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Adrenergic Drugs
USMLE Step 1
Drug | MOA & ADRs |
---|---|
Adrenergic receptor: Alpha-1 | stimulate PLC, yielding high DAG, IP3; this results in activated protein kinase C and high Ca, causes vasoconstriction, increased peripheral resistence, increased BP, mydriasis & increased internal bladder sphincter tone |
Adrenergic receptor: Alpha-2 | inhibits adenylate cyclase, yielding low cAMP, cause decreased NE release, also decreases insulin release |
Adrenergic receptor: Beta-1 | stimulate adenylate cyclase, yielding high cAMP , causes tachycardia, increased cardiac contractility and increased lipolysis |
Adrenergic receptor: Beta-2 | causes vasodilation, a small decrease in total peripheral resistance, bronchodilation, increased gluconeogenesis, increases glycogen release and relaxes the uterus |
Dopamine receptor: D1 | causes renal & mesenteric vasodilatation |
Dopamine receptor: D2 | causes decreased NE release |
Phentolamine | MOA: non-selective alpha-blocker used in HPTN crisis & dx of pheochromocytoma; ADRs: orthohypoTN, reflex tachy, vertigo & decreased ejaculation |
Prazosin | MOA: alpha-1 blocker used for HPTN, used for benign prostatic hypertrophy to decrease tone of urethral smooth muscle; ADRs: orthohypoTN, reflex tachy, vertigo & decreased ejaculation, 1st dose syncope |
Terazosin | MOA: alpha-1 blocker used for HPTN, used for benign prostatic hypertrophy to decrease tone of urethral smooth muscle; ADRs: orthohypoTN, reflex tachy, vertigo & decreased ejaculation, 1st dose syncope |
Clonidine | MOA: alpha-2 agonist not used for HPTN in gen pop, but for HPTN suffering from opiate or BZD w/drawl, decrease sympathetic outflow |
Beta-blockers | MOA: 1 has direct effects on the heart where as - of 2 results in bronchoconstriction, dont cause postural hypoTN b/c alpha-1 in control of periphery, used in migraine prophylaxis and glaucoma (block ciliary body secretion), beta-2 dont use in asthmatics |
Terbutaline | MOA: beta-2 agonist esp good for asthma, - bronchoconstriction, used to decrease premature uterine contractions in preganacy |
Albuterol | MOA: beta-2 agonist esp good for asthma, - bronchoconstriction, used to decrease premature uterine contractions in pregnancy |
Dopamine | MOA: + D1 receptors for shock b/c it acts like pressor 2 raise bld mmHg, keeps renal & mesenteric vessel open, beta-1 action increases CO, DOC 4 certain type of shock b/c increases inotropy & chronotropy, increase BP & maintain renal & splanchnic bld Q |
Reserpine | MOA: prevents NE & dopamine from getting packaged into vesicles, then degraded by MAO & thus no extra-cellular effect, used for HPTN |
Guanethidine | MOA: similar to reserpine, but also blocks NE release of any NE already in vesicular stores, used for HPTN; ADRs: decreased male sexual fx & orthostatic hypoTN |