Term
| Mean arterial pressure is |
|
Definition
|
|
Term
|
Definition
| heart, beta 1 and 2. agonizing beta causes an inc in cardiac output |
|
|
Term
|
Definition
| alpha 1, alpha 2, beta 2. agonize alpha 1 and SVR goes up, opposite with beta 2 and central alpha 2 agonists |
|
|
Term
| drugs that mainly affect B1 |
|
Definition
| metoprolol (met a pro. lol), acebutolol (ace butter lol), alprenolol (alfredo lol), atenolol (attend lol), betaxolol (better tax lol), celiprolol (sell a pro lol), esmolol (is small lol), nebivolol (never bowl lol) (selectivity can be lost w increased dose) |
|
|
Term
| drugs that affect B1 and B2 evenly |
|
Definition
| propanolol, cartelol (cart all), nadolol (neighbor all), penbutolol (pen button all), pindolol (pin doll all), timolol (timber all) |
|
|
Term
| drugs that mainly affect B2 |
|
Definition
|
|
Term
|
Definition
| prazosin, terazosin, doxazosin, phenoxybenzamine (fend off ben) |
|
|
Term
|
Definition
|
|
Term
| non-selective a1+2 blocker |
|
Definition
| phentolamine (fend off amy) |
|
|
Term
|
Definition
| yohimbine (yo him) (improves male sexual function and promotes sympathetic outflow, not clinically proven) |
|
|
Term
|
Definition
| not commonly used because duration of action is too long, can last up to 48 hrs |
|
|
Term
|
Definition
| MEN2A2B, Metoprolol (met a pro. lol), esmolol (is small lol), nebivolol (never bowl lol), atenolol (attend lol), acebutolol (ace butter lol), bisoprolol (biz pro lol), betaxolol (better tax lol), may be safer to use in asthmatics than non selective beta blockers (bc blocking B2 can cause bronchial smooth muscle contraction which would be bad in asthmatics) |
|
|
Term
| non-selective B1+2 and a1 antagonists |
|
Definition
| carvedilol, labetalol (label it all) (for greater lowering of BP) |
|
|
Term
|
Definition
| all the other "-lol"s, ex propanolol, sotalol (sortof all) |
|
|
Term
|
Definition
| most 10 hrs w exception of esmolol (IV) which is shorter (10 min) (good for emergent situations) |
|
|
Term
| beta blocker lipid solubility |
|
Definition
| higher lipid solubility, more it will penetrate CNS (GAD, stage fright) |
|
|
Term
| partial agonist activity beta blockers |
|
Definition
| acebutolol (ace butter lol), cartelol (cart all), celiprolol (sell a pro lol), pindolol (pin doll all), penbutolol (pen button all) (partially activate beta receptor and inhibit at same time, keep HR and BP stable, not commonly used in practice) |
|
|
Term
| beta blocker local anesthetic aciton |
|
Definition
| experimentally been shown to block calcium channels, not used this way clinically |
|
|
Term
|
Definition
| a1 blockers- zosins (can cause dec in systemic svr and bp) or a1 tamulosin (better, prostate and bladder smooth muscle will relax) |
|
|
Term
| alpha 1 blockers for hypertension |
|
Definition
| zosins (dec svr, located in baroreceptors of carotid arteries) |
|
|
Term
| treatment for hypertension |
|
Definition
| any beta blocker, (also a1 blocker). beta blockers dec cardiac output by decreasing heart's ability to pump out volume, dec volume to surplus circulation -> dec BP. they also suppress the RAS system- renin-angiotensin-aldosterone system, beta blockers in the kidneys where RAS is activated so dec SVR by decreasing amount of sodium in circulation- sodium helps promote the absorption of water) |
|
|
Term
| ischemic heart disease treatment |
|
Definition
| any beta blocker, works by decreasing cardiac output by decreasing oxygen demand by the heart, slows it down, also decreased amnt of fluid by suppressing RAS so heart doesn't have to work as hard |
|
|
Term
|
Definition
| any beta blocker, decreased demand, decreased fluids so heart doesn't have to work as hard |
|
|
Term
| cardiac arrhythmia treatment |
|
Definition
| any beta blocker, decrease HR (also effective for managing supraventricular arrhythmias/atrial arrhythmias). beta 1+2 antagonists work by increasing atrioventricular nodal refractory period |
|
|
Term
| ventricular arrhythmia treatment |
|
Definition
| sotalol- blocks beta receptors in the heart and potassium channels |
|
|
Term
| conduction fibers of heart and electrical functioning and ventricular arrhythmias |
|
Definition
| electricity flows down these from SA node (starts HR) to middle of heart AV node (gatekeeper of electrical impulses to ventricles), pass into ventricles and cause contraction (atrial contraction 1st -> AV node -> ventricular contraction). beta receptors are primarily located at AV node. why beta blockers are bad for ventricular arrhythmias bc it bypasses the AV node |
|
|
Term
|
Definition
| adrenergic, stressed out, dopamine, norepi, epi neutrotransmitters, receptors are alpha, beta and dopamine |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| agonize beta 2 or central alpha 2 |
|
Definition
|
|
Term
| receptor selectivity for alphas and betas |
|
Definition
| not absolute, dose dependent and drug-drug interactions can affect drug receptor specificity, ex give drug that enhances effects of dopamine. or if you have liver failure get inc lvls of drug and dec receptor specificity |
|
|
Term
|
Definition
agonism of alpha 1 -> conversion of GDP to GTP -> upregulation and inc activity of phospholipase C ->
-> inc activity of DAG -> inc activity of protein kinase C
-> enhanced by IP3 -> inc free calcium -> release of adrenergic neurotransmitter
[image]
[image] |
|
|
Term
|
Definition
agonist activates beta receptor -> GDP -> GTP -> inc ATP -> inc GTP to cyclic AMP -> inc release of calcium -> action potential and inc release of epi, norepi, dopamine
[image] |
|
|
Term
|
Definition
agonize alpha 2 -> GDP -> GTP -> dec conversion of ATP -> cAMP -> dec dopamine, norepi, epi
[image] |
|
|
Term
| first sympathiomimetic drug isolated |
|
Definition
|
|
Term
|
Definition
| has OH present in 3rd or 4th position, ex dopamine (inc's potency, dec duration of action, dec CNS penetration) (ex dopamine has 15 min half life and phenylethylamine has 1 hr half life) (dopamine not clinically useful for CNS diseases, amphetamine-ADHD- is bc has OH) |
|
|
Term
| structure of sympathiomemetic drugs |
|
Definition
| inc size of alkyl size chain or the longer the side chain, the more likely it will agonize beta receptor and the less likely it will agonize alpha receptor, ex isoproterenol has a long side chain and large alkyl subunit so it is more likely to be a beta selective agonist, epinephrine has equal beta and alpha selectivity, norepi is shortest and has more alpha selectivity |
|
|
Term
| add a group to alpha of side chain |
|
Definition
| inc duration of action, blocks degredation by MAO (ex CH3 group on methoxamine, ephedrine and amphetamine that increases duration of action) |
|
|
Term
| alpha agonists a1> a2>>>>>>beta |
|
Definition
| phenylephrine (finally free dine), methoxamine (a1> a2>>>>>>beta), clonidine (chronic dine), methylnorepinephrine (might i never dine) (a2>a1>>>>>>>Beta) |
|
|
Term
| mixed alpha and beta agonists |
|
Definition
| norepinephrine (a1=a2, b1>>b2), epinephrine (a1=a2, b1=b2) |
|
|
Term
|
Definition
| dobutamine (dobby is mine) (b1>b2>>>>a), isoproterenol (i so pretend it all) (b1=b2>>>>a), albuterol terbutaline (there's a brutal line) metaproterenol (might i pretend it all) ritodrine (right in line) (b2>>b1>>>>a) |
|
|
Term
|
Definition
| dopamine (D1 = D2>>b>>a), Fenoldopam (fend off the pam) (D1>>D2) |
|
|
Term
| phenylephrine (finally free dine) |
|
Definition
| inc's SVR, commonly referred to as an IV vasopressor bc of its selective alpha 1 agonism activity |
|
|
Term
| mixed alpha and beta agonists |
|
Definition
| dopamine, norepi, epi, have vasopressor effect and inotrope effect |
|
|
Term
| agonism of beta 1 and 2 drug is called |
|
Definition
| inotrope (inc CO, SV and HR) |
|
|
Term
| agonism of alpha 1 drug is called |
|
Definition
|
|
Term
| differences in agonism of betas and alphas |
|
Definition
| agonism of beta 1 and 2 causes inc cardiac output, agonism of beta 1 causes inc cardiac output-primaryily affects myocardium, b2 agonism cuases inc cardiac output and causes bronchial smooth muscle to relax (good for asthma/albuterol) |
|
|
Term
|
Definition
| dobutamine and isoproterenol |
|
|
Term
| oral vasopressor that agonizes alpha 1 activity |
|
Definition
| midodrine (middle of dream) |
|
|
Term
|
Definition
| epinephrine, norepinephrine, dopamine, phenylephrine (finally free dine) |
|
|
Term
|
Definition
| epinephrine, norepinephrine, dopamine, fenoldopam (fend off the pam) , dopamine agonists, dobutamine (dobby of mine) |
|
|
Term
|
Definition
| amphetamine, modafinil (modify), methylphenidate (mild fend off date) |
|
|
Term
|
Definition
| cocaine, ephedrine (weight loss no longer available), tyramine (try me) |
|
|
Term
|
Definition
| terbutaline inj. (there's a brutal line), ritodrine (riddle dream) |
|
|
Term
|
Definition
| dexmedetomidine (dexter of mine) |
|
|
Term
| pulmonary b2 for local application |
|
Definition
albuterol ,terbutaline inj. (inhaler available only
in Canada) |
|
|
Term
| opthalmic a2 for local application |
|
Definition
| brimonidine (brim of a dime) |
|
|
Term
| nasal a2a for local application |
|
Definition
| Oxymetazoline (ought you get in line) |
|
|
Term
|
Definition
• Complex acute cardiovascular syndrome, low BP
• dec mean arterial pressure, dec ability to deliver oxygen to tissues-> cell death->organ failure |
|
|
Term
|
Definition
| IV vasopressors (epinephrine, norepinephrine, dopamine, phenylephrine), exception is cardiogenic shock- use IV inotropes (dobutamine, isoproterenol) then vasopressors |
|
|
Term
|
Definition
| NO CASH, Neurogenic, Obstructive, Cardiogenic, Anaphylactic, Septic, Hypovoluemic |
|
|
Term
|
Definition
| vasodilation, septic and anaphylactic, immune-mediated |
|
|
Term
|
Definition
| found in foods that are highly fermented (cheese, wine, alcohol), inc consumpiton -> inc conversion to norepinephrine. tyramine is broken down by MOA (monamine oxidase). if you take an MOA inhibitor (depression), inc's tyramine indirectly. but if you also consume a lot of tyramine containing foods, inc risk of too much norepinephrine -> inc CO and SVR -> hypertension or hypertensive crisis |
|
|
Term
| most commonly used beta 2 agonist |
|
Definition
| albuterol, and terbutaline injectable (for asthma), historically used to treat w epinephrine and isoproterenol (inc SVR and BP) |
|
|
