Pharm block 1c

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Pharm block 1c
2010-10-26 18:44:42
Pharm block 1c

Pharm block 1c
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  1. General Functions of Metyrosine
    Interfere with the synthesis of of adrenergic stimulents
  2. Blockade of uptake 1 at nerve terminal
    Cocaine and Imipramine
  3. Blockage of storage in granule or granular uptake.
    why dont we use this anymore?
    • Reserpine
    • decreases dopamine levels too low so that depressive effects occurs.
  4. Promotion of NE release.
    Amphetamine and Ephedrine
  5. Prevention of Release of NE.
    Bretylium, Guanethidine
  6. Where is MAO-A located?
    What does it do?
    What inhibits it?
    Located in the Nerves/ intestines/ liver (really anywhere)

    Metabolizes NE, 5-HT, Dopamine and tyramine

    Inhibitors are: Phenelzine, and Tranylcypromine
  7. What is the Cheese reaction?
    It is Caused when someone is on a MAO-A inhibitor and eating cheese (which has Tyramine in it). Tyrimine isn't brocken down--> tyrimine releases NE--> causes Severe hypertension.
  8. Where is MAO-B located?
    What does it do?
    What inhibits it?
    Located in the Brain

    Metabolizes Dopamine, NE, and serotonin.

    Inhibited by: Selegiline, Rasagiline
  9. What are some COMT inhibitors?
    Tolcapone, Entacapone
  10. What dont you give dopamine in the treatment of Parkasons?
    What should you do?
    Problem is there is not enough Dopamine, if you give dopamine, it is water soluble--> so it will not beable to cross the BBB--> it just creates systemic effects.

    Should give a MAO-B inhibitor--> increase the activity of Dopamine.
  11. Agonist acting on Alpha 1 receptors
    Phenylephrine, Mephenteramine, Methoxamine
  12. Agonist acting on Alpha 2 receptors.
    Clonidine, Alpha Methyldopa
  13. Agonist acting on Beta 1 and 2 receptors
  14. Agonist acting on Beta 1 receptor
  15. Agonist acting on Beta 2
    Terbutaline, Albuterol, Ritodrine, Metaproterenol
  16. Dopamine 1 receptor agaonist
  17. What receptors does Epi act on?
    What are its actions on CVS? and what receptor is that?
    Acts on all adrenergic receptors.

    • Beta 1 receptor.
    • Incresases Contraction force
    • Increases heart rate
    • Increases conductions through AV node
  18. What is Epis Effect on Vascular Blood Vessels?
    Constriction--> increasing BP High Dose--Alpha 2

    • Dilation of Vessels of skeletal Muscle--> decreasing BP
    • low dose --- Beta 2 (more sensative)
  19. Epinephrine in low doses on Beta 1
    on Beta 2
    ----Increases HR, SV, CO, and Pulse Pressure

    ---- Decreases Peripheral Resistance, BP
  20. How do you calculate the Mean Arterial Pressure?
    2/3 diastolic, and 1/3 systolic pressures
  21. what is the effect of Medium dose of Epi?
    Slight increase in Mean arterial Pressure because Alpha 2s are activated (increase in TPR and BP)
  22. What is the Effect of High does of Epi?
    Increase in HR, MAP, --> reflex --> bradycardia

    Activation of Alpha 1 receptors ( increase TPR and BP).
  23. What happens when you give Epi before Alpha Blackade and After?
    What does this Occur?
    Before--- Increase in BP

    After----- Decreases BP

    Because all the Alpha Receptors are blocked and only Beta 2 receptors are active.
  24. What is Epis effects on Smooth Muscle?
    GIT-- Peristalsis is reduced and sphinctors are consticted

    Bladder-- Trigone and sphincter is contracted

    Uterus-- Relaxation at term
  25. Epi Effects on the Eye. What receptors?
    Causes Mydriasis (radial Muscle Constiction) but do NOT effect accomadation. (Alpha 1)
  26. Epi effects on Metabolic Actions?
    1.Activation of Beta 2 receptors result in uptake of K into the cells--> may lead to hypokalemia

    2.Renin increased by Epi (Beta 1)

    3. Produces Glycogenolysis and lipolysis
  27. Locations of:
    • -Heart
    • -Resp, Uterine, Vascular Smooth m, Skeletal m, Liver
    • - Fat cells
    • -smooth muscle
    • - Nerve endings
  28. What is the effect of Alpha 2 receptors being activated in the Pancreas?
    Inhibits insulin release.
  29. What is Fenoldopam
    when is it used?
    a dopamine agonist

    used for Emergency Hypertension.
  30. What is Dobutamine?
    When do you used it?
    Why use it instead of dopamine?
    Similar to dopamine, except it does not act on D1 and 2 receptors. It is predominantly a Beta 1 receptor.

    Used in Heart failure and cardiac shock-- Increases force of contraction, but NOT heart rate.
  31. What is Ephedrine?
    What does it act on?
    Is it effective orally? Why or Why not?
    When is it used?
    it is a mixed Adrenergic agonist.

    • Acts Directly on A and B receptors
    • acts Indirectly by releasing NE.

    Effective Orally-- resistant to MAO (not broken down).

    Used in Bronchial asthma and hypertension.
  32. What is Amphetamine?
    Is it orally active?
    What are its effects?
    When do you used it?
    • it is an Indirectly acting adrenergic agonist.
    • Orally active-- Resistant to MAO and COMT

    Causes Alertness, increased concentration (CNS action)

    Used in ADHD and Narcolepsy.