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Prototype Nonselective adrenergic agonist
Epinephrine
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Prototype alpha 1 adrenergic agonist
Phenylephrine
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Prototype alpha 2 adrenergic agonist
Clonidine
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Prototype beta adrenergic agonist
Dopamine
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Prototype beta 1 agonist
Albuterol
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Prototype dopaminergic agonist
Fenoldopam
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Prototype Alpha antagonist
Prazosin
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Prototype beta blocker
Metoprolol
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Sympathetic/ Adrenergic system responsible for Fight or flight will :
- Increased heart rate
- dilate pupils
- mobilize energy
- redirect bloodflow from nonessential organs to skeletal muscles
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Postganglionic neurotransmitter that is produced and store in the presynaptic nerve terminals of the SNS
Norepinephrine
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Hormone converted from norepinephrine in the adrenal Medulla, also known as adrenaline
Epinephrine
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Epinephrine was stimulate all adrenergic receptors except
Dopaminergic
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______ receptors are less sensitive to epinephrine so it's initial response will Be to _______stimulation
Alpha and Beta
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Alpha-1 receptors are found in
Eyes, blood vessels, bladder, male sex organs, prostatic capsule
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Alpha-2 receptors are found In
Presynaptic nerve terminals
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Beta-1 receptors are found in
Primarily the heart, and kidneys
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Beta-2 receptors are found in
Arterioles of the heart, lungs, skeletal muscles, bronchi, uterus, liver
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Alpha-1 is responsible for
Vasoconstriction of coronary arteries and veins and decrease smooth muscle motility in the G.I. tract
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Alpha-2 receptors are responsible for
Shutting down the release of norepinephrine
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Beta-1 receptors are responsible for
Increase cardiac output by increasing the speed of conduction, increasing the force of contraction, and increasing the pulse rate
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Beta-2 receptors are responsible for
Dilation to promote breathing, creating energy from the breakdown of that stored in fat tissue also known as lipolysis, or from providing glucose to the cells through new creation of glucose (gluconeogenesis) or the breakdown of glycogen into glucose
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Beta three receptors are responsible for
help break down fats in fact issues for imaging heat and plays a major role in regulation of weight but also causes tremors that's making pharmacologically unuseful at this time
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Alpha-1 and beta-1 receptors response to what type of stimuli
Epinephrine, norepinephrine, and dopamine
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Alpha-2 and beta-2 receptors response to what type of stimuli
Epinephrine and norepinephrine
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Many dopamine receptors are located where
In the kidneys. and in low amounts dopamine Binds with vascular and renal receptors dilating blood vessels, increasing blood flow to the renal, mesenteric, and coronary heart
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As dopamine increases, beta-1 receptors are stimulated. Dopamine in highest concentrations act on alpha-1 receptors.
Info
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There are 5 types of dopamine receptors and only two mediate responses in the Adrenergic nervous system, what are those two?
Dopamine one and dopamine two
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Stimulation of dopamine one and dopamine two receptors results in ________ ;however stimulating both receptors may have either complementary or opposing effects
Peripheral vasodilation
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_________ Is a dopamine one agonist in the prototype for dopaminergic agonist drugs
Fenoldopam
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Fenoldopam is use in the hospital for short-term management of what disease
Severe hypertension
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Fenoldopam is contradicted in patients with what issues
Hypersensitivity to sulfites, history of glaucoma or intraocular hypertension, Hypokalemia because fenoldopam may reduce serum potassium with administrative for more than six hours. Also is given cautiously in the patients with acute cerebral infarction or hemorrhage just because it may call hypotension
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When giving Fenoldapam
Should be diluted with sodium chloride or dextrose, titrated, and monitored closely
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Prazosin is used to treat what diseases
- CHF
- Raynaud vasospasms
- prostatic outflow obstruction
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Prazosin blocks postsynaptic alpha-1 adrenergic recepotrs and lowers what two blood pressures
supine and standing
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You should not use Prazosin in what contrindicated populations
- Hypersensitivy
- pts. with angina because hypotension may worsen the condition
- CHF or renal failure
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Light headedness, dizziness, headache, drowsiness, weakness, lethargy, nausea, and palpitations are all adverse effects of what drug.
Prazosin
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Symptomatic hypotension, tachycardia, adbominal or back pain, GI effects, sweating, and CNS effects such as insomnia, dizziness, nervousness, or anxiety are all adverse efeects of _______________
Fenoldopam
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___________ is used for the treatment of hypertensio, angina, and controlled CHF
Metoprolol
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Pharmacodynamics of Metoporol is?
decreases cardiac output, blood pressure, and slows atrioventricular conduction and suppression of automaticity
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enteral route uses _______ for the ingestion and absorption of drugs.
GI tract
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Parenteral route, which includes topical as a sub classification, distrubutes drugs how?
By bypassing the GI tract in forms of injections and topical appliance to skin or mucous membranes
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Most drug absortption occurs where?
small intestines
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Desired therapeutic effect of the drug is called?
pharmacotherapeutics
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what is phatmacokinetics?
the changes that occur to the drug while it is inside the body
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Pharmacodynamics is _____________
the effects of the drug on the body
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What are effects that may occur when the drug is given along with another drug, food, or substance?
drug interactions
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Core patient variables are:
- health status
- life span and gender
- lifestyle, diet, and habits
- environment
- culture and inherited traits
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Pre clincal trials are designed
to provide basic safety, bioavailability, pharmacokinetic, and intial efficay data about the drug and are carried out in animal subjects in the laboratory setting
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Parasympathetic/cholinergic nervous system is stimulated by what neurotransmitter
acetylcholine
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What are the 2 drug categories in the PSNS
- cholinergic agonists
- anticholinergics
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PSNS is responsible for:
- Salvation
- Lacrimation
- Urination
- Digestion
- Defecation
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ACh cause _____________ to produce nitric oxides, which diffuses to ______ and results in vasodilation and perfusion of organs
- endothelial cells
- smooth muscle
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Cholinergic receptors include
- Nicotinic M
- Nicotinic N
- Muscarinic
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Nicotinc M receptors are found? N?
- M: neuromuscular junctions of skeletal muscle
- N: in cell bodies of postganglionic neurons in the SNS, PSNS, and adrenal medulla
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Muscarinic receptors reponds to _____ and binds to _____
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Pilocarpine (akarpine) causes
miosis and increase salivary flow
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When using pilocarpine drops ask about? Oral or topical admin?
- retinal detachment
- bradyarthymias
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Direct acting nicotinic agonists is
nicotine
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Indirect acting cholinergic agonist
AChE is cleared by ACh and blocks the action of ACh
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Neostigmine (progstigmin) is a long-acting cholinesterase inhibitor and potent miotice used in the management of______
glaucoma
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Neostigmine helps_____________
drain fluids from the eyes which decreases pressure and is a category X drug because it may cause fetal defomities. Also helps with myasthenia gravis
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Neostigmine is best given how? and what should you ask and do before admin?
- Parenterally
- Ask last bowel movement and check on resp. status and issues
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Cholinergic antagonists used for bradycardia and choliergic crisis is?
Atropine
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Atropine works how?
targets and block muscarine receptors. You should know hx of cardiac arrthymias before giving this drug
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Alkaloids
reacts with the body's acids and forms salts which is soluable in body fluids
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glycosides
contains CHO or sugar molecule
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Gums
mucilagenous secretions that attract and hold water
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Volatile oils
insoluable in H2O, derived from plants and only evaporate in air
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Fixed oils
derivered from both plants and animal sources and consistency varies with temperature
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Resins
solid or semisolid, water insoluable, organic substances of vegetable origin commonly used as a laxative or caustic agents
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USP
standards of strength, quality, purity, and prepartions of medicinal compounds
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National Formulary
expands efforts to set national standards fro drug quality
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1906
pure food and drug act passed
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1938
Food, drug, and cosmetic act
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the most frequent indications for adrenergic agonist drug is____________
shock
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Epinephrine is used for
asthma and shock and should be watched in people with hypersesitvity, sulfite sensitvity, closed angle glaucoma, and druing labor
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Phenylephrine is used when?
- parenterally for vascular failure in shock
- topical for relief of nasal mucocal congestion
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Organogenesis in the pregnant female occurs when?
from implantation to 58-60 days after conception
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drug excretion rates _________ during pregnacy due to what?
Increase; by the 3rd trimester renal blood flow has increased 40%-50% increasing glomerular filtration rate
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____________ decrease gastric tone and motility and prolongs stomach empyting times which might alter oral medications
Progesterone
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Play therapy is used for?
reduction of children's anxiety
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Im injections should be given in the leg until what age group?
School aged (6-12) now given ventrogluetual
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Bilirubin accumulation in the CNS is called________ and is life threatining
kernicterus
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Induction of the P-450 system is accomplished by the stimulating synthesis of the _______ enzymes
hepatic
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decreased P-450 enzymes the longer the half life of a drug will be due to decrease liver functioning
info
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The inhibition of CYP3A4 causes?
decrease GI metabolism of the drug allowing more of the drug to be absorbed
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what effects CYP3A4
grapefruit juice, St. Johns Wart both inhibit it
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