receptor in:
GI tract |
all are present but a1 is primary
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Primary receptor in:
Trigone |
a1
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Primary receptor in:
Adipose tissue in liver |
a2 (only place it is the primary receptor)
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Primary receptor in:
Cardiac muscle |
b1
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Primary receptor in:
Detrussor muscle |
b2
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Primary receptor in:
Ciliary muscle |
b2
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Primary receptor in:
Bronchioles |
b2
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a2 receptors sitimulate G__ where as b have opposite affect and simulate G __
a1 works trough G__ and is like a M receptor |
Gi (inhibitory)
Gs (stimulatory) Gq |
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Termination of NE done mosly by __
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re uptake
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Epinephrine:
Acts at __ receptors Uses: __ __ BP __ PR __ HR |
All alpha and beta
vasoconstrictor, treat acute allergic rxn, cardiac arrest, topical hemosasis Inc (slighly) BP, dec PR, inc HR |
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Norepi:
Acts at __ receptor Uses: __ BP __ PR __ HR |
all alpha and b1
treat low BP Inc BP Inc PR Decr HR |
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Isoproterenol:
Acts at __ receptors Uses: __ BP __ PR __ HR |
seleved for betas
treat bradycardia and heartblock Dec (slightly) BP Decr PR Inc HR |
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Selective a1 agonists- are used for __, treat __
2 examples |
Nasal decongestant, treat hypotension
Phenylephrine, Methoxamine (Phenyl met one alpha-dog) |
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Selective a2 agonists
Uses: __ (works better than a1), treat __ (acts trough CNS), treat __, __ pain and __ symptoms Ex (6) |
Nasal decongestant, HYPERtension (note a1 treats HYPOtension), glaucoma, nuropathic, reduce withdrawl symptoms
Methyldopamone Naphzaoline Cloniding Oxymetasoline Guanabenz Tetrahydrozoline Ex. M.dopa Naped Clon's Ox Guano All-2 Tetra's-hydout |
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Selective b1 agonists
Uses: Ex. (2) |
He gave us no uses until the last packet: Acute TMT of CHF
Dopa/Dobutamine |
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Selective b2 agonists
Uses: trat __ and __ (think relaxing) Ex. |
Asthma and premature labor
Abuterol, Salmeterol, Bioterol, Meaproterenol, Retoddring, Terbutaline Think "rol" or "nol" for b2 selective ("lol" for other beta blockers) Ex. "Rol" + Rit-Terbut |
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Drugs can work __ (simulating the apha/beta receptors them selves) or __ causing a change (inc/dec) of NE at synapse or both
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Direcly
Indirectly |
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Indirect sympathomimetic drugs
__-work by relasesing NE from nerve ending |
Ampthetammin/meth
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Indirect sympathomimetic drugs
__-dilates pupil-used on opthamology |
Hydroxyamphetamine
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Indirect sympathomimetic drugs
__-used to treat narcolepsy |
Methypehnidate
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Indirect sympathomimetic drugs
__-inhibits re-uptake of NE |
cocaine
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List the indirect sympathomimetic drugs
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Tyramin, Amphetamine, hydroxyamphetamine, methylphenidate, cocaine
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List the Mixed action symathomimetic drugs
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Ephedrine
Pseudephdrine Phenylpropanolamine |
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Mixed action
__-used to increase BP |
Ephedrine
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Mixed action
__-decongestant used to treat rhinitis |
Pseuoephedrine
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Mixed action
__-used for weight control but increased strokes |
Phenylpropanolamine
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Side effects of adrenergic receptor drugs:
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Hypertension/hypotension, tach and arrythmias, mydriasis, increased interocular pressure, urine retention, dry mouth, jitteriness, nervousness, drowsiness, hyperglycemia
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Which one is NOT a side effect of adrenergic receptor drugs:
Hypertension, hypotension, tach and arrythmias, mydriasis, decreased interocular pressure, urine retention, dry mouth, jitteriness, nervousness, drowsiness, hypoglycemia |
hypoglycemia and decreased interocular pressure are not symptoms
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Watch vasoconstrictor in which pts?
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Steroid dependant asthma, uncontrolled HTN, uncontrolled hyperthyroidism, angina, recent MI
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Name 2 non-selcetive adrenergic blockers: (block all receptors except ___)
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Labetalol
Carvedilol a2 receptors |
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2 non-selective alpha adrenergic blockers:
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Phentolamine, Phenoxybenzamine
Alphenphen |
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A1 selective blockers:
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"Zosin"
parazosin, terazosin, doxazosin |
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A2 selective blockers:
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Yohimbine
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Selective a2 agonists
Uses: __ (works better than a1), treat __ (acts trough CNS), treat __, __ pain and __ symptoms Ex (6) |
Nasal decongestant, HYPERtension (note a1 treats HYPOtension), glaucoma, nuropathic, reduce withdrawl symptoms
Methyldopamone Naphzaoline Cloniding Oxymetasoline Guanabenz Tetrahydrozoline Ex. M.dopa Naped Clon's Ox Guano All-2 Tetra's-hydout |
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Selective b1
Uses: Ex. (2) |
He gave us no uses
Dopa/Dobutamine |
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Selective b2
Uses: trat __ and __ (think relaxing) Ex. |
Asthma and premature labor
Abuterol, Salmeterol, Bioterol, Meaproterenol, Retoddring, Terbutaline Think "rol" or "nol" for b2 selective ("lol" for other beta blockers) Ex. "Rol" + Rit-Terbut |
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Drugs can work __ (simulating the apha/beta receptors them selves) or __ causing a change (inc/dec) of NE at synapse or both
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Direcly
Indirectly |
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Indirect sympathomimetic drugs
__-work by relasesing NE from nerve ending |
Ampthetammin/meth
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Indirect sympathomimetic drugs
__-dilates pupil-used on opthamology |
Hydroxyamphetamine
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Indirect sympathomimetic drugs
__-used to treat narcolepsy |
Methypehnidate
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Indirect sympathomimetic drugs
__-inhibits re-uptake of NE |
cocaine
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List the indirect sympathomimetic drugs
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Tyramin, Amphetamine, hydroxyamphetamine, methylphenidate, cocaine
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List the Mixed action symathomimetic drugs
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Ephedrine
Pseudephdrine Phenylpropanolamine |
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B1 selective blockers- Remember beta blockers will end in "OLOL"
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Metroprolol, Atenolol
MAB1 |
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Beta selective blockers:
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Prindolol, Propanolol
PrinProB |
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List the clinical uses of Alpha blockers:
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Hypertension, Benigh prostatic hyperplasica, peripheral vascular disease, pheochyrmocytoma, impotence
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Adverse effects of Alpha blockers:
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Reflex tachycardia, Na retention, orthostatic hypotension, fatigue, dry mouth, impared ejaculation, nasal stuffiness
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List the clinical uses of Beta blockers:
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Hypertension, angina pectorlaiz, arrhythmias, HF, recurrent MI's, glaucoma, migraine, stage fright migraine
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Side effects of beta blockers:
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weakness, fatigue, dipression, bronchospasms, bradycardia, worsening of periperal vascular disease, hyperglycemia
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P wave is associated with
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depolarization of atrium (inc Ca conductance)
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QRS wave is associated with
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depolarization of the ventricle (Na channels responsible)
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T wave is associated w/
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repolarizaiton of ventricle (K responsible for this)
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Repolarization of atrium is associated with which wave
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it is hidden in QRS wave
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Drugs that affect:
velocity act__ area refractory period act __ area automaticity act __ area of the ventricle/purkinje wave |
0
3 4 |
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Class I drugs block __
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Na Channels
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Ex of Class IA drugs
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quinidin, procamide
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Ex of class IB drugs
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LIdocain, topocamide, moxilitine
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Ex of class IC drugs
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Flecanide, propafenone
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Class II drugs block __
Ex |
B-adrenergic receptors
Popanolol, emsolol |
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Class III drugs block __
Ex. |
K channels
Amiodrone, sotalol |
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Class IV drugs block__
Ex |
Ca channels
Verapimil, diltiazem |
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_ and __ drugs restricted to upper chambers of heart
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Class IV and adensoine
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__ drugs are restricted to lower chambers of heart
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Ib drugs
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Drugs that decrease SA automaticity
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All classes except Ib and Ic-i'm not sure about the Ic because on one chart says no but in the description of the drugs it says they do
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Drugs that decrease AV conduction velocity
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All except Ib
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Drugs that increase PR interval (delayes conduction)
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All except IB
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Drugs that increase QRS
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Ia and Ic
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Drugs taht increase QT interval
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Ia and III (if increase this too much then high risk of torades despointes)
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Class Ia drug that has antimuscarinic effects- can be a possible hazard
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Quinidine
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Class Ia drug that has weaker antimuscarinic effects and a side effect can be lupus
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Proainamide
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Drug used to decrease qutomaticity in ectopic pacemaker
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Lidocaine
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2 drugs that are metaboized by cP450 so have variable half lives
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Flecanide Propafenone
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Drug that is primarily a Na channel blocker but also blcks Ca and beta receptors
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Propafenone
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2 drugs with extremely short half lives
__-Class II __-give only IV in rapid bolus |
Esmolol (.2 hours)
Adenosine-10 s Adenosine |
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Class II Drug that is good for rate control-b/c AV node to control rate in ventricle
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Propanolol
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Class III drug with VERY long half life if used chronically
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Amidoarone
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Adenosine effects-stimulate adenosine receptors and increases __ conductance while inhibiting opening of __ channels, reduces automaticity
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K+
Ca+ |
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Angiotensin II has 4 effects:
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Increase venous return, increase afterload, increase remodleing, increased aldosterone
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Aldosterone causes:
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Na and water retention, K+ loss, Mg+ loss, reduced barorefelx, cardiac fibrosis, ischemia, sympathetic activation
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Diuretics-reduces __ by increasing sodium and water
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fluid load
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ACE inhibitors (end in"__"), reduces __ , __ and __
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"Pril"
afterload, preload and remodeling |
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1st drug of choice in HF
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ACE inhibitors
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ACE converts __ to __ so when blocked stop this process
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Angiotensin I to II
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Angiotensing II receptor blockers end in "__"
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Sartan
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Aldosterone antagonists ex __-effects: __
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Spironaolactone
Reduces mycardial fibrosis, reduces early morning rise in HR, Inc plasma K+ |
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Digitalis works by inhibition of __ leading to increased __
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Na+/K+ ATPase
Ca+ |
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Digitalis leads to increased __ interval but if too much then can have heart block
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PR
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__ drug can cause a dramatic decrease in plasma K+ where as __ can cause a large increase in K+
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Digitalis
Spironaolactone |
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3 things that reverse digitalis
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KCl, lidocaine, antidigitalis antibodies (digibind)
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Vasodilatiors-cause a reduction in __; ex. __
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Cardiac load
nitrates, hyralazine |
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3 ex of drugs used for short-term therapy (hospital setting only)
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Sympathomimietics (dobutamine, dopamine)
Bipyridines Nesiritide |
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Drug that may acually decrease the survival rate in HF pts
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Bipyridines-Inamrione, mirinone
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Drug used in acute therpay that binds to guanylate cyclase receptor and stimulates prod of cGMP (reduces pre and afterload)
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Nesiritide
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Bipyridines inhibit low ___, may increase __ into the myocardiou and these both cause vasodilation
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Km phosphodiesterase
Ca+ |
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Acute HF drug that is useful in cases of hypertension and congestive HF secondary to acute MI
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Dobutamine
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Acute HF drug that is usedful in cardiogenic shock
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Dopamine
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