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Sketchy Pharm- ANS drugs- LAH > Autonomic Drugs: Ch. 2.1: Sympathomimetics > Flashcards

Autonomic Drugs: Ch. 2.1: Sympathomimetics Flashcards

1
Q

Cue:

  • “Do Not Disturb” sign under sleeping pregnant lady
A
  • “Do Not DisTURB” = Terbutaline (beta-2 agonist)
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2
Q

Drugs that mimic the actions of Epi or NE are called ______.

A

sympathomimetics

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3
Q

Cue:

  • compass pointing north
A

norepinephrine

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4
Q

Name the 4 types of sympathetic (adrenergic) receptor subtypes.

A
  1. alpha 1
  2. alpha 2
  3. beta 1
  4. beta 2
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5
Q

What receptor does albuterol work on?

A

beta-2

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6
Q

_____ receptor activation at pancreatic islet cells causes increased insulin release.

A

Beta-2

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7
Q

_____ receptors are found on pancreatic islet cells, causing decreased insulin release.

A

Alpha-2

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8
Q

Alpha-2 adrenergic receptors are coupled to ____, which causes a decrease in intracellular cAMP levels.

A

Gi

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9
Q

What is phenylephrine? What is it used to treat?

A
  • an alpha-1 agonist
  • tx for:
    • nasal congestion
    • septic shock (used as a pressor to increase SVR and BP)
    • also causes mydriasis
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10
Q

Cue:

  • 3 dogs with red leashes pulled tight are in front of the Alpha-1 cabin; one is carrying a bone
A
  • 3 dogs = 3 DAGs = IP3/DAG pathway
  • tight red leashes = constricted small arteries = increased peripheral arterial resistance (vasoconstriction)
  • alpha-1 = adrenergic receptor coupled to Gq
  • bone = Ca++ = IP3/DAG pathway causes increased intracellular Ca++ in smooth muscle cells
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11
Q

Name 5 direct sympathomimetic drugs.

A
  1. NE
  2. phenylephrine
  3. epi
  4. dobutamine
  5. isoproterenol
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12
Q

Cue:

  • Mime getting chased by a bear
A
  • mime = sympathetic
  • mimic = sympathomimetics
  • bear = classic Fight or Flight scenario
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13
Q

Beta-receptor agonists increase _____.

A

cAMP

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14
Q

Activation of _____ receptors on fat cells causes decreased lipolysis and decreased release of fatty acids.

A

Alpha-2

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15
Q

Cue:

  • rolled-up “Welcome Inside” mat
A
  • Ins = Insulin rolled up because insulin release is inhibited by Alpha-2
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16
Q
  • alpha 1 = G__
  • alpha 2 = G__
  • beta 1 = G___
  • beta 2 = G___
A
  • alpha 1 = Gq
  • alpha 2 = Gi
  • beta 1 = Gs
  • beta 2 = Gs
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17
Q

____ relax uterine smooth muscle to suppress labor (short term).

A

Beta-2 agonists

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18
Q

Cue:

  • Scout in front of Alpha-1 cabin looking thru binoculars, so his pupils look huge
A
  • Alpha 1 = Gq adrenergic receptor
  • large pupils = pupillary dilator muscle –> mydriasis
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19
Q

What is ritodrine? What is it used for?

A
  • a beta-2 agonist
  • tx:
    • labor suppression (short term)
    • asthma
    • COPD
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20
Q

____ receptor activation in fat cells causes lipolysis and fatty acid release.

A

Beta-2

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21
Q

Activation of Alpha-2 receptors cause ____ and therefore _____.

A

decreased sympathetic tone –> decreased BP

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22
Q

What is reflex bradycardia?

A

a boost in BP –> baroreceptors stretched –> increased vagal tone –> slowed heart rate

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23
Q

What does the IP3/DAG pathway lead to?

A

increased intracellular Ca++

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24
Q

Alpha-2 adrenergic receptors are coupled to Gi, which causes ______.

A

a decrease in intracellular cAMP levels

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25
Q

Cue:

  • “Iso-pro-tunnel” between the beta-1 and beta-2 camps
A
  • “Iso-pro-tunnel” = isoproterenol (both beta-1 and beta-2 agonist)
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26
Q

Cue:

  • “Flannel friends” carrying a single candle
A
  • flannel friends = phenylephrine
  • single candle = alpha-1 agonist
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27
Q

____ receptor activation at the liver promotes gluconeogenesis.

A

Beta-2

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28
Q

Epinephrine acts as a hormone, while norepinephrine acts as a _____.

A

neurotransmitter

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29
Q

What sympathomimetic drugs can cause reflex bradycardia?

A
  • phenylephrine
  • norepinephrine
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30
Q

Beta-1 receptors are expressed on _____ cells, causing increased renin release.

A

renal juxtaglomerular

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31
Q

What is isoproterenol? What is it used to treat?

A
  • both beta-1 and beta-2 agonist
  • tx for:
    • bradycardia
    • heart block
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32
Q

Cue:

  • Beta-1 bugler has a buff arm
A
  • buff arm = increased contractility
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33
Q

Cue:

  • 3 dogs with blue leashes pulled tight are in front of the Alpha-1 cabin
A
  • 3 dogs = 3 dags = IP3/DAG pathway
  • blue leashes = venous vasoconstriction
  • Alpha-1 = Gq adrenergic receptor
34
Q

What is a sympathomimetic?

A
  • a drug that mimics the effects of sympathetic stimulators (Epi or NE) –> activation of SNS
  • aka fight or flight
35
Q

What does the adrenal medulla release in response to stress?

A

epi

36
Q

Cue:

  • one candle in the window of the Alpha-1 cabin
A
  • alpha-1 agonist = coupled to Gq = activates IP3/DAG pathway
37
Q

What is the major NT used in the sympathetic nervous system?

A

NE

38
Q

What is brimonidine? What is it used for?

A
  • an alpha-2 receptor agonist
  • tx for: chronic open-angle glaucoma
39
Q

What is Terbutaline? What is it used for?

A
  • a beta-2 agonist
  • tx = labor suppression (short term)
40
Q

What is mydriasis?

A

pupillary dilation

41
Q

The sympathetic nervous system is particularly key in the regulation of _____.

A

blood pressure

42
Q

_____ receptors are coupled to Gi, which causes a decrease in intracellular cAMP levels.

A

Alpha-2 adrenergic

43
Q

Which alpha-2 agonist is used to treat chronic open-angle glaucoma?

A

brimonidine

44
Q

Beta-2 receptors cause a decrease in _____ blood pressure.

A

diastolic

45
Q

Cue:

  • Beta-1 bugler with an “I heart Beta-and Camp” shirt
A
  • beta-1 = adrenergic receptor coupled to Gs
  • heart = receptors on cardiac muscle
  • Camp = cAMP
  • *** Beta-1 activation causes increased cAMP –> increased intracellular calcium
46
Q

What does venous vasoconstriction cause?

A
  • decreased venous capacitance
  • increased venous return
47
Q

What is norepinephrine? What is it used for?

A
  • an alpha-1/beta-1 agonist
  • tx for septic shock
48
Q

____ receptor activation leads to increased cAMP, leading to activation of PKA, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.

A

Beta-2

49
Q

Noreprinephine also activates beta-1 receptors to cause ____ in the heart.

A

increased contractility

50
Q

Adrenergic receptors are coupled to ____ that function as transducers.

A

G proteins

51
Q

Activation of ____ in the ciliary body of the eye causes increased aqueous humor production.

A

Beta-2

52
Q

Beta-1 receptors are expressed on renal juxtaglomerular cells, causing increased ____ release.

A

renin

53
Q

What is the medical term for pupillary dilation?

A

mydriasis

54
Q

What is epinephrine? What is it used for?

A
  • an alpha and beta (beta more) agonist
  • tx for:
    • bronchoconstriction
    • anaphylactic shock
    • cardiac arrest
    • resuscitation
55
Q

Cue:

  • Left side of the picture is labeled “Alpha Scouts”
A
  • alpha = alpha adrenergic receptors
56
Q

Cue:

  • “I Dream of Band Camp” shirt
A
  • “I Dream of Band Camp” = ritodrine (beta-2 agonist)
57
Q

Beta-2 receptor activation at pancreatic islet cells causes increased insulin release. What serum electrolyte change will therefore be seen?

A

decreased K+ (possible hypokalemia) bc insulin drives K+ into cells

58
Q

Cue:

  • girl wearing a “Just DO BUgling” tshirt
A
  • Just DO BUgling = dobutamine (mostly beta-1 agonist but has a little beta-2)
59
Q

What is dobutamine? What does it treat?

A
  • a beta-1/beta-2 agonist
  • tx for:
    • refractory heart failure
    • acute heart failure
    • cardiogenic shock
    • also used in cardiac stress testing (increased O2 demand)
60
Q

Beta-2 receptor activation leads to ____, leading to activation of PKA, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.

A

increased cAMP

61
Q

Cue:

  • a camp tent in front of the Alpha-2 cabin that is getting packed up
A
  • camp tent = cAMP
  • Alpha 2 = Gi adrenergic receptor
  • packed up = decreased cAMP levels
62
Q

____ receptors are expressed on renal juxtaglomerular cells, causing increased renin release.

A

Beta-1

63
Q

Cue:

  • Boy holding the dogs’ leashes in front of the alpha-1 cabin is also holding a sign that says “Map increased”
A
  • alpha-1 = Gq receptor
  • MAP = mean arterial pressure aka blood pressure
  • *** Alpha-1 activation increases mean arterial pressure (MAP)
64
Q

Beta-1 activation on cardiac muscle causes _____ and therefore ____.

A

increased intracellular Ca++ –> increased HR at the SA node

65
Q

____ receptors are found on the ciliary body in the eye, thereby decreasing aqueous humor production.

A

Alpha-2

66
Q

What do respiratory beta-2 agonists usually end in?

A
  • “-rol”
  • ex: albuterol
67
Q

Receptors coupled to _____ activate the IP3/DAG pathway.

A

Gq

68
Q

What receptor does epinephrine work on?

A
  • both alpha and beta (more alpha at high doses but beta>alpha at low doses)
69
Q

Beta-2 receptor activation leads to increased cAMP, leading to activation of ____, causing relaxation of smooth muscle and relaxation of coronary and skeletal muscle arteries.

A

PKA

70
Q

Cue:

  • two candles in the window of the Alpha-2 cabin and graffiti that says “Sympathy” scratched out
A
  • Alpha 2 = Gi receptor
  • sympathy scratched out = sympatholytics (decrease sympathetic tone)
71
Q

Alpha-1 receptor activation in a vascular bed leads to _____.

A

arteriole and venous vasoconstriction

72
Q

Cue:

  • raft with “QISS” on the sail
A
  • QISS = type of G protein coupled to the adrenergic receptor subtypes:
    • alpha 1 = Gq
    • alpha 2 = Gi
    • beta 1 = Gs
    • beta 2 = Gs
73
Q

Any drug that activates Beta-1 receptors will cause _____ pulse pressure.

A

increased

74
Q

______ is a nonselective (but alpha>beta) agonist.

A

Norepinephrine

75
Q

Alpha-1 receptors are highly expressed in?

A
  • smooth muscle cells
  • vascular beds
  • sphincters
76
Q

NE activates _____ receptors on post-synaptic sites.

A

adrenergic

77
Q

Which pts do not have an appropriate reflex bradycardia response?

A

those with decreased autonomic function, such as diabetics with neuropathy

78
Q

Receptors coupled to Gq activate the _____ pathway.

A

IP3/DAG

79
Q

Cue:

  • Scout in front of Alpha-1 cabin is carrying a bladder canteen and is pulling the drawstring on his pants really tightly
A
  • Alpha 1 = Gq adrenergic receptor
  • bladder canteen = full bladder (urinary retention)
  • tight pants = urethral sphincter and prostatic smooth muscle contraction –> urinary retention
80
Q

Beta-2 receptor activation leads to increased cAMP, leading to activation of PKA, causing _____ and ____.

A
  • relaxation of smooth muscle and
  • relaxation of coronary and skeletal muscle arteries (decreased SVR)

Sketchy Pharm- ANS drugs- LAH (7 decks)

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