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Name the 3 major classes of sANS agonists.
- Direct Sympathomimetics
- Indirect Sympathomimetics
- Sympathoplegics
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Name the 11 direct sympathomimetics, split into 3 classes (3, 1, 7).
- Mixed Agonists: Epinephrine, Norepinephrine, Dopamine
- Alpha Agonist: Phenylephrine
- Beta Agonists: Dobutamine, Isoproterenol, Metaproterenol, Albuterol, Salmeterol, Terbutaline, Ritodrine
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Name the 4 indirect sympathomimetics.
- Amphetamine
- Ephedrine
- Cocaine
- Tyramine
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Name the 2 sympathoplegics.
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Name the targets and actions of epinephrine.
- α1α2β1β2 agonist, selective for β1β2 at low doses (βlow)
- Used to reverse anaphylaxis, open angle glaucoma, asthma, and hypotension
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Name the targets and actions of norepinephrine.
- α1α2 > β1
- Used to reverse hypotension, but also decreases renal perfusion
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Name the targets and actions of dopamine.
- D1 = D2 > β > α
- Both inotropic and chronotropic
- Used in hemostatic shock, theoretically increasing renal perfusion, and heart failure
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Name the targets and actions of phenylephrine.
- α1 > α2
- Used to stop emergent epistaxis, causes vasoconstriction, pupillary dilation, and nasal decongestion.
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Name the targets and actions of dobutamine.
- β1 > β2 ; inotropic and slightly chronotropic
- Used to help reverse shock, treat heart failure, and in cardiac stress testing.
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Name the targets and actions of isoproterenol.
- β1 = β2 (isolated to β)
- No longer commonly used, but was used to treat AV block.
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Name the targets and actions of the MAST drugs.
- MAST = Metoproterenol, Albuterol, Salmeterol, Terbutaline
- β2 >>> β1
- Causes bronchiolar dilation, but can also raise HR at high doses
- Meto and Albu are for acute asthma (Mortal Asthma)
- Salme for long term (Sustained) asthma treatment
- Terbutaline = Tocolytic
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Name the targets and actions of ritodrine.
- Completely selective β2 agonist
- Reduces premature uterine contractions (tocolytic).
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Name the targets and actions of amphetamine.
- Indirect general α/β agonist, releases stored catecholamines.
- Used in ADHD, narcolepsy, obesity, and Rx bridge in depression with antidepressants.
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Name the targets and actions of ephedrine.
- Indirect α/β agonist, releases stored catecholamines.
- Used for nasal decongestion, urinary incontinence, and hypotension; taken off the market for weight loss (FenPhen).
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Name the targets and actions of cocaine.
- Indirect α/β agonist, acts as reuptake inhibitor.
- Causes vasoconstriction and local anesthesia (Na+ channel block).
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Name the targets and actions of tyramine.
- Monoamine that releases stored catecholamines.
- Found in aged foods (wine, cheeses) and contraindicated with monoamine oxidase inhibitors, as it can cause a hypertensive crisis.
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Name the targets and actions of clonidine and α-methyldopa.
- Centrally acting α2 agonist, decreasing central outflow.
- Used in hypertension, especially with renal disease (does not decrease renal perfusion).
- Clonidine is short acting and causes severe rebound effects.
- α-methyldopa is safe to use in pregnancy (pre-eclampsia).
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