Sympathomimetics Flashcards

1
Q

Ephedrine dose, onset, peak, duration?

A

dose: 2.5-10 mg
onset: < 1 minute
peak: 2 - 5 minutes
duration: 10 - 60 minutes

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2
Q

Is ephedrine an alpha 1, alpha 2, beta 1, and/or beta 2 agonist?

A

INDIRECT alpha 1 and beta 1

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3
Q

Phenylephrine (Neosynephrine) dose, onset, peak, duration?

A

dose: 40-100 mcg
onset: < 1 minute
peak: 1 minute
duration: 15 - 30 minutes

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4
Q

Is phenylephrine (Neosynephrine) an alpha 1, alpha 2, beta 1, and/or beta 2 agonist?

A

DIRECT Alpha 1

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5
Q

Epinephrine dose, onset, peak, duration?

A

dose: 2-20 mcg/min
onset: 30 seconds
peak: 3 minutes
duration: 10 minutes

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6
Q

Alpha 1 stimulation causes?

A

Increase inotropy and vasoconstriction

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7
Q

Alpha 2 stimulation causes?

A

Vasodilation due to CNS presynaptic inhibition of norepinephrine

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8
Q

Beta 1 stimulation causes?

A

Increase inotropy, chronotropy, and dromotropy

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9
Q

Beta 2 stimulation causes?

A

Increase inotropy, chronotropy, vascular dilation, and bronchial dilation

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10
Q

DA1 stimulation causes?

A

Vasodilation

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11
Q

DA2 stimulation causes?

A

Inhibition of norepinephrine release

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12
Q

Is epinephrine an alpha 1, alpha 2, beta 1, and/or beta 2 agonist?

A

All of the above

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13
Q

Phenylephrine (Neosynephrine) mechanism of action.

A

DIRECT alpha agonist - binds to and agonizes sympathetic adrenergic Gq-receptors

ultimately stimulates calcium release by the sarcoplasmic reticulum (in arteries and veins, this leads to constriction)

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14
Q

Cardiac effects of phenylephrine.

A

increases PVR, afterload, and BP

mild increases in chronotropy and inotropy at high doses

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15
Q

How is phenylephrine metabolized?

A

monoamine oxidase (MAO)

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16
Q

Ephedrine mechanism of action.

A

INDIRECT alpha 1 and beta 1 agonist - causes norepinephrine to be released, resulting in the stimulation of alpha 1 and beta 1 receptors

DIRECT beta 2 agonist (mild)

17
Q

Pulmonary and cardiac effects of ephedrine.

A

pulmonary - mild bronchodilation d/t mild beta 2 stimulation

cardiac - increases PVR, afterload, and BP; increases chronotropy and inotropy; decreases uterine blood flow

18
Q

How is ephedrine metabolized?

A

hepatic metabolism

renal elimination

19
Q

How is epinephrine metabolized?

A

monoamine oxidase (MAO) and hepatic

20
Q

What is the dose in mcg/mL of epinephrine 1:200,000? 1:100,000? 1:1000? 1:400,000?

A

1: 200,000 = 5 mcg/mL
1: 100,000 = 10 mcg/mL
1: 1000 = 1000 mcg/mL (or 1 mg/mL)
1: 400,000 = 2.5 mcg/mL

21
Q

What medication is used to reverse an overdose of phenylephrine?

A

hydralazine

22
Q

What is the max dose of ephedrine? and why?

A

50mg (the amount that’s in one ephedrine vial)

because any more than that will deplete norepinephine stores. (since ephedrine causes its release)