Pharmacology of Epinephrine
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Questions and Answers

What drug class does epinephrine belong to?

Sympathomimetic non-selective adrenergic agonist

Which of the following is a contraindication for epinephrine administration?

  • Parkinson's disease (correct)
  • Closed-angle glaucoma (correct)
  • Brain disease (correct)
  • Hyperthyroidism (correct)
  • All of the above (correct)

What effect does epinephrine have on blood glucose and serum lactic acid levels?

  • Increases both (correct)
  • Decreases blood glucose, increases serum lactic acid
  • Increases blood glucose, decreases serum lactic acid
  • Decreases both

Which drug class can potentiate the effects of epinephrine?

<p>A and B only (C)</p> Signup and view all the answers

Describe the pharmacokinetic properties of epinephrine, including its absorption, distribution, metabolism, and elimination.

<p>Epinephrine is rapidly absorbed via subcutaneous, intramuscular, and intravenous routes. It undergoes minimal absorption in the gastrointestinal tract. Distribution is characterized by protein binding. Epinephrine has a short half-life of less than five minutes when administered intravenously. Elimination occurs primarily through urinary excretion, with a small amount found in breast milk.</p> Signup and view all the answers

What is the onset, peak, and duration of epinephrine when administered subcutaneously?

<p>Onset: 5-10 minutes, Peak: 20 minutes, Duration: 1-4 hours (A)</p> Signup and view all the answers

Which of the following conditions is epinephrine NOT typically used to treat?

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

Which of the following is a potential side effect of epinephrine administration?

<p>Tremors (A), Restlessness (B), Nausea and vomiting (C), Headache (D), Pallor (E), Agitation (F), All of the above (G)</p> Signup and view all the answers

Which of the following is a life-threatening adverse reaction to epinephrine?

<p>Pulmonary edema (A), Dysrhythmias (D)</p> Signup and view all the answers

What drug class does clonidine belong to?

<p>Alpha-2 agonist</p> Signup and view all the answers

What is the primary therapeutic use of clonidine?

<p>Hypertension</p> Signup and view all the answers

Describe the mechanisms by which clonidine lowers blood pressure.

<p>Clonidine reduces the release of norepinephrine from sympathetic nerve endings in the central nervous system. This decrease in norepinephrine results in reduced peripheral receptor activation, leading to a decrease in vasoconstriction and lowered blood pressure.</p> Signup and view all the answers

Which of the following is NOT a potential side effect of clonidine?

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

What drug class does atenolol belong to?

<p>Beta-1 blocker</p> Signup and view all the answers

Which of the following is a contraindication for atenolol administration?

<p>Hypersensitivity (A), Bradycardia (B), Heart blocks (C), Cardiogenic shock (D), Uncompensated heart failure (E), All of the above (F)</p> Signup and view all the answers

Which drug class can increase the risk of hypoglycemia when co-administered with atenolol?

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

Describe the pharmacokinetic properties of atenolol, including its absorption, distribution, metabolism, and excretion.

<p>Atenolol exhibits moderate absorption from the gastrointestinal tract, with approximately 50% bioavailability. Distribution involves protein binding to a significant extent, about 10%. The elimination half-life of atenolol is estimated to be 6-7 hours. Excretion primarily occurs through urine and feces.</p> Signup and view all the answers

What are the onset, peak, and duration of action of atenolol when administered orally?

<p>When administered orally, atenolol exhibits an onset of action around 1 hour, a peak effect between 2 and 4 hours, and a duration of action lasting approximately 24 hours.</p> Signup and view all the answers

Which of the following is a therapeutic use for atenolol?

<p>Hypertension (A), Angina (B), Treatment and prevention of myocardial infarction (MI) (C), All of the above (D)</p> Signup and view all the answers

Which of the following is a common adverse reaction to atenolol?

<p>Bradycardia (A), Hypotension (B), Dyspnea (C), Bronchospasm (D), Chest pain (E), Heart failure (F), Renal failure (G), All of the above (H)</p> Signup and view all the answers

Flashcards

What is a sympathomimetic?

A type of medication that stimulates the sympathetic nervous system, mimicking the effects of adrenaline.

How does epinephrine work?

Epinephrine is a non-selective adrenergic agonist, meaning it activates both alpha and beta receptors in the sympathetic nervous system.

What is epinephrine used for?

Epinephrine is used to treat a variety of conditions, including allergic reactions, cardiac arrest, asthma, and nasal congestion.

What are some side effects of epinephrine?

Epinephrine can cause side effects such as tremors, restlessness, nausea, vomiting, headache, pallor, agitation, oliguria, dizziness, blood sugar changes, and paresthesia.

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What are some adverse reactions to epinephrine?

Epinephrine can cause serious adverse reactions such as hypertension, tachycardia, palpitations, dyspnea, myocardial infarction, renal insufficiency, and life-threatening conditions like pulmonary edema and dysrhythmias.

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What is clonidine and how does it work?

Clondine is a medication that works by activating alpha-2 receptors in the sympathetic nervous system, resulting in a decrease in the release of norepinephrine and reduced peripheral receptor activation.

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What is clonidine primarily used for?

Clondine is used to treat hypertension, which is high blood pressure.

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What is atenolol and how does it work?

Atenolol is a medication that blocks beta-1 receptors in the sympathetic nervous system, primarily affecting the heart.

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What is atenolol used for?

Atenolol is used to treat a variety of cardiovascular conditions including hypertension, angina, and to prevent myocardial infarction (heart attack).

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What are some side effects of atenolol?

Atenolol can cause side effects such as drowsiness, dizziness, headache, depression, fatigue, nausea, diarrhea, and erectile dysfunction.

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What is epinephrine?

Epinephrine is a sympathomimetic, meaning it mimics the effects of adrenaline. It's a type of medication that stimulates the sympathetic nervous system.

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What is clonidine?

Clonidine belongs to a class of drugs called alpha-2 agonists. These drugs work by activating alpha-2 receptors in the sympathetic nervous system.

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How does clonidine work?

When alpha-2 receptors are activated, it results in a decrease in the release of norepinephrine, a chemical that triggers the 'fight or flight' response in the body. This, in turn, reduces peripheral receptor activation leading to a decrease in blood pressure.

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What is clonidine used for?

Clonidine is primarily used to treat hypertension, which is high blood pressure.

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What are some side effects of clonidine?

Clonidine can cause side effects such as headaches, nasal congestion, drowsiness, nightmares, constipation, edema, elevated hepatic enzymes, and issues with ejaculation.

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What is atenolol?

Atenolol is a medication that blocks beta-1 receptors in the sympathetic nervous system. These receptors are primarily located in the heart.

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How does atenolol work?

This blocking action slows down the heart rate and reduces the force of heart contractions, which helps to lower blood pressure.

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What are some adverse reactions to atenolol?

Atenolol can cause more serious adverse reactions like bradycardia, hypotension, chest pain, heart failure, dyspnea, bronchospasm, and renal failure. These happen less frequently but require serious attention.

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What are sympathomimetics?

Sympathomimetics are a class of medications that mimic the actions of the sympathetic nervous system. This system is responsible for the 'fight or flight' response.

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What is an example of a sympathomimetic?

Epinephrine is a classic example of a sympathomimetic. It's a non-selective adrenergic agonist, meaning it activates both alpha and beta receptors in the sympathetic nervous system.

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What are alpha-2 agonists?

Alpha-2 agonists are a class of medications that work by activating alpha-2 receptors in the sympathetic nervous system. This activation decreases the release of norepinephrine, a neurotransmitter, which helps lower blood pressure.

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What is an example of an alpha-2 agonist?

Clonidine is a well-known example of an alpha-2 agonist. It is primarily used to treat hypertension.

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What are beta-1 blockers?

Beta-1 blockers are a class of medications that work by blocking beta-1 receptors in the sympathetic nervous system. These receptors predominantly affect the heart, resulting in a decreased heart rate and force of contraction.

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What is an example of a beta-1 blocker?

Atenolol is a common beta-1 blocker used for hypertension, angina, and to prevent heart attacks.

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What is the 'fight or flight' response?

The 'fight or flight' response is the body's natural reaction to stress. It involves a rapid increase in heart rate, blood pressure, and breathing rate to prepare for action.

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How is the 'fight or flight' response related to epinephrine?

Epinephrine, a sympathomimetic, is a drug that stimulates the 'fight or flight' response. This can be helpful in emergency situations such as anaphylaxis (allergic reaction), where a quick surge of adrenaline is needed.

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What role does norepinephrine play in the 'fight or flight' response?

Norepinephrine, also known as noradrenaline, is a neurotransmitter that is released during the 'fight or flight' response. It's involved in many physiological responses, including increased heart rate and blood pressure.

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How does clonidine impact the 'fight or flight' response?

Clonidine, an alpha-2 agonist, works by reducing the release of norepinephrine. This dampens the 'fight or flight' response, leading to a decrease in heart rate and blood pressure, which is beneficial for managing hypertension.

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How are beta-1 receptors involved in the 'fight or flight' response?

Beta-1 receptors are activated by norepinephrine and epinephrine, leading to increased heart rate and force of contraction. Beta-1 blockers, like atenolol, block these receptors, effectively lowering the heart rate and contractility.

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What are contraindications in medication?

Contraindications refer to situations where a medication should not be used. They are usually based on potential risks to the patient.

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What are some contraindications for epinephrine?

Epinephrine has several contraindications, including Parkinson's disease, closed-angle glaucoma, brain disease, hypertension, diabetes mellitus, hyperthyroidism, renal dysfunction, hypovolemia, and labor.

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What are drug interactions?

Drug interactions occur when the effects of one medication are altered by another medication or substance.

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What are some drug interactions with epinephrine?

Epinephrine can interact with other medications, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), increasing their effects. It can also be antagonized by beta-blockers, and digoxin can cause dysrhythmias.

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Study Notes

Epinephrine

  • Class: Sympathomimetic non-selective adrenergic agonist
  • Contraindications: Parkinson's disease, closed-angle glaucoma, brain disease, hypertension (HTN), diabetes mellitus (DM), hyperthyroidism, renal dysfunction, hypovolemia, labor
  • Lab Interactions: Increased blood glucose, serum lactic acid
  • Drug Interactions: Increased effects with TCAs and MAOIs; beta-blockers antagonize effects; digoxin may cause dysrhythmias
  • Pharmacokinetics: Rapid absorption via SQ, IM, IV; Inactivated in the GI tract; Protein binding; Half-life (IV) < 5 minutes; Excreted in urine and breast milk
  • Pharmacodynamics:
  • SQ: Onset 5-10 minutes; Peak 20 minutes; Duration 1-4 hours
  • IV: Onset immediate; Peak 2-5 minutes; Duration 5-10 minutes
  • IM: Variable onset; Duration 1-4 hours
  • Purposes: Nasal congestion, allergic reactions, cardiac arrest, asthma, bronchospasm
  • Side Effects: Tremors, restlessness, nausea and vomiting (NV), headache, pallor, agitation, oliguria, dizziness, variable blood glucose (BG), paresthesia
  • Adverse Reactions: Hypertension, tachycardia, palpitations, dyspnea, myocardial infarction (MI), renal insufficiency; life-threatening: pulmonary edema, dysrhythmias

Clonidine

  • Class: Alpha 2 agonist
  • Purpose: Hypertension
  • Mechanism of Action: Decreases norepinephrine release and peripheral receptor activation
  • Side Effects: Headache, nasal congestion, drowsiness, nightmares, constipation, edema, elevated hepatic enzymes, ejaculation issues

Atenolol

  • Class: Beta 1 blocker
  • Contraindications: Hypersensitivity, bradycardia, heart blocks, cardiogenic shock, uncompensated heart failure; Caution with renal issues, DM, bronchospasm, pulmonary edema, and pregnancy
  • Drug Interactions: Increased absorption with atropine; decreased effects with NSAIDs; increased risk of hypoglycemia with insulin
  • Pharmacokinetics: 50% absorbed in the GI tract; 10% protein binding; Half-life (t1/2): 6-7 hours; Excreted in urine and feces
  • Pharmacodynamics:
  • PO: Onset 1 hour; Peak 2-4 hours; Duration 24 hours
  • Purpose: Hypertension, angina, treatment and prevention of MI
  • Side Effects: Drowsiness, dizziness, headache, depression, fatigue, nausea, diarrhea, erectile dysfunction (ED)
  • Adverse Reactions: Bradycardia, hypotension, chest pain, heart failure, dyspnea, bronchospasm, renal failure

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Description

This quiz covers the essential pharmacological aspects of epinephrine, including its classification, contraindications, interactions, pharmacokinetics, pharmacodynamics, and uses. Test your knowledge on this vital drug used in various medical situations such as allergic reactions and cardiac arrest.

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