step 1 physiology flash cards
TRANSCRIPT
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Term 1
what kind of drug is NE?
Definition 1
a1, a2, B1 agonist
Term 2
what kind of drug is epi?
Definition 2
a1, a2, B1, B2 agonist
Term 3
what kind of drug is
dopamine?
Definition 3
dopamine receptor, B
agonist
Term 4
what kind of drug is
tyramine?
Definition 4
indirectly acting
sympathomimetic
Term 5
what kind of drug is
ephedrine?
Definition 5
directly and indirectly acting
sympathomimetic
Term 6
what kind of drug is
amphetamine?
Definition 6
indirectly acting
sympathomimetic
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Term 7
what kind of drug is
phenylephrine?
Definition 7
a1 agonist
Term 8
what kind of drug is
clonidine?
Definition 8
a2 agonist
Term 9
what kind of drug is
isoproterenol?
Definition 9
B1 and B2 agonist
Term 10
what kind of drug is
dobutamine?
Definition 10
B1 agonist
Term 11
what kind of drug is
metaproterenol?
Definition 11
B2 agonist
Term 12
what kind of drug is
albuterol?
Definition 12
B2 agonist
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Term 13
what kind of drug is
terbutaline?
Definition 13
B2 agonist
Term 14
prototype a1 agonist
Definition 14
phenylephrine
Term 15
what drug is used when
have a stuffy nose to clear
airway?
Definition 15
phenylephrine (a1 agonist)
Term 16
what is a drug that can be
used in the ICU to increase
peripheral resistance without
increasing CO?
Definition 16
phenylephrine (a1 agonist)
Term 17
prototype drug for a2
receptor
Definition 17
clonidine
Term 18
action of clonidine
Definition 18
at the neuroeffector junctio
- on the nerve terminus itse
feeds back and binds a2
receptor of the neuron
releasing NE and inhibits
release of more NE
feedback regulator of NE
release
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Term 19
prototype drug for B1
receptor
Definition 19
dobutamine
Term 20
prototype drug for B2
receptor
Definition 20
terbutaline
Term 21
what are the 3 ways
adrenergic agonists can
have an effect?
Definition 21
1. act directly on adrenergic
receptors
2. act by promoting release
of endogenous NE
3. mixed actions
Term 22
actions of a1 receptor
agonists
Definition 22
1. vasoconstriction -
increases peripheral
resistance and BP
2. venoconstriction -
decreases capacitance and
increases venous pressure
and right heart filling
pressure
3. contraction of the iris
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Term 23
arteriole effect of a1 receptor
agonists
Definition 23
vasocontriction
increases peripheral
resistance and BP
Term 24
venous effect of a1 receptor
agonists
Definition 24
venoconstriction
decreases capacitance
increases venous pressure
and right heart filling
pressure
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Term 25
effect of a1 receptor agonists
in the eye
Definition 25
contraction of the iris radial
(dilator) muscle
induces mydriasis
Term 26
effect of a1 receptor agonists
on bladder and intestine
Definition 26
contraction of sphincters
Term 27
actions of a2 receptor
agonists
Definition 27
inhibition of neuronal NE
release - decrease BP
Term 28
prototype a2 receptor
agonist
Definition 28
clonidine
developed to be an anti-HTN
drug - decrease BP by
inhibiting neuronal release o
NE
Term 29
prototype a1 receptor
agonist
Definition 29
phenylephrine
Term 30
effect of phenylephrine
infusion?
Definition 30
BP increaseBV are related to heart via
baroreceptors
constrict vessels -->
decrease CO --> decrease
HR and SV via baroreceptor
reversible
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Term 31
normal response to getting
up from laying down (getting
up in the morning)?
Definition 31
BP drops initially - a1
receptors cause constriction
to stop from crashing
need more blood - HR and
contractility increase -
vasoconstrict
Term 32
side effects of a1 blockage
Definition 32
orthostatic HTN and
syncope - block normal phy
that allows for
vasoconstriction
problem elderly woman on
a1 receptor blocker for HTN
can fall and break a hip
Term 33
a1 receptor mediates ____ in
BV
Definition 33
peripheral tone
Term 34
effect of a1 on veins
Definition 34
don't constrict - stiffen and
decrease compliance
causes - blood to be
increased back to the heart
and increase right heart
filling pressure and thus pre
load
Term 35
actions of B1 receptor
agonists
Definition 35
1. increased cardiac
contractility and HR
2. increased lipolysis
3. production of renin from
the kidneys
Term 36
effects of B1 receptor
agonist on heart
Definition 36
increased contractility and
HR
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Term 37
effects of B1 receptor
agonist on peripheral fat
Definition 37
increased lipolysis
Term 38
effects of B1 receptor
agonist on renin production
Definition 38
increased renin production
from kidneys
kidneys are singly
innervated by the arterioles
that lead to them
Term 39
action of B2 receptor
agonists
Definition 39
1. relaxation of vascular SM;
vasodilation results in
decreased peripheral
vascular resistance and BP
2. reflexive tachycardia with
B2 agonist infusion
3. bronchodilation
4. uterine SM relaxation
5. gluconeogenesis and
Term 40
effects of B2 receptor
agonist on vasculature
Definition 40
relaxation of vascular SM -
vasodilation
results in decreased
peripheral vascular
resistance and BP
Term 41
effects of B2 receptor
agonist on heart
Definition 41
reflexive tachycardia
Term 42
effects of B2 receptor
agonist on lungs
Definition 42
bronchodilation
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Term 43
effects of B2 receptor
agonist on uterus
Definition 43
uterine SM relaxation
Term 44
effects of B2 receptor
agonist on liver
Definition 44
gluconeogenesis and
glycogenolysis
Term 45
most B1 receptors are
located on
Definition 45
heart - CO
Term 46
what determines CO?
Definition 46
HR and SV
Term 47
components of SV?
Definition 47
preload
contractility
afterload
Term 48
effects of infusing B1
agonist?
Definition 48
increase HR
increase contractility (force
of contraction)
afterload - NOT increased
with selective B1 agonist
preload - not increased
directly by B1; determined
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Term 49
effect on afterload with
selective B1 agonist?
Definition 49
NOT increased
Term 50
why does preload increase
with B1 receptor agonists?
Definition 50
not directly
determined by veins
Term 51
B2 receptor locations
Definition 51
airway
skeletal muscle BV
BV going to liver
NOT in central BV
Term 52
which BV do not contain B2
receptors?
Definition 52
central BVs
Term 53
effect on HR with infusion of
a1 receptor agonist?
Definition 53
reflexive bradycardia
Term 54
effect on HR with infusion of
B2 receptor agonist?
Definition 54
reflexive tachycardia
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Term 55
NE is an agonist to which
receptors?
Definition 55
a1, a2, B2 adrenergic
receptors
Term 56
effect of NE in renal BV?
Definition 56
induces profound
constriction of renal BV
dangerously reduces rena
blood flow
problem in patient with low
GFR
Term 57
is NE effective in oral admin?
Definition 57
NO
Term 58
why is NE not effective when
administered orally?
Definition 58
degraded by acidic pH
Term 59
does NE cross the BBB?
Definition 59
NO
Term 60
epi is an agonist to which
receptors?
Definition 60
a1, a2, B1, B2 receptors
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Term 61
what receptor mediates
bronchodilator effect of epi?
Definition 61
B2
Term 62
what complicates the B2
bronchodilator effect of epi?
Definition 62
cardiac stimulation - B1
and
elevations in systolic BP - a
Term 63
use of epi
Definition 63
emergency management of
anaphylactic shock -
characterized by severe
bronchial constriction and
CV collapse
included as a
vasoconstrictor agent in
most local anesthetic
(procaine-like) preparations
Term 64
why is epi included in most
local anesthetic
preparations?
Definition 64
as a vasoconstrictor agent
to limit diffusion of local
anesthetic
Term 65
side effects of epi used
parenterally in high doses?
Definition 65
can produce cardiac
arrhythmia
Term 66
when can epi produce
cardiac arrythmias?
Definition 66
when used parenterally in
high doses
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Term 67
how is epi administered?
Definition 67
by parenteral injection - as
cardiac stimulant in
emergencies
inhalation or injection - as
bronchodilator
Term 68
which receptor does NE not
target physiologically?
Definition 68
B2
epi does - accounts for
difference in CV response
between the two
Term 69
which binds a2 with higher
affinity: epi or NE?
Definition 69
epi
Term 70
what is the physiologically
more important location of
a2 receptors?
Definition 70
neuroeffector junction
Term 71
what is the physiologically
most important ligand for a2
receptors? why?
Definition 71
NE
epi is not released at the
neuroeffector junction which
is the physiologically most
important location of a2
receptors
epi can bind a2 - not its
primary role
Term 72
phenylephrine type
Definition 72
prototype a1 selective
agonist
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Term 73
phenylephrine local use
Definition 73
applied topically to the nasal
mucosa - induces
vasoconstriction to improve
air flow
works well for stuffy noses
and common cold
Term 74
phenylephrine systemic use
Definition 74
increase BP - induces a
vagally-mediated reflex of
slowing the heart in patient
with paroxysmal tachycardi
Term 75
clonidine and a-methyl-dopa
type
Definition 75
agonist at presynaptic a2
adrenergic receptors
Term 76
a-methyl-dopa is converted
to ____ and stored in ____
Definition 76
a-methylnorepinephrine
sympathetic nerve terminal
Term 77
what is the classic non-
selective B adrenergic
agonist?
Definition 77
isoproterenol
Term 78
isoproterenol type
Definition 78
agonist of B1 and B2
adrenergic receptors
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Term 79
isoproterenol use
Definition 79
by inhalation as a bronchial
dilator
Term 80
isoproterenol side effects
Definition 80
induces tachycardia more
frequently than B2 selectiv
agonists (lacks specificity)
Term 81
dobutamine tends to have
____ action on the _____
than dopamine
Definition 81
more
heart
Term 82
dobutamine type
Definition 82
agonist for B-adrenergic
receptors
Term 83
dobutamine use
Definition 83
used to stimulate the heart in
cardiogenic shock
Term 84
metaproterenol, albuterol,
terbutaline, and salmeterol
type
Definition 84
selective agonist for B2
adrenergic receptors
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Term 85
metaproterenol, albuterol,
terbutaline, and salmeterol
use
Definition 85
used for bronchodilation in
management of reversible
airway diseases (asthma,
COPD)
Term 86
metaproterenol, albuterol,
terbutaline, and salmeterol
delivery
Definition 86
by inhalers - deliver meds to
airway and avoid
confounding effects
Term 87
who typically gets
metaproterenol, albuterol,
terbutaline, and salmeterol
toxicity
Definition 87
patients with dyspnea and
anxiety about not being able
to breath - often take too
much of the drugs
Term 88
effects of taking too much
metaproterenol, albuterol,
terbutaline, and salmeterol
Definition 88
drives Na/K ATPase - can
cause hypokalemia and
problems that go along with
it
Term 89
effects of dompamine at
moderate doses?
Definition 89
agonist of D1 dopaminergic
receptors
relaxes SM in renal BV and
improves renal blood flow
Term 90
effects of dopamine at high
doses
Definition 90
agonist of cardiac B1 (and
B2) receptors
increases cardiac
contractility
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Term 91
effects of dopamine at VERY
high doses
Definition 91
becomes an agonist of a1
adrenergic receptors
produce vasoconstriction
and raise BP
Term 92
half life of dopamine
Definition 92
short - rapid inactivation by
hepatic MAO and COMT
Term 93
inactivation of dopamine
Definition 93
rapid
by hepatic MAO and COMT
Term 94
ephedrine orgin
Definition 94
found in many plants
used in China for >200 year
introduced in West medicin
in 1924 as the first orally
active sympathomimetic
Term 95
ephedrine structure
Definition 95
non-catechol
phenylisopropylamine
Term 96
half life of ephedrine
Definition 96
long
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Term 97
ephedrine direct action
Definition 97
direct a1 and B2 adrenergic
activity
Term 98
ephedrine indirect action
Definition 98
mainly - indirectly to promot
release of endogenous NE
Term 99
how does ephedrine mostly
act?
Definition 99
indirectly
promote release of
endogenous NE
Term 100
ephedrine effect on CNS?
Definition 100
stimulant
Term 101
use of ephedrine
Definition 101
principal use - decongestant
also recommended for
stress incontinence in
women
Term 102
what drug would cause
slight decrease in HR,
increase in systolic,
diastolic, and mean BP, and
a large increase in peripheral
resistance?
Definition 102
NE - get reflexive
bradycardia from peripheravasoconstriction despite B
activation (from barorecepto
reflex) could be
phenylephrine - same BP
response (maybe larger); H
reduced more because no
B1 action
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Term 103
what drug would cause
slight increase in HR,
increase in systolic BP,
decrease in diastolic BP,
very minimal increase in
mean BP, and a slight
decrease in peripheral
resistance?
Definition 103
epi - acts on B2
eliminates rise in BP seen
with NE
don't get reflexive
bradycardia seen with NE
binds B1 - increases HR
B2 actions on BV - primarily
in liver and skeletal muscle
Term 104
what drug would cause
significant increase in HR,
slight increase in systolic
BP, decrease in diastolic BP,
slight decrease in mean BP,
and a large decrease in
peripheral resistance?
Definition 104
isoproterenol - B1 and B2
only; no a
big increase in HR
no vascoconstrictor
response
enormous change in
peripheral resistance
Term 105
peripheral resistance is the
relationship between?
Definition 105
CO and BP
Term 106
pressure from inflow (aortic
flow) - resistance to pressure
(outflow) =
Definition 106
peripheral resistance
Term 107
B1 agonist effect on CO?
Definition 107
increases CO
Term 108
what is tocolytic therapy?
Definition 108
use of B adrenergic agents
to attenuate premature labo
delay delivery, allow fetal
maturation
thereby - reducing neonata
morbidity and mortality
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Term 109
what is a common side effect
of B-adrenergic tocolytic
therapy for treatment of
preterm labor?
Definition 109
hypokalemia
Term 110
what drug is often used for
tocolytic therapy?
Definition 110
terbutaline (B-adrenergic
agonist)
Term 111
how do B-adrenergic
agonists control serum K?
Definition 111
activate Na/K ATPase by
increasing cAMP - take K out
of blood and store in cell -->
hypokalemia
Term 112
what can happen with abrupt
withdrawal of a B adrenergic
agonist?
Definition 112
can get rebound
hyperkalemia
Term 113
what are the major side
effects of B agonists?
Definition 113
cardiac arrhythmias
hypokalemia
can precipitate angina
insomnia
anxiety
tremor
Term 114
what are the major side
effects of a agonists?
Definition 114
headache
**reflexive bradycardia
excitability
restlessness
can precipitate angina
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Term 115
ephedrine actions
Definition 115
direct and indirect agonist
Term 116
tyramine type
Definition 116
indirect acting
sympathomimetics
Term 117
tyramine origin
Definition 117
normal byproduct of tyrosine
metabolism
Term 118
where is tyramine found in
high concentrations?
Definition 118
fermented foods (cheese)
Term 119
tyramine action
Definition 119
enters NE nerve terminal via
the amine transporter and
causes NE release
Term 120
tyramine in converted to
____ by ______
Definition 120
octopamine
dopamine-B-hydroxylase
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Term 121
metabolism of tyramine
Definition 121
readily metabolized by MAO
Term 122
in what patients are the
effects of tyramine
intensified?
Definition 122
patients treated with MAO
inhibitors
Term 123
how does drug tolerance to
tyramine develop?
Definition 123
develops as NE is
completely replaced by
octopamine
Term 124
amphetamines type
Definition 124
indirect acting
sympathomimetic
Term 125
amphetamines action
Definition 125
facilitate release of NE
Term 126
do amphetamines have
direct effect on adrenergic
receptors?
Definition 126
NO
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Term 127
effect of amphetamines on
CNS?
Definition 127
stimulant
Term 128
cocaine type
Definition 128
indirect acting
sympathomimetic
Term 129
cocaine action
Definition 129
blocks neuronal uptake1
pathway for NE
extends half life of NE at
synaptic cleft
Term 130
what is important to know
about cocaine toxicity?
Definition 130
negative impact can be
played out over 72-98 hours
after ingested
toxicity is potentially severa
days after use because of
long half life