Pharmacology Lecture 8: Anesthetics and Adrenaline

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Questions and Answers

What is the maximum dosage of dopamine infusion?

10 ug/kg/min

30 ug/kg/min

20 ug/kg/min (correct)

15 ug/kg/min

What is the therapeutic use of isoprenaline?

Chronic heart block

Chronic bronchial asthma

Hypertension

Acute heart block (correct)

What is the dosage of isoprenaline by IV infusion?

5-50 ug/min

10-100 ug/min

2-20 ug/min (correct)

1-10 ug/min

What is the contraindication of isoprenaline?

Tachycardia Signup and view all the answers

What is the mechanism of action of dobutamine?

β1 receptor agonist Signup and view all the answers

What is the dosage of dobutamine infusion?

2.5-15 ug/kg/min Signup and view all the answers

What is the advantage of dobutamine over other sympathomimetic drugs?

It decreases oxygen demands of the myocardium Signup and view all the answers

What is a common adverse effect of dobutamine?

Arrhythmias Signup and view all the answers

What is the primary use of albuterol and terbutaline?

Treatment of bronchospasm and chronic obstructive pulmonary disease Signup and view all the answers

Which of the following is a therapeutic use of terbutaline?

Relaxation of the uterus during premature labor Signup and view all the answers

What is a common side effect of β2 agonists?

Tremor Signup and view all the answers

How long does a single dose of salmeterol or formoterol provide bronchodilation?

More than 12 hours Signup and view all the answers

What is the difference between salmeterol and formoterol?

Salmeterol has a somewhat delayed onset of action Signup and view all the answers

How are salmeterol and formoterol typically used?

In combination with a corticosteroid Signup and view all the answers

What is the route of administration for albuterol and terbutaline?

Metered-dose inhaler Signup and view all the answers

What type of receptors do salmeterol and formoterol selectively activate?

β2-adrenergic receptors Signup and view all the answers

Which of the following anesthetics can potentiate the effect of Adrenaline, leading to cardiac arrhythmias?

All of the above Signup and view all the answers

What is a major adverse effect of Adrenaline?

Hypertension Signup and view all the answers

Which of the following is a minor side effect of Adrenaline?

Tremors Signup and view all the answers

What can occur due to the use of infiltration anesthetics containing Adrenaline?

Severe vasoconstriction Signup and view all the answers

What is Noradrenaline used for?

Acute hypotension Signup and view all the answers

What is a therapeutic use of Noradrenaline?

Postoperative shock Signup and view all the answers

What can occur due to a large dose of Adrenaline?

Cerebral hemorrhage Signup and view all the answers

What is a common adverse effect of Adrenaline?

Palpitation Signup and view all the answers

What is the effect of oxymetazoline on the body?

It produces nervousness, headaches, and trouble sleeping Signup and view all the answers

What is the mechanism of action of indirect-acting adrenergic agonists?

They cause the release of norepinephrine from presynaptic terminals or inhibit its uptake Signup and view all the answers

What is the effect of amphetamine on blood pressure?

It increases blood pressure significantly Signup and view all the answers

What is the primary mechanism of action of amphetamine?

Blockade of norepinephrine uptake and release of stored catecholamines Signup and view all the answers

What is amphetamine used to treat?

Hyperactivity in children, narcolepsy, and appetite control Signup and view all the answers

Why should amphetamine be avoided during pregnancy?

Because of adverse effects on fetal development Signup and view all the answers

What type of drug is ephedrine?

Sympathomimetic non-catecholamine Signup and view all the answers

What is the classification of ephedrine and pseudoephedrine?

Plant alkaloids now made synthetically Signup and view all the answers

What is the primary indication for using salmeterol and formoterol?

Treating nocturnal asthma Signup and view all the answers

What is the main characteristic of phenylephrine?

It is a direct-acting, synthetic adrenergic drug Signup and view all the answers

What is the primary effect of phenylephrine on blood pressure?

It raises both systolic and diastolic blood pressures Signup and view all the answers

What is the adverse effect of large doses of phenylephrine?

Hypertensive headache and cardiac irregularities Signup and view all the answers

What is the primary mechanism of action of oxymetazoline?

Direct stimulation of α receptors on blood vessels Signup and view all the answers

What is the primary use of oxymetazoline?

Treating nasal congestion and conjunctival inflammation Signup and view all the answers

What is the effect of salmeterol and formoterol overuse?

It can cause death Signup and view all the answers

What is the primary effect of phenylephrine on nasal mucous membranes?

It decreases blood flow and reduces congestion Signup and view all the answers

Study Notes

Adrenaline (Epinephrine)

Adverse effects: cardiac arrhythmias, hypertension, palpitation, dizziness, anxiety, headache, skeletal muscle tremors, myocardial infarction, and pulmonary edema
Toxicity and side effects: anxiety, restlessness, headache, tremors, palpitation, angina pain, and cerebral hemorrhage
Large doses can lead to sharp rise in blood pressure, severe vasoconstriction, and gangrene of fingers or toes

Other Sympathomimetics

Noradrenaline (Nor Epinephrine): natural sympathomimetic catecholamine, administered by I.V. infusion, used for acute hypotension, post-operative shock, and spinal anesthesia
Dopamine (Intropin): dosage 5 ug/kg/min by continuous infusion, adverse effects: nausea, vomiting, hypertension, arrhythmia
Isoprenaline (Isoproterenol or Isuprel): synthetic sympathomimetic catecholamine, not effective orally, administered by injection or inhalation, therapeutic uses: acute heart block, acute bronchial asthma
Dobutamine (Dobutrex): synthetic direct-acting catecholamine, β1 receptor agonist, increases cardiac rate and output with few vascular effects, used to treat unstable congestive heart failure and shock

Beta-2 Agonists

Albuterol (Salbutamol) and Terbutaline: short-acting β2 agonists, used primarily as bronchodilators, administered by metered-dose inhaler
Therapeutic uses: treatment of bronchospasm (asthma), chronic obstructive pulmonary disease, and bronchitis
Side effects: tremor, primarily due to excessive β2-receptor activation
Salmeterol and Formoterol: long-acting β2-adrenergic selective agonists, used for nocturnal asthma, not recommended as monotherapy, but effective when combined with corticosteroid

Alpha-Adrenergic Agonists

Phenylephrine (Neo-Synephrine): direct-acting synthetic adrenergic drug, binds primarily to α1 receptors, raises both systolic and diastolic blood pressures, used topically on nasal mucous membranes and in ophthalmic solutions for mydriasis
Oxymetazoline: direct-acting synthetic adrenergic agonist, stimulates both α1- and α2-adrenergic receptors, used locally in the eye or nose as a vasoconstrictor

Indirect-acting Adrenergic Agonists

Amphetamine: increases blood pressure significantly by α1-agonist action on the vasculature and β-stimulatory effects on the heart, indirect-acting adrenergic agonist, used for treating hyperactivity in children, narcolepsy, and appetite control

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Description

This quiz covers the effects of anesthetics like chloroform, cyclopropane, and halothane on cardiac arrhythmias, particularly when used with adrenaline. It also discusses the adverse effects of adrenaline.