Podcast
Questions and Answers
Which receptor subtype has the highest affinity for dopamine at low doses, leading to vasodilation in renal and mesenteric vascular beds?
Which receptor subtype has the highest affinity for dopamine at low doses, leading to vasodilation in renal and mesenteric vascular beds?
- Beta 1
- D1 (correct)
- Alpha 1
- Beta 2
A patient with cardiogenic shock requires a medication to increase cardiac output with minimal vascular effects. Which medication is most appropriate?
A patient with cardiogenic shock requires a medication to increase cardiac output with minimal vascular effects. Which medication is most appropriate?
- Dobutamine (correct)
- Low-dose Dopamine
- High-dose Dopamine
- Xylometazoline
Which of the following effects is associated with stimulation of beta-2 adrenergic receptors?
Which of the following effects is associated with stimulation of beta-2 adrenergic receptors?
- Bronchodilation (correct)
- Increased uterine contraction
- Vasoconstriction
- Decreased heart rate
Ritodrine is a selective beta-2 agonist used for tocolysis. By what route(s) can it be administered?
Ritodrine is a selective beta-2 agonist used for tocolysis. By what route(s) can it be administered?
A patient is experiencing premature labor. Which Beta-2 agonist could be administered as a tocolytic?
A patient is experiencing premature labor. Which Beta-2 agonist could be administered as a tocolytic?
What is a potential adverse effect associated with the use of selective Beta 2 agonists, particularly at high doses?
What is a potential adverse effect associated with the use of selective Beta 2 agonists, particularly at high doses?
Mirabegron is a selective Beta 3 agonist used to treat overactive bladder. What is the mechanism of action?
Mirabegron is a selective Beta 3 agonist used to treat overactive bladder. What is the mechanism of action?
A patient using Xylometazoline nasal spray for an extended period reports increased nasal congestion when they stop using it. What is the likely cause?
A patient using Xylometazoline nasal spray for an extended period reports increased nasal congestion when they stop using it. What is the likely cause?
Why should caution be taken when using non-selective alpha agonists in hypertensive patients?
Why should caution be taken when using non-selective alpha agonists in hypertensive patients?
Which of the following is a therapeutic use of phenylephrine?
Which of the following is a therapeutic use of phenylephrine?
A 68-year-old male with a history of hypertension is prescribed a nasal decongestant for a cold. Which of the following active ingredients in the decongestant should raise concern?
A 68-year-old male with a history of hypertension is prescribed a nasal decongestant for a cold. Which of the following active ingredients in the decongestant should raise concern?
What is the primary mechanism of action of clonidine?
What is the primary mechanism of action of clonidine?
Tizanidine is a congener of clonidine, but it is primarily used as what?
Tizanidine is a congener of clonidine, but it is primarily used as what?
Which of the following statements best describes the difference between clonidine and tizanidine?
Which of the following statements best describes the difference between clonidine and tizanidine?
Which short-acting selective Beta 2 agonist is administered by oral route?
Which short-acting selective Beta 2 agonist is administered by oral route?
Which of the following adrenergic agonists is commonly present in nasal sprays to treat nasal congestion?
Which of the following adrenergic agonists is commonly present in nasal sprays to treat nasal congestion?
Which of the following is a use tizanidine?
Which of the following is a use tizanidine?
Which of the following a selective beta 2 agonists?
Which of the following a selective beta 2 agonists?
A patient with a history of asthma is experiencing bronchospasm. Which of the following medications would be most appropriate to provide immediate relief?
A patient with a history of asthma is experiencing bronchospasm. Which of the following medications would be most appropriate to provide immediate relief?
A patient on a Beta 2 agonist complains about experiencing hand tremors. What is the mechanism for this adverse effect?
A patient on a Beta 2 agonist complains about experiencing hand tremors. What is the mechanism for this adverse effect?
A patient is experiencing orthostatic hypotension and requires a medication to increase blood pressure. Which of the following medications would be most appropriate?
A patient is experiencing orthostatic hypotension and requires a medication to increase blood pressure. Which of the following medications would be most appropriate?
A patient with an overactive bladder is prescribed Mirabegron. What is a possible side effect of this medication?
A patient with an overactive bladder is prescribed Mirabegron. What is a possible side effect of this medication?
A patient is prescribed clonidine for hypertension. What is the primary mechanism of action by which clonidine lowers blood pressure?
A patient is prescribed clonidine for hypertension. What is the primary mechanism of action by which clonidine lowers blood pressure?
Which of the following medications is a synthetic catecholamine?
Which of the following medications is a synthetic catecholamine?
Which medication causes the following: Stimulates D1 > β1 > α1 receptors?
Which medication causes the following: Stimulates D1 > β1 > α1 receptors?
Which of the following medications is used primarily as a tocolytic agent?
Which of the following medications is used primarily as a tocolytic agent?
What receptor selectivity is lost when Beta 2 agonists is administered in high doses?
What receptor selectivity is lost when Beta 2 agonists is administered in high doses?
Which of the following medications has a relatively minimal effect on blood pressure?
Which of the following medications has a relatively minimal effect on blood pressure?
A previously healthy 25-year-old female presents to urgent care with a chief complaint of nasal congestion for 1 week not resolving with saline nasal spray. She denies any allergies, fever, cough, or other symptoms. She asks if there is anything stronger she can use for her congestion. What would be your recommendation?
A previously healthy 25-year-old female presents to urgent care with a chief complaint of nasal congestion for 1 week not resolving with saline nasal spray. She denies any allergies, fever, cough, or other symptoms. She asks if there is anything stronger she can use for her congestion. What would be your recommendation?
A patient with a known history of stable heart failure taking appropriate medications presents to the Emergency Department with shortness of breath and is found to be hypotensive. The patient requires an agent to improve cardiac output and blood pressure. Which of the following medications would be most appropriate?
A patient with a known history of stable heart failure taking appropriate medications presents to the Emergency Department with shortness of breath and is found to be hypotensive. The patient requires an agent to improve cardiac output and blood pressure. Which of the following medications would be most appropriate?
A researcher is investigating the effects of adrenergic agonists on vascular smooth muscle. Which of the following receptors, when stimulated, would be most likely to cause vasoconstriction?
A researcher is investigating the effects of adrenergic agonists on vascular smooth muscle. Which of the following receptors, when stimulated, would be most likely to cause vasoconstriction?
A pregnant woman in her third trimester is experiencing preterm labor. Her physician decides to administer a Beta-2 adrenergic agonist to help suppress uterine contractions. Which of the following is the most likely mechanism by which this class of drugs achieves uterine relaxation?
A pregnant woman in her third trimester is experiencing preterm labor. Her physician decides to administer a Beta-2 adrenergic agonist to help suppress uterine contractions. Which of the following is the most likely mechanism by which this class of drugs achieves uterine relaxation?
An anesthesiologist is preparing to administer a medication to increase a patient's blood pressure during surgery. The patient has a known history of asthma, and the anesthesiologist wants to avoid any medication that could potentially trigger bronchoconstriction. Which of the following adrenergic agonists would be the MOST appropriate choice?
An anesthesiologist is preparing to administer a medication to increase a patient's blood pressure during surgery. The patient has a known history of asthma, and the anesthesiologist wants to avoid any medication that could potentially trigger bronchoconstriction. Which of the following adrenergic agonists would be the MOST appropriate choice?
A patient is experiencing severe bradycardia and hypotension following a drug overdose. The medical team decides to administer an adrenergic agonist to increase heart rate and blood pressure. Which of the following medications, with its receptor selectivity, would be MOST effective in this scenario?
A patient is experiencing severe bradycardia and hypotension following a drug overdose. The medical team decides to administer an adrenergic agonist to increase heart rate and blood pressure. Which of the following medications, with its receptor selectivity, would be MOST effective in this scenario?
A 70-year-old man with a history of benign prostatic hyperplasia (BPH) is prescribed phenylephrine nasal drops for nasal congestion. Which of the following potential adverse effects should the patient be MOST cautious about due to his underlying BPH?
A 70-year-old man with a history of benign prostatic hyperplasia (BPH) is prescribed phenylephrine nasal drops for nasal congestion. Which of the following potential adverse effects should the patient be MOST cautious about due to his underlying BPH?
A researcher is studying the effects of various adrenergic agonists on uterine smooth muscle. Which of the following interventions would MOST likely promote uterine relaxation and be useful in the treatment of preterm labor?
A researcher is studying the effects of various adrenergic agonists on uterine smooth muscle. Which of the following interventions would MOST likely promote uterine relaxation and be useful in the treatment of preterm labor?
A patient with a known hypersensitivity to catecholamines requires vasopressor support during septic shock. The patient's physician decides to use a vasopressor with minimal interaction with adrenergic receptors. Which of the following agents is MOST appropriate?
A patient with a known hypersensitivity to catecholamines requires vasopressor support during septic shock. The patient's physician decides to use a vasopressor with minimal interaction with adrenergic receptors. Which of the following agents is MOST appropriate?
A researcher is investigating how different adrenergic agonists affect heart rate and blood pressure. They administer four different drugs (A, B, C, and D) to animal models and monitor the changes in heart rate (HR) and mean arterial pressure (MAP). The results are shown below:
Drug A: HR increased significantly, MAP remained relatively unchanged.
Drug B: HR decreased significantly, MAP increased significantly.
Drug C: HR increased moderately, MAP increased moderately.
Drug D: HR decreased slightly, MAP remained relatively unchanged.
Based on these observations, which drug is MOST likely a selective α2-adrenergic agonist?
A researcher is investigating how different adrenergic agonists affect heart rate and blood pressure. They administer four different drugs (A, B, C, and D) to animal models and monitor the changes in heart rate (HR) and mean arterial pressure (MAP). The results are shown below:
Drug A: HR increased significantly, MAP remained relatively unchanged. Drug B: HR decreased significantly, MAP increased significantly. Drug C: HR increased moderately, MAP increased moderately. Drug D: HR decreased slightly, MAP remained relatively unchanged.
Based on these observations, which drug is MOST likely a selective α2-adrenergic agonist?
A 30-year-old woman presents to her physician with complaints of frequent urination, urgency, and nocturia. After ruling out other potential causes, she is diagnosed with overactive bladder (OAB). The physician decides to prescribe mirabegron, a beta-3 adrenergic agonist. Which of the following mechanisms of action BEST describes how mirabegron helps to alleviate the symptoms of OAB?
A 30-year-old woman presents to her physician with complaints of frequent urination, urgency, and nocturia. After ruling out other potential causes, she is diagnosed with overactive bladder (OAB). The physician decides to prescribe mirabegron, a beta-3 adrenergic agonist. Which of the following mechanisms of action BEST describes how mirabegron helps to alleviate the symptoms of OAB?
A researcher is investigating the effects of a novel adrenergic agonist on various tissues. The researcher observes that the drug causes significant bronchodilation but also increases heart rate and contractility. Upon further investigation, the researcher finds that the drug has high affinity for both β1 and β2 adrenergic receptors. Which of the following strategies would be MOST effective in reducing the cardiac side effects while maintaining the bronchodilatory effects?
A researcher is investigating the effects of a novel adrenergic agonist on various tissues. The researcher observes that the drug causes significant bronchodilation but also increases heart rate and contractility. Upon further investigation, the researcher finds that the drug has high affinity for both β1 and β2 adrenergic receptors. Which of the following strategies would be MOST effective in reducing the cardiac side effects while maintaining the bronchodilatory effects?
Flashcards
Dopamine
Dopamine
A natural catecholamine given intravenously with a very short duration of action.
Dopamine (low doses)
Dopamine (low doses)
Dopamine at low doses stimulates D1 receptors in renal and mesenteric vascular beds, leading to vasodilation and increased renal/hepatic blood flow.
Dopamine (intermediate doses)
Dopamine (intermediate doses)
Dopamine at intermediate doses stimulates beta-1 receptors, which increases contractility and Cardiac Output.
Dopamine (large doses)
Dopamine (large doses)
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Dobutamine
Dobutamine
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Dobutamine's primary effect
Dobutamine's primary effect
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Dobutamine uses
Dobutamine uses
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Selective Beta-2 Agonists
Selective Beta-2 Agonists
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Bronchial Beta-2 Agonist Effect
Bronchial Beta-2 Agonist Effect
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Vascular Beta-2 Agonist Effect
Vascular Beta-2 Agonist Effect
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Uterine Beta-2 Agonist Effect
Uterine Beta-2 Agonist Effect
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Short-Acting Beta-2 Agonists (SABA)
Short-Acting Beta-2 Agonists (SABA)
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Long-Acting Beta-2 Agonists (LABA)
Long-Acting Beta-2 Agonists (LABA)
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Beta-2 Agonists Therapeutic Use
Beta-2 Agonists Therapeutic Use
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Tocolytic use of Beta-2 Agonists
Tocolytic use of Beta-2 Agonists
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Adverse effects of Beta-2 Agonists
Adverse effects of Beta-2 Agonists
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Mirabegron
Mirabegron
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Mirabegron use
Mirabegron use
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Side effects of Mirabegron
Side effects of Mirabegron
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Non-Selective Alpha Agonists
Non-Selective Alpha Agonists
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Xylometazoline & Oxymetazoline Use
Xylometazoline & Oxymetazoline Use
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Side effects of Non-Selective Alpha Agonists
Side effects of Non-Selective Alpha Agonists
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Alpha-1 Agonists Effects
Alpha-1 Agonists Effects
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Alpha-1 Selective Agonists Uses
Alpha-1 Selective Agonists Uses
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Clonidine Mechanism
Clonidine Mechanism
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Tizanidine Mechanism
Tizanidine Mechanism
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Clonidine Effects
Clonidine Effects
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Tizanidine Effects
Tizanidine Effects
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Clonidine Uses
Clonidine Uses
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Tizanidine Uses
Tizanidine Uses
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Clonidine Side Effect
Clonidine Side Effect
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Tizanidine Side Effects
Tizanidine Side Effects
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Study Notes
- Adrenergic drugs work on the autonomic nervous system
Dopamine vs Dobutamine
- Dopamine is a natural catecholamine, while dobutamine is synthetic
- Both have a very short duration of action and are administered via intravenous infusion
- Dopamine stimulates D1, beta-1, and alpha-1 receptors
- Low doses of dopamine stimulate D1 receptors in renal and mesenteric vascular beds, leading to vasodilation and increased renal/hepatic blood flow
- Intermediate doses of dopamine stimulate beta-1 receptors, increasing contractility and cardiac output
- Large doses of dopamine stimulate alpha-1 receptors, causing vasoconstriction and increased blood pressure
- Dopamine's therapeutic uses include the treatment of shock states, increasing cardiac output, renal blood flow, and blood pressure
- Dobutamine primarily stimulates cardiac beta-1 receptors, increasing cardiac output with little or no vascular effects
- Dobutamine is used therapeutically for cardiogenic shock or acute ventricular failure
Selective Beta-2 Agonists
- Selective beta-2 agonists cause relaxation of smooth muscles
- Beta-2 agonists cause bronchodilation in bronchial smooth muscles
- Beta-2 agonists cause vasodilation in vascular smooth muscles
- Beta-2 agonists cause tocolysis (inhibition of uterine contractions) in uterine smooth muscles
- Short-acting beta-2 agonists (SABA) include salbutamol and terbutaline
- Long-acting beta-2 agonists (LABA) include salmeterol and formeterol
- Beta-2 agonists can be administered by inhalation, orally, or by injection
- Ritodrine is a short-acting selective beta-2 agonist available in oral and injectable forms
- At high doses, beta-2 agonists lose their selectivity and may act on beta-1 receptors
Beta-2 Agonists: Therapeutic Uses and Adverse Effects
- Beta-2 agonists treat bronchial asthma
- Beta-2 agonists can be used as tocolytics to delay premature labor; ritodrine and terbutaline are examples
- Adverse effects of beta-2 agonists include tachycardia and arrhythmias (at high doses), due to loss of selectivity and reflex hypotension
- Other adverse effects include tremors (due to facilitation of neuromuscular transmission), tolerance, and hypokalemia
Selective Beta-3 Agonist: Mirabegron
- Mirabegron relaxes the detrusor smooth muscle of the urinary bladder by activating beta-3 receptors, thus improving the filling capacity of the bladder
- Mirabegron can be used alone or with a muscarinic antagonist to treat overactive bladder
- An overactive bladder presents as frequent and urgent urination, and an inability to control urination
- Mirabegron’s side effects include constipation, increased blood pressure and heart rate, common cold symptoms, and bladder infection
Non-Selective Alpha Agonists
- Non-selective alpha agonists include xylometazoline and oxymetazoline, which stimulate alpha-1 and alpha-2 receptors, leading to vasoconstriction
- They are used locally as eye or nose drops for decongestion
- Adverse effects when used locally include irritation, sneezing, and rebound nasal congestion with long-term use
- Rebound nasal congestion can counteracted by using the minimal dose over the shortest duration
- If absorbed systemically, adverse effects include nervousness, headaches, trouble sleeping, and increased blood pressure (caution in patients who are hypertensive)
Selective Alpha-1 Agonists
- Selective alpha-1 agonists, which are non-catecholamines include phenylephrine and midodrine
- Alpha-1 agonists lead to vasoconstriction, increasing both systolic and diastolic pressures, which results in reflex bradycardia
- They are used as vasopressors to correct chronic hypotension, including orthostatic hypotension
- Alpha-1 agonists can locally produce vasoconstriction to relieve congestion, as in eye or nose drops that are decongestants
Selective Alpha-2 Agonists
- Clonidine and tizanidine are selective alpha-2 agonists
- Clonidine is a centrally-acting alpha-2 agonist and is used as an antihypertensive drug, which can cause dry mouth
- Tizanidine works as a centrally-acting alpha-2 agonist but with greater effect presynaptically in the spinal cord
- Tizanidine inhibits neurotransmitter release and reduces muscle spasm, with a minimal effect on blood pressure and causes slight side effects
- Tizanidine is used as a skeletal muscle relaxant to minimize spasticity caused by multiple sclerosis, stroke, and spinal cord injury
- Clonidine will be discussed in more detail in the next lecture
Review Question 1
- Which of the following adrenergic agonists is commonly present in nasal sprays to treat nasal congestion?
- The correct answer is B. Xylometazoline
Review Question 2
- Which of the following is a use for tizanidine?
- The correct answer is B. Skeletal muscle relaxant
Review Question 3
- Which of the following is a selective beta 2 agonists?
- The correct answer is D. Salbutamol
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