Adrenergic Agonists and Receptor Activation
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Questions and Answers

What is the main mechanism of action for direct adrenergic agonists?

  • Inhibition of norepinephrine inactivation
  • Promotion of norepinephrine release
  • Blockade of norepinephrine re uptake
  • Work on receptor binding (correct)

Which of the following is NOT a major catecholamine?

  • Norepinephrine
  • Isoproterenol
  • Ephedrine (correct)
  • Dopamine

What property do all catecholamines share due to their chemistry?

  • Ability to act in the central nervous system
  • Brief duration of action (correct)
  • Oral use availability
  • Long duration of action

What is the name of the enzymes that quickly metabolize catecholamines?

<p>Catechol-O-methyltransferase [COMT] (B)</p> Signup and view all the answers

What distinguishes indirect adrenergic agonists from direct ones?

<p>They promote norepinephrine release (C)</p> Signup and view all the answers

Which class of adrenergic agonists is named after its structural components?

<p>Catecholamines (C)</p> Signup and view all the answers

Why can't catecholamines be used orally?

<p>They cannot cross the blood-brain barrier (D)</p> Signup and view all the answers

Which enzyme is responsible for the degradation of noncatecholamines and metabolizes them slowly?

<p>MAO (B)</p> Signup and view all the answers

Why are catecholamine-containing solutions discarded when they turn pink or brown?

<p>Due to oxidation of the catecholamine molecule (D)</p> Signup and view all the answers

What makes noncatecholamines considerably less polar than catecholamines?

<p>Presence of a catechol group (C)</p> Signup and view all the answers

Why are catecholamines ineffective when given orally?

<p>They rapidly degrade by MAO and COMT (D)</p> Signup and view all the answers

What causes the pink or brown discoloration of catecholamine-containing solutions over time?

<p>Oxidation of the catecholamine molecule (A)</p> Signup and view all the answers

How do noncatecholamines differ from catecholamines in terms of reaching systemic circulation when given orally?

<p>Noncatecholamines can reach systemic circulation more effectively (B)</p> Signup and view all the answers

What allows noncatecholamines to cross the blood brain barrier more easily?

<p>Considerably less polar nature (D)</p> Signup and view all the answers

What is the receptor specificity of albuterol?

<p>B2 receptors only (B)</p> Signup and view all the answers

At what dose does the selectivity of albuterol decline?

<p>High doses (B)</p> Signup and view all the answers

What are the two responses elicited by activation of A1 receptors?

<p>Vasoconstriction and mydriasis (D)</p> Signup and view all the answers

What are the therapeutic applications of activation of A1 receptors?

<p>Hemostasis and nasal decongestion (D)</p> Signup and view all the answers

What causes the adverse effects of alpha-1 receptor activation?

<p>Vasoconstriction (C)</p> Signup and view all the answers

What is the clinical significance of alpha-2 receptor activation in the central nervous system?

<p>Inhibits NE release (A)</p> Signup and view all the answers

What is the main therapeutic use of activation of alpha-2 receptors in the central nervous system?

<p>Sedation (B)</p> Signup and view all the answers

What determines the ability of a drug to selectively activate certain receptors?

<p>Dosage level (D)</p> Signup and view all the answers

Which effect is associated with the activation of beta-1 receptors in the heart?

<p>Increase in heart rate (A)</p> Signup and view all the answers

What is a potential risk for patients with compromised coronary circulation when exposed to beta-1 agonists?

<p>Increased risk for angina (D)</p> Signup and view all the answers

Which therapeutic application is associated with B2 receptors in the body?

<p>Relaxation of uterine smooth muscle (C)</p> Signup and view all the answers

What adverse effect is specifically seen in diabetics due to the activation of B2 receptors?

<p>Hyperglycemia (D)</p> Signup and view all the answers

What is the main effect of B1 agonists in terms of cardiac O2 demand?

<p>Increase in cardiac O2 demand (B)</p> Signup and view all the answers

Which condition is NOT a therapeutic application of B2 receptors?

<p>Shock (C)</p> Signup and view all the answers

What is a potential adverse effect of B2 receptor activation in non-diabetic individuals?

<p>Tachycardia (D)</p> Signup and view all the answers

Which effect is associated with the activation of B1 receptors in the kidneys?

<p>No untoward effects (D)</p> Signup and view all the answers

What is the receptor specificity of dopamine at high doses?

<p>A1 (C)</p> Signup and view all the answers

Which adrenergic agonist is indicated for the treatment of heart failure?

<p>Dobutamine (A)</p> Signup and view all the answers

What is the receptor specificity of phenylephrine?

<p>A1 receptors (A)</p> Signup and view all the answers

What is the specific therapeutic application of albuterol?

<p>Asthma (C)</p> Signup and view all the answers

What is the main adverse effect associated with ephedrine's activation of alpha and beta receptors?

<p>Hypertension (B)</p> Signup and view all the answers

At what doses does albuterol activate B1 receptors?

<p>High doses (C)</p> Signup and view all the answers

What is the main adverse effect of dobutamine?

<p>Tachycardia (D)</p> Signup and view all the answers

4

<p>A1 receptors (A)</p> Signup and view all the answers

What type of drug is phenylephrine?

<p>Noncatecholamine (B)</p> Signup and view all the answers

What is the specific therapeutic application of dopamine?

<p>Shock (C)</p> Signup and view all the answers

What adverse effect can be caused by albuterol at high doses?

<p>Tremor (D)</p> Signup and view all the answers

What is the receptor specificity of dopamine?

<p>Alpha-1, alpha-2, and beta-1 (C)</p> Signup and view all the answers

What is the main therapeutic use of norepinephrine?

<p>Hypotensive states (D)</p> Signup and view all the answers

Which adverse effect is specifically associated with the use of epinephrine?

<p>Local necrosis on extravasation (B)</p> Signup and view all the answers

What is the receptor specificity of isoproterenol?

<p>Beta-1 and beta-2 (B)</p> Signup and view all the answers

What are the therapeutic uses of epinephrine?

<p>All of the above (D)</p> Signup and view all the answers

Which enzyme is responsible for metabolizing epinephrine?

<p>MAO and COMT (D)</p> Signup and view all the answers

What is the adverse effect associated with norepinephrine?

<p>Angina (C)</p> Signup and view all the answers

What is the primary mechanism of action for adrenergic antagonists?

<p>Reversible competitive blockade of adrenergic receptors (B)</p> Signup and view all the answers

How do adrenergic antagonists lower arterial pressure?

<p>By dilating veins to indirectly reduce arterial pressure (B)</p> Signup and view all the answers

In what condition can an alpha adrenergic antagonist be used to prevent injury?

<p>Extravasated necrosis due to local vasoconstriction (C)</p> Signup and view all the answers

What is the therapeutic application of alpha blockade in BPH?

<p>To treat the proliferation of the prostate gland (C)</p> Signup and view all the answers

What is the primary effect of overdose with an alpha-adrenergic agonist?

<p>Hypertension due to excessive activation of A1 receptors on blood vessels (A)</p> Signup and view all the answers

What is the main therapeutic application of reversible competitive blockade?

<p>Treatment of essential hypertension (A)</p> Signup and view all the answers

What is the specific therapeutic application of alpha blockade in Raynaud Disease?

<p>Treatment of local vasoconstriction and prevention of injury (B)</p> Signup and view all the answers

In what condition does an alpha adrenergic antagonist cause the reduction of arterial pressure by indirect process?

<p>Extravasated necrosis due to intense local vasoconstriction (C)</p> Signup and view all the answers

What is the direct effect of dilation of arterioles caused by adrenergic antagonists?

<p>Reduction in cardiac output and arterial pressure (D)</p> Signup and view all the answers

What is the primary action of adrenergic antagonists when used for reversal of toxicity from alpha agonists?

<p>Blocking the excessive vasoconstriction caused by the alpha agonist (D)</p> Signup and view all the answers

What differentiates most adrenergic antagonists from adrenergic agonists?

<p>They are more selective than adrenergic agonists (B)</p> Signup and view all the answers

What is the primary symptom of Raynaud's disease?

<p>Discoloration due to decreased circulation in toes and fingers (D)</p> Signup and view all the answers

Why is orthostatic hypotension a significant adverse effect of alpha-1 receptor blockade?

<p>It is secondary to blockade of alpha receptors on veins, reducing muscle tone in the venous wall (C)</p> Signup and view all the answers

Which group of alpha adrenergic blocking agents produces selective A1 blockade?

<p>Prazosin (C)</p> Signup and view all the answers

What is the most significant adverse effect associated with alpha-2 receptor blockade?

<p>Potentiation of reflex tachycardia (D)</p> Signup and view all the answers

Which alpha adrenergic blocking agent can cause abnormal ejaculation and has an increased risk for rhinitis?

<p>Tamsulosin (C)</p> Signup and view all the answers

What is the primary use of prazosin among the 'zosins' group of drugs?

<p>Treatment of hypertension (B)</p> Signup and view all the answers

What is the specific reason for giving alpha-1 antagonists prior to surgery for pheochromocytoma?

<p>To avoid manipulation of the tumor causing massive catecholamine release (A)</p> Signup and view all the answers

Why is impotence reversible once alpha-1 antagonist drug is discontinued?

<p>'First-dose' effect leads to reversible impotence (B)</p> Signup and view all the answers

Which peripheral vascular disorder can be suppressed by preventing alpha-mediated base vasoconstriction?

<p>Raynaud's disease (C)</p> Signup and view all the answers

What is the major reason for using alpha-1 antagonists long term if the pheochromocytoma tumor is inoperable?

<p>To treat hypertension resulting from tumor activity (B)</p> Signup and view all the answers

What adverse effect results from sodium retention and increased blood volume due to reduced blood pressure caused by alpha-1 blockade?

<p>Orthostatic hypotension (B)</p> Signup and view all the answers

What distinguishes prazosin from alfuzosin among the 'zosins' group of drugs?

<p>Alfuzosin can prolong QT and should not be given with inhibitors of CYP34A, while prazosin does not have these effects. (D)</p> Signup and view all the answers

What is the main therapeutic application of phentolamine?

<p>Treatment of pheochromocytoma (C)</p> Signup and view all the answers

How do beta adrenergic blockers prevent ischemia and pain?

<p>By reducing oxygen demand and balancing it with oxygen supply (C)</p> Signup and view all the answers

What is a common long-term effect of beta adrenergic antagonist use on peripheral vascular resistance?

<p>Decreased peripheral vascular resistance (B)</p> Signup and view all the answers

What is the main therapeutic application of beta adrenergic blockers in antianginal therapy?

<p>Reducing oxygen demand (D)</p> Signup and view all the answers

What is the primary use of beta adrenergic antagonists in treating dysrhythmias?

<p>Reducing electrical activity in the sinus node and atria (C)</p> Signup and view all the answers

What is the long-lasting effect of phenoxybenzamine receptor blockade?

<p>Irreversible receptor blockade (A)</p> Signup and view all the answers

What are the approved applications of phentolamine?

<p>Diagnosis and treatment of pheochromocytoma, prevention of tissue necrosis, reversal of soft tissue anesthesia (A)</p> Signup and view all the answers

What is the primary effect of beta adrenergic antagonists on cardiac workload?

<p>Decreasing cardiac workload (C)</p> Signup and view all the answers

What are the adverse effects associated with phentolamine?

<p>Orthostatic hypotension and reflex tachycardia (A)</p> Signup and view all the answers

What are the approved applications of phenoxybenzamine?

<p>Diagnosis and treatment of pheochromocytoma, prevention of tissue necrosis (B)</p> Signup and view all the answers

Which adverse effect can be caused by the activation of B2 receptors in the lung?

<p>Bronchoconstriction (D)</p> Signup and view all the answers

What is the primary therapeutic use of propranolol?

<p>Prevention of migraine (A)</p> Signup and view all the answers

What is the effect of blocking B1 receptors in the heart by propranolol?

<p>Decreased cardiac output (A)</p> Signup and view all the answers

Which adverse effect is specifically associated with the use of metoprolol?

<p>Bradycardia (C)</p> Signup and view all the answers

What is the primary reason for using a B1 selective agent in patients with asthma who need a beta blocker?

<p>To prevent bronchoconstriction (B)</p> Signup and view all the answers

What is the mechanism by which propranolol reduces the force of ventricular contraction?

<p>Suppression of impulse conduction through the AV node (B)</p> Signup and view all the answers

What is the primary reason for minimizing the risk of rebound excitation when withdrawing beta blockers?

<p>To prevent anginal pain or ventricular dysrhythmias (D)</p> Signup and view all the answers

What is the primary effect of metoprolol on heart rate?

<p>Decreased heart rate (A)</p> Signup and view all the answers

What is the most significant adverse effect observed with Betaxolol and other beta blockers?

<p>Bradycardia (D)</p> Signup and view all the answers

What is the primary reason for using a B1 selective agent in patients with diabetes mellitus who need a beta blocker?

<p>To avoid hypoglycemia (A)</p> Signup and view all the answers

How do beta blockers contribute to the treatment of an MI?

<p>They reduce the pain (B)</p> Signup and view all the answers

What is the mechanism by which beta blockers prevent tachydysrhythmia and angina in hyperthyroidism?

<p>By normalizing the levels of sympathetic activity to the heart (A)</p> Signup and view all the answers

What is one of the therapeutic applications of beta blockers?

<p>Stage fright (C)</p> Signup and view all the answers

What is a potential risk associated with using beta blockers in patients with heart failure or reduced cardiac reserve?

<p>Insufficient tissue perfusion (B)</p> Signup and view all the answers

Why should beta blockers be discontinued in patients with stage D heart failure?

<p>They exacerbate heart failure symptoms (A)</p> Signup and view all the answers

What is AV heart block defined as?

<p>A delay in atrial impulse conduction through the AV node (D)</p> Signup and view all the answers

What effect do non-selective beta adrenergic blocking agents produce compared to cardioselective beta-adrenergic antagonists?

<p>Broader spectrum of adverse effects (B)</p> Signup and view all the answers

What is a specific therapeutic use of non-selective beta blockade?

<p>Treatment of glaucoma (D)</p> Signup and view all the answers

What is one of the adverse effects of Beta1 blockade?

<p>Suppression of cardiac function (D)</p> Signup and view all the answers

What adverse effect can beta blockers precipitate in some patients?

<p>Heart failure (B)</p> Signup and view all the answers

Which beta blockers have high solubility and primarily penetrate the blood-brain barrier?

<p>Propranolol, Metoprolol (C)</p> Signup and view all the answers

What is the only approved indication for esmolol?

<p>Emergency IV therapy of SVT (A)</p> Signup and view all the answers

Which beta blocker can cause postural hypotension?

<p>Carvedilol (D)</p> Signup and view all the answers

Which beta blockers have a black box warning for abrupt discontinuation and increased risk for angina and MI?

<p>Atenolol, Metoprolol (D)</p> Signup and view all the answers

Which type of adrenergic blocking drugs are used primarily for hypertension?

<p>Indirect-acting antiadrenergic agents (A)</p> Signup and view all the answers

What is the main difference between labetalol, carvedilol, and nebivolol from other beta blockers?

<p>They primarily block alpha adrenergic receptors (D)</p> Signup and view all the answers

What makes sotalol and esmolol unsuitable for treating hypertension?

<p>They require maintenance of blood levels throughout the day (A)</p> Signup and view all the answers

What is the effect of activating A2 receptors located on presynaptic nerve terminals?

<p>Decreased NE synthesis (C)</p> Signup and view all the answers

What is the main adverse effect associated with carvedilol, labetalol, and nebivolol?

<p>Postural hypotension (A)</p> Signup and view all the answers

Which receptor activation do the indirect-acting antiadrenergic agents prevent by mechanisms not involving direct interaction with peripheral receptors?

<p>A1 receptors (B)</p> Signup and view all the answers

What is the main pharmacological effect of clonidine?

<p>Bradycardia and decrease in cardiac output (C)</p> Signup and view all the answers

Why is clonidine not recommended during pregnancy?

<p>It can have adverse effects on the fetus (D)</p> Signup and view all the answers

What is a common adverse effect of clonidine experienced by 40% of patients?

<p>Xerostomia (dry mouth) (D)</p> Signup and view all the answers

How does clonidine affect sympathetic outflow to the blood vessels and heart?

<p>It reduces sympathetic outflow (A)</p> Signup and view all the answers

What is the route of administration for clonidine in epidural administration?

<p>Solution for epidural administration (B)</p> Signup and view all the answers

In what area of the central nervous system does clonidine selectively activate A2 receptors?

<p>Brainstem associated with autonomic regulation (A)</p> Signup and view all the answers

What is the primary mechanism of clonidine's action in reducing sympathetic outflow?

<p>Selective activation of A2 receptors in the CNS (C)</p> Signup and view all the answers

Which adverse effect is specifically associated with clonidine withdrawal?

<p>Rebound hypertension (A)</p> Signup and view all the answers

What is the primary therapeutic use of guanfacine?

<p>Treatment of hypertension and ADHD (D)</p> Signup and view all the answers

How do guanfacine and clonidine benefit patients with hypertension?

<p>By activating brainstem A2 adrenergic receptors (A)</p> Signup and view all the answers

What distinguishes methyldopate from methyldopa?

<p>Route of administration (B)</p> Signup and view all the answers

What is the only therapeutic use of methyldopa and methyldopate?

<p>Treatment of hypertension (A)</p> Signup and view all the answers

Which organization designated methyldopa as one of the preferred drugs for managing hypertension during pregnancy?

<p>American College of Obstetricians and Gynecologists (D)</p> Signup and view all the answers

What are the adverse effects associated with methyldopa?

<p>Hemolytic anemia and hepatic necrosis (A)</p> Signup and view all the answers

What is the primary reason for designating methyldopa as one of the preferred drugs for managing hypertension during pregnancy?

<p>No fetal harm associated with this medication (D)</p> Signup and view all the answers

What are the other two drugs designated by the American College of Obstetricians and Gynecologists for managing hypertension during pregnancy?

<p>Labetalol and nifedipine (A)</p> Signup and view all the answers

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