step 1 physiology flash cards

7/29/2019 Step 1 Physiology Flash Cards

1/22

Term 1

what kind of drug is NE?

Definition 1

a1, a2, B1 agonist

Term 2

what kind of drug is epi?

Definition 2

a1, a2, B1, B2 agonist

Term 3

what kind of drug is

dopamine?

Definition 3

dopamine receptor, B

agonist

Term 4


tyramine?

Definition 4

indirectly acting

sympathomimetic

Term 5


ephedrine?

Definition 5

directly and indirectly acting

sympathomimetic

Term 6


amphetamine?

Definition 6

indirectly acting

sympathomimetic


2/22

Term 7


phenylephrine?

Definition 7

a1 agonist

Term 8


clonidine?

Definition 8

a2 agonist

Term 9


isoproterenol?

Definition 9

B1 and B2 agonist

Term 10


dobutamine?

Definition 10

B1 agonist

Term 11


metaproterenol?

Definition 11

B2 agonist

Term 12


albuterol?

Definition 12

B2 agonist


3/22

Term 13


terbutaline?

Definition 13

B2 agonist

Term 14

prototype a1 agonist

Definition 14

phenylephrine

Term 15

what drug is used when

have a stuffy nose to clear

airway?

Definition 15

phenylephrine (a1 agonist)

Term 16

what is a drug that can be

used in the ICU to increase

peripheral resistance without

increasing CO?

Definition 16

phenylephrine (a1 agonist)

Term 17

prototype drug for a2

receptor

Definition 17

clonidine

Term 18

action of clonidine

Definition 18

at the neuroeffector junctio

- on the nerve terminus itse

feeds back and binds a2

receptor of the neuron

releasing NE and inhibits

release of more NE

feedback regulator of NE

release


4/22

Term 19

prototype drug for B1

receptor

Definition 19

dobutamine

Term 20

prototype drug for B2

receptor

Definition 20

terbutaline

Term 21

what are the 3 ways

adrenergic agonists can

have an effect?

Definition 21

1. act directly on adrenergic

receptors

2. act by promoting release

of endogenous NE

3. mixed actions

Term 22

actions of a1 receptor

agonists

Definition 22

1. vasoconstriction -

increases peripheral

resistance and BP

2. venoconstriction -

decreases capacitance and

increases venous pressure

and right heart filling

pressure

3. contraction of the iris

-

Term 23

arteriole effect of a1 receptor

agonists

Definition 23

vasocontriction

increases peripheral

resistance and BP

Term 24

venous effect of a1 receptor

agonists

Definition 24

venoconstriction

decreases capacitance

increases venous pressure

and right heart filling

pressure


5/22

Term 25

effect of a1 receptor agonists

in the eye

Definition 25

contraction of the iris radial

(dilator) muscle

induces mydriasis

Term 26

effect of a1 receptor agonists

on bladder and intestine

Definition 26

contraction of sphincters

Term 27

actions of a2 receptor

agonists

Definition 27

inhibition of neuronal NE

release - decrease BP

Term 28

prototype a2 receptor

agonist

Definition 28

clonidine

developed to be an anti-HTN

drug - decrease BP by

inhibiting neuronal release o

NE

Term 29

prototype a1 receptor

agonist

Definition 29

phenylephrine

Term 30

effect of phenylephrine

infusion?

Definition 30

BP increaseBV are related to heart via

baroreceptors

constrict vessels -->

decrease CO --> decrease

HR and SV via baroreceptor

reversible


6/22

Term 31

normal response to getting

up from laying down (getting

up in the morning)?

Definition 31

BP drops initially - a1

receptors cause constriction

to stop from crashing

need more blood - HR and

contractility increase -

vasoconstrict

Term 32

side effects of a1 blockage

Definition 32

orthostatic HTN and

syncope - block normal phy

that allows for

vasoconstriction

problem elderly woman on

a1 receptor blocker for HTN

can fall and break a hip

Term 33

a1 receptor mediates ____ in

BV

Definition 33

peripheral tone

Term 34

effect of a1 on veins

Definition 34

don't constrict - stiffen and

decrease compliance

causes - blood to be

increased back to the heart

and increase right heart

filling pressure and thus pre

load

Term 35

actions of B1 receptor

agonists

Definition 35

1. increased cardiac

contractility and HR

2. increased lipolysis

3. production of renin from

the kidneys

Term 36

effects of B1 receptor

agonist on heart

Definition 36

increased contractility and

HR


7/22

Term 37


agonist on peripheral fat

Definition 37

increased lipolysis

Term 38


agonist on renin production

Definition 38

increased renin production

from kidneys

kidneys are singly

innervated by the arterioles

that lead to them

Term 39

action of B2 receptor

agonists

Definition 39

1. relaxation of vascular SM;

vasodilation results in

decreased peripheral

vascular resistance and BP

2. reflexive tachycardia with

B2 agonist infusion

3. bronchodilation

4. uterine SM relaxation

5. gluconeogenesis and

Term 40


agonist on vasculature

Definition 40

relaxation of vascular SM -

vasodilation

results in decreased

peripheral vascular

resistance and BP

Term 41


agonist on heart

Definition 41

reflexive tachycardia

Term 42


agonist on lungs

Definition 42

bronchodilation


8/22

Term 43


agonist on uterus

Definition 43

uterine SM relaxation

Term 44


agonist on liver

Definition 44

gluconeogenesis and

glycogenolysis

Term 45

most B1 receptors are

located on

Definition 45

heart - CO

Term 46

what determines CO?

Definition 46

HR and SV

Term 47

components of SV?

Definition 47

preload

contractility

afterload

Term 48

effects of infusing B1

agonist?

Definition 48

increase HR

increase contractility (force

of contraction)

afterload - NOT increased

with selective B1 agonist

preload - not increased

directly by B1; determined


9/22

Term 49

effect on afterload with

selective B1 agonist?

Definition 49

NOT increased

Term 50

why does preload increase

with B1 receptor agonists?

Definition 50

not directly

determined by veins

Term 51

B2 receptor locations

Definition 51

airway

skeletal muscle BV

BV going to liver

NOT in central BV

Term 52

which BV do not contain B2

receptors?

Definition 52

central BVs

Term 53

effect on HR with infusion of

a1 receptor agonist?

Definition 53

reflexive bradycardia

Term 54

effect on HR with infusion of

B2 receptor agonist?

Definition 54

reflexive tachycardia


10/22

Term 55

NE is an agonist to which

receptors?

Definition 55

a1, a2, B2 adrenergic

receptors

Term 56

effect of NE in renal BV?

Definition 56

induces profound

constriction of renal BV

dangerously reduces rena

blood flow

problem in patient with low

GFR

Term 57

is NE effective in oral admin?

Definition 57

NO

Term 58

why is NE not effective when

administered orally?

Definition 58

degraded by acidic pH

Term 59

does NE cross the BBB?

Definition 59

NO

Term 60

epi is an agonist to which

receptors?

Definition 60

a1, a2, B1, B2 receptors


11/22

Term 61

what receptor mediates

bronchodilator effect of epi?

Definition 61

B2

Term 62

what complicates the B2

bronchodilator effect of epi?

Definition 62

cardiac stimulation - B1

and

elevations in systolic BP - a

Term 63

use of epi

Definition 63

emergency management of

anaphylactic shock -

characterized by severe

bronchial constriction and

CV collapse

included as a

vasoconstrictor agent in

most local anesthetic

(procaine-like) preparations

Term 64

why is epi included in most

local anesthetic

preparations?

Definition 64

as a vasoconstrictor agent

to limit diffusion of local

anesthetic

Term 65

side effects of epi used

parenterally in high doses?

Definition 65

can produce cardiac

arrhythmia

Term 66

when can epi produce

cardiac arrythmias?

Definition 66

when used parenterally in

high doses


12/22

Term 67

how is epi administered?

Definition 67

by parenteral injection - as

cardiac stimulant in

emergencies

inhalation or injection - as

bronchodilator

Term 68

which receptor does NE not

target physiologically?

Definition 68

B2

epi does - accounts for

difference in CV response

between the two

Term 69

which binds a2 with higher

affinity: epi or NE?

Definition 69

epi

Term 70

what is the physiologically

more important location of

a2 receptors?

Definition 70

neuroeffector junction

Term 71

what is the physiologically

most important ligand for a2

receptors? why?

Definition 71

NE

epi is not released at the

neuroeffector junction which

is the physiologically most

important location of a2

receptors

epi can bind a2 - not its

primary role

Term 72

phenylephrine type

Definition 72

prototype a1 selective

agonist


13/22

Term 73

phenylephrine local use

Definition 73

applied topically to the nasal

mucosa - induces

vasoconstriction to improve

air flow

works well for stuffy noses

and common cold

Term 74

phenylephrine systemic use

Definition 74

increase BP - induces a

vagally-mediated reflex of

slowing the heart in patient

with paroxysmal tachycardi

Term 75

clonidine and a-methyl-dopa

type

Definition 75

agonist at presynaptic a2

adrenergic receptors

Term 76

a-methyl-dopa is converted

to ____ and stored in ____

Definition 76

a-methylnorepinephrine

sympathetic nerve terminal

Term 77

what is the classic non-

selective B adrenergic

agonist?

Definition 77

isoproterenol

Term 78

isoproterenol type

Definition 78

agonist of B1 and B2



14/22

Term 79

isoproterenol use

Definition 79

by inhalation as a bronchial

dilator

Term 80

isoproterenol side effects

Definition 80

induces tachycardia more

frequently than B2 selectiv

agonists (lacks specificity)

Term 81

dobutamine tends to have

____ action on the _____

than dopamine

Definition 81

more

heart

Term 82

dobutamine type

Definition 82

agonist for B-adrenergic

receptors

Term 83

dobutamine use

Definition 83

used to stimulate the heart in

cardiogenic shock

Term 84

metaproterenol, albuterol,

terbutaline, and salmeterol

type

Definition 84

selective agonist for B2



15/22

Term 85



use

Definition 85

used for bronchodilation in

management of reversible

airway diseases (asthma,

COPD)

Term 86



delivery

Definition 86

by inhalers - deliver meds to

airway and avoid

confounding effects

Term 87

who typically gets



toxicity

Definition 87

patients with dyspnea and

anxiety about not being able

to breath - often take too

much of the drugs

Term 88

effects of taking too much



Definition 88

drives Na/K ATPase - can

cause hypokalemia and

problems that go along with

it

Term 89

effects of dompamine at

moderate doses?

Definition 89

agonist of D1 dopaminergic

receptors

relaxes SM in renal BV and

improves renal blood flow

Term 90

effects of dopamine at high

doses

Definition 90

agonist of cardiac B1 (and

B2) receptors

increases cardiac

contractility


16/22

Term 91

effects of dopamine at VERY

high doses

Definition 91

becomes an agonist of a1


produce vasoconstriction

and raise BP

Term 92

half life of dopamine

Definition 92

short - rapid inactivation by

hepatic MAO and COMT

Term 93

inactivation of dopamine

Definition 93

rapid

by hepatic MAO and COMT

Term 94

ephedrine orgin

Definition 94

found in many plants

used in China for >200 year

introduced in West medicin

in 1924 as the first orally

active sympathomimetic

Term 95

ephedrine structure

Definition 95

non-catechol

phenylisopropylamine

Term 96

half life of ephedrine

Definition 96

long


17/22

Term 97

ephedrine direct action

Definition 97

direct a1 and B2 adrenergic

activity

Term 98

ephedrine indirect action

Definition 98

mainly - indirectly to promot

release of endogenous NE

Term 99

how does ephedrine mostly

act?

Definition 99

indirectly

promote release of

endogenous NE

Term 100

ephedrine effect on CNS?

Definition 100

stimulant

Term 101

use of ephedrine

Definition 101

principal use - decongestant

also recommended for

stress incontinence in

women

Term 102

what drug would cause

slight decrease in HR,

increase in systolic,

diastolic, and mean BP, and

a large increase in peripheral

resistance?

Definition 102

NE - get reflexive

bradycardia from peripheravasoconstriction despite B

activation (from barorecepto

reflex) could be

phenylephrine - same BP

response (maybe larger); H

reduced more because no

B1 action


18/22

Term 103


slight increase in HR,

increase in systolic BP,

decrease in diastolic BP,

very minimal increase in

mean BP, and a slight

decrease in peripheral

resistance?

Definition 103

epi - acts on B2

eliminates rise in BP seen

with NE

don't get reflexive

bradycardia seen with NE

binds B1 - increases HR

B2 actions on BV - primarily

in liver and skeletal muscle

Term 104


significant increase in HR,

slight increase in systolic

BP, decrease in diastolic BP,

slight decrease in mean BP,

and a large decrease in

peripheral resistance?

Definition 104

isoproterenol - B1 and B2

only; no a

big increase in HR

no vascoconstrictor

response

enormous change in

peripheral resistance

Term 105

peripheral resistance is the

relationship between?

Definition 105

CO and BP

Term 106

pressure from inflow (aortic

flow) - resistance to pressure

(outflow) =

Definition 106

peripheral resistance

Term 107

B1 agonist effect on CO?

Definition 107

increases CO

Term 108

what is tocolytic therapy?

Definition 108

use of B adrenergic agents

to attenuate premature labo

delay delivery, allow fetal

maturation

thereby - reducing neonata

morbidity and mortality


19/22

Term 109

what is a common side effect

of B-adrenergic tocolytic

therapy for treatment of

preterm labor?

Definition 109

hypokalemia

Term 110

what drug is often used for

tocolytic therapy?

Definition 110

terbutaline (B-adrenergic

agonist)

Term 111

how do B-adrenergic

agonists control serum K?

Definition 111

activate Na/K ATPase by

increasing cAMP - take K out

of blood and store in cell -->

hypokalemia

Term 112

what can happen with abrupt

withdrawal of a B adrenergic

agonist?

Definition 112

can get rebound

hyperkalemia

Term 113

what are the major side

effects of B agonists?

Definition 113

cardiac arrhythmias

hypokalemia

can precipitate angina

insomnia

anxiety

tremor

Term 114

what are the major side

effects of a agonists?

Definition 114

headache

**reflexive bradycardia

excitability

restlessness

can precipitate angina


20/22

Term 115

ephedrine actions

Definition 115

direct and indirect agonist

Term 116

tyramine type

Definition 116

indirect acting

sympathomimetics

Term 117

tyramine origin

Definition 117

normal byproduct of tyrosine

metabolism

Term 118

where is tyramine found in

high concentrations?

Definition 118

fermented foods (cheese)

Term 119

tyramine action

Definition 119

enters NE nerve terminal via

the amine transporter and

causes NE release

Term 120

tyramine in converted to

____ by ______

Definition 120

octopamine

dopamine-B-hydroxylase


21/22

Term 121

metabolism of tyramine

Definition 121

readily metabolized by MAO

Term 122

in what patients are the

effects of tyramine

intensified?

Definition 122

patients treated with MAO

inhibitors

Term 123

how does drug tolerance to

tyramine develop?

Definition 123

develops as NE is

completely replaced by

octopamine

Term 124

amphetamines type

Definition 124

indirect acting

sympathomimetic

Term 125

amphetamines action

Definition 125

facilitate release of NE

Term 126

do amphetamines have

direct effect on adrenergic

receptors?

Definition 126

NO


22/22

Term 127

effect of amphetamines on

CNS?

Definition 127

stimulant

Term 128

cocaine type

Definition 128

indirect acting

sympathomimetic

Term 129

cocaine action

Definition 129

blocks neuronal uptake1

pathway for NE

extends half life of NE at

synaptic cleft

Term 130

what is important to know

about cocaine toxicity?

Definition 130

negative impact can be

played out over 72-98 hours

after ingested

toxicity is potentially severa

days after use because of

long half life

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