adrenergic agonist

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Author:
jmullen101
ID:
306794
Filename:
adrenergic agonist
Updated:
2015-08-27 21:34:18
Tags:
adrenergic
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Description:
adrenergic
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  1. a2 activation =
    reduced sympathetic outflow, peripheral vasodilation, decreased BP, and sedation

    *decreased norepinephrine release
  2. a1 activation =
    • mydriasis
    • bronchoconstriction
    • vasoconstriction (increased PVR, afterload, and ABP. Decreased renal and splanchnic blood flow)

  3. B2 activation =
    bronchodilation, vasodilation, decreased serum potassium (activate sodium-potassium pump)
  4. B1 activation =
    increased chronotropy, dromotropy, and inotropy 

    found primarily in heart
  5. Dopaminergic
    adrenergic receptors activated by dopamine

    D1 activation= vasodilation in kidney, intestine, and heart * increased renal blood flow promotes diuresis, does not impart any beneficial effects on renal function

    D2 activation
  6. Dobutamine
    • a1 0/+ 
    • B1 +++
    • B2 +
    • inotropic support= increased CO
    • increases myocardial oxygen consumption
  7. What is the dose of dobutamine?
    infusion at a rate of 2-20mcg/kg/min
  8. Dopamine
    • a1 ++
    • a2 ++ 
    • B1 ++
    • B2 +
    • DA1 +++
    • DA2 +++
    • effects vary markedly with dose:

    • 0.5- 3 mcg/kg/min - primarily activates dopaminergic receptors
    • 3-10  mcg/kg/min - B1 stimulation increases contractility, HR, SBP, and CO
    • 10-20 mcg/kg/min - a1 effects increase PVR and a fall in renal blood flow

    proarrhythmic and chronotropic effect limit its usefulness in some patients
  9. Ephedrine
    • noncatecholamine sympathomimetic
    • similar to epinephrine, less potent
    • longer duration of action
    • tachyphylaxis
    • IV bolus dose: 2.5mg-10mg
  10. Noerepinephrine
    • a1 ++
    • a2 ++
    • B1++
    • bolus 0.1mcg/kg
    • Infusion rate:
  11. Phenylephrine
    • a1 +++
    • dose IV bolus: 50-100 mcg 
    • reflex bradycardia
    • Infusion rate:
  12. epinephrine
    • a1++
    • a2++
    • B1+++
    • B2+++
    • dose dependent
    • 0.01 - 0.05 mcg/kg/min chiefly B effects
  13. precedex
    • a1+
    • a2+++
    • sedative, analgesic, sympatholytic
    • half life 2-3 hrs
    • no ventilatory suppression
    • SE: bradycardia, hypotension
    • LD: 1mcg/kg
    • infusion rate: 0.2-0.7 mcg/kg/hr
  14. Clonodine
    • a2 agonist
    • antihypertensive
    • negative chronotrope
    • decreases anesthetic requirements, sedation, anxiolysis

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