Chapter 9 Adrenergic

Question 1

What are parasympathomyemetics also referred to as?

Answer 1

Cholinomemetics

This term is used to describe agents that stimulate the parasympathetic nervous system.

Question 2

What do adrenergic agonists and antagonists simulate?

Answer 2

Sympathetic nervous system response

These agents affect heart and peripheral vasculature.

Question 3

What neurotransmitter primarily regulates the main effects of adrenergic agonists?

Answer 3

Norepinephrine

Question 4

What physiological response occurs when mean arterial pressure drops?

Answer 4

Medulla oblongata sends a signal through pre ganglionic fiber to stimulate the heart.

Sympathetic response activated

Parasympathetic response slowed

RAAS system activated

Question 5

What are the categories of adrenergic agonists?

Answer 5

Direct-acting, indirect-acting, both direct and indirect-acting

Question 6

What are epinephrine and norepinephrine classified as?

Answer 6

Catecholamines

Question 7

What defines a catechol group?

Answer 7

A benzene ring with two hydroxyl groups at positions three and four

Question 8

What is a key structural difference between norepinephrine and epinephrine?

Answer 8

Epinephrine has an additional methyl group at the end of the amine.

Question 9

What types of receptors do adrenergic drugs target?

Answer 9

Alpha receptors, beta receptors, dopamine receptors

Question 10

True or False: No drug is specific for only one subtype of adrenergic receptor.

Answer 10

True

Question 11

What is the function of monoamine transporters?

Answer 11

Transport neurotransmitters (monamines - Norepinephrine,epi , dopamine, serotonin ) back up into the presynaptic neuron

Examples: NET, SERT, DAT

Question 12

What is the norepinephrine transporter (NET) blocked by?

Answer 12

Cocaine and amphetamines

Question 13

What is the typical cardiac output for a normal heart?

Answer 13

About 5,000 milliliters per minute

4-6 LPM

Question 14

What happens when norepinephrine binds to beta-1 receptors in the heart?

Answer 14

Increases cardiac output - positive inotropic and chronotropic effects

and decreases peripheral vascular resistance - increased cAMP - causes relaxation in smooth muscle

Question 15

What is bronchodilation and which receptors are primarily involved?

Answer 15

Relaxation of bronchial smooth muscles via beta-2 receptors

Question 16

What effect do catecholamines typically have on the central nervous system?

Answer 16

Limited effects due to inability to cross blood-brain barrier

Question 17

Fill in the blank: Non-catecholamines are _______ that do not have a catechol group.

Answer 17

Sympathomimetics

Question 18

What is phenylephrine primarily used for?

Answer 18

As a decongestant

Question 19

What is the main action of isoproterenol?

Answer 19

Increase heart force and rate of contraction

Can help with vasodilation

Beta 1 and beta 2 agonist

Question 20

What distinguishes ephedrine from catecholamines?

Answer 20

It releases stored catecholamines and crosses the blood-brain barrier.

Question 21

What is the primary use of pseudoephredrine?

Answer 21

As a nasal decongestant

Question 22

True or False: Methamphetamines have recognized medical uses.

Answer 22

False

Question 23

What is a common side effect of amphetamines?

Answer 23

Mood elevation and appetite suppression

Question 24

What are sympathomimetics?

Answer 24

Chemicals that mimic the effects of the sympathetic nervous system

Includes substances like amphetamines and methamphetamines.

Question 25

What is the primary effect of methamphetamine?

Answer 25

Central nervous system effects, particularly addiction ## Footnote Methamphetamine has no medical use and is highly destructive.

Question 26

What was phenylpropanolamine used for?

Answer 26

Over-the-counter appetite suppressant ## Footnote It was marketed as a diet drug and is no longer available.

Question 27

How does cocaine affect the central nervous system?

Answer 27

Prolongs norepinephrine at the synapse and inhibits dopamine uptake ## Footnote This contributes to its addictive properties.

Question 28

What is hypotension?

Answer 28

Decreased blood pressure ## Footnote Can result from various causes, including blood loss or heart issues.

Question 29

What type of drugs can be used to increase blood pressure in hypotensive emergencies?

Answer 29

Direct-acting alpha agonists ## Footnote Examples include norepinephrine and phenylephrine.

Question 30

What is the role of beta agonists in shock treatment?

Answer 30

Target the heart to improve function ## Footnote Examples include epinephrine and isoproterenol.

Question 31

What is the purpose of using epinephrine in anaphylaxis?

Answer 31

Stimulates a response to counteract bronchospasm and cardiovascular collapse ## Footnote Commonly carried as an EpiPen.

Question 32

What are alpha antagonists used for?

Answer 32

Lowering blood pressure and treating benign prostatic hyperplasia ## Footnote They can be reversible or irreversible.

Question 33

What is phenoxybenzamine?

Answer 33

An irreversible alpha antagonist ## Footnote Used in treating pheochromocytoma.

Question 34

What is the primary effect of beta blockers?

Answer 34

Lower blood pressure by affecting the heart ## Footnote They have negative inotropic and chronotropic effects.

Question 35

What happens to blood pressure initially when using beta blockers?

Answer 35

It may increase slightly due to blocking beta-2 receptors ## Footnote Over time, consistent use leads to decreased blood pressure.

Question 36

Fill in the blank: Methamphetamines have a much higher ratio of central nervous system to peripheral nervous system actions than _______.

Answer 36

amphetamines

Question 37

True or False: Phenylpropanolamine is still available on the market today.

Answer 37

False ## Footnote It was discontinued due to safety concerns.

Question 38

What is the effect of norepinephrine in shock treatment?

Answer 38

Targets both the heart and periphery to enhance blood flow ## Footnote Useful in cardiac insufficiency scenarios.

Question 39

How do alpha-2 agonists function in anesthesia?

Answer 39

Lower blood pressure and cause sedation ## Footnote Examples include clonidine and dexmedetomidine.

Question 40

What is the mechanism of action for non-selective alpha antagonists?

Answer 40

Block the effects of epinephrine ## Footnote Useful in treating pheochromocytoma.

Question 41

What condition can alpha blockers help alleviate in elderly males?

Answer 41

Benign prostatic hyperplasia ## Footnote They increase urinary output.

Question 42

What is the significance of beta-2 selective agonists?

Answer 42

They are used in respiratory treatments, such as asthma ## Footnote Examples include albuterol and metaproterenol.

Question 43

What is the primary use of prazosin?

Answer 43

Treat hypertension and benign prostatic hyperplasia ## Footnote It is highly selective for alpha-1 receptors.

Question 44

What are the inotropic and negative chronotropic effects of beta blockers?

Answer 44

They slow down the rates and slow down the force of contraction.

Question 45

What happens to blood pressure initially when using a beta blocker like propranolol?

Answer 45

Blood pressure increases slightly.

Question 46

Why does blood pressure decrease over time with prolonged use of beta blockers?

Answer 46

The body adapts to the lower effect of the heart and lower cardiac output.

Question 47

What is the effect of beta blockers on airway resistance?

Answer 47

They increase airway resistance, which is undesirable by blocking beta 2.

Question 48

What type of beta blocker preferentially targets beta-1 receptors?

Answer 48

Beta blockers that are beta-1 selective Atenolol, metoprolol, Esmolol, Bisoprolol, betaxolol M.A.B.B.E

Question 49

What is the effect of beta blockers on intraocular pressure?

Answer 49

They decrease intraocular pressure.

Question 50

How do beta blockers affect metabolism?

Answer 50

They inhibit the breakdown of fat and glycogen. Slow metabolism

Question 51

What is a potential long-term effect of beta blocker therapy on cholesterol levels?

Answer 51

It can increase bad cholesterol and good cholesterol Since they inhibit glycogen and fat breakdown

Question 52

What is the primary beta blocker mentioned that works equally on beta-1 and beta-2 receptors?

Answer 52

Propranolol.

Question 53

Why is propranolol not typically preferred for asthmatic patients?

Answer 53

It increases airway resistance.

Question 54

What is the role of esmolol in surgery?

Answer 54

It is a fast-acting beta blocker used to control sudden increases in blood pressure.

Question 55

What conditions are beta blockers primarily useful for?

Answer 55

High blood pressure and ischemic heart disease.

Question 56

What is an arrhythmia?

Answer 56

Any deviation from the normal heart rate or function.

Question 57

How can beta blockers help with arrhythmias?

Answer 57

They can help improve arrhythmias by slowing down the heart

Question 58

Which beta blocker is known for being the first on the market?

Answer 58

Propranolol.

Question 59

What is the difference between beta-1 and beta-2 receptors in the context of beta blockers?

Answer 59

Beta-1 receptors primarily affect the heart, while beta-2 receptors affect the lungs.

Question 60

Fill in the blank: Beta blockers are used in the treatment of _______.

Answer 60

hypertension.

Question 61

What is the significance of beta-1 selective beta blockers for patients with COPD?

Answer 61

They are safer for patients with asthma or COPD.

Question 62

What are the four basic classes of drugs mentioned in the lecture?

Answer 62

* Beta-blockers * Alpha-blockers Cholinomimetics * Anti-muscarinics