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Catecholamines
Drugs
- –Epinephrine (Adrenalin)
- –Norepinephrine (Levophed)
- –Isoproterenolol (Isuprel)
- –Dopamine
- –Dobutamine (Dobutrex)
- cannot be given orally
- (broken down by maoi & COMT)
- do not cross BB barrier
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Epinephrine
- Apha1 agonist-vasoconstriction, Increases blood pressure, Delay absorption of local anesthetics, Control superficial bleeding, Mydriasis for eye exams, Shock and anaphylaxis
- Alpha 2 agonist-
- Beta 1 agonist- Overcome AV heat block, Restore cardiac function in cardiac arrest and shock
- Beta 2 agonist- Bronchodilation to treat, asthma and anaphylaxis
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Epinephrine- Adverse reactions
- Hypertension, Necrosis, Angina, Dysrhythmias, Hyperglycemia
- Extravasation=necrosis
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Epinephrine- drug interactions
- MAOI (>level), TCA (inhibits reuptake)
- Alpha Blockers, Beta Blockers: <levels
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Norepinephrine
- •Similar effects as epinephrine
- •Used primarily to treat hypotension and cardiac arrest
- •Does not affect beta 2 receptors
- •Monitor BP
- •Avoid extravasation
- no B2/ cant use to treat asthma
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Isoproterenol
- •Affect only beta 1 and beta 2 receptors
- –Used to treat shock and cardiac arrest
- –Asthma
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Isoproterenol ADRs
Adverse effects –Tachycardia –Angina –Hyperglycemia
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Isoproterenol-Drug interactions
MAOI –TCA –Beta blockers
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Dopamine
- •Activate alpha 1, beta 1 and dopamine receptors
- –Used to treat shock- highest dose
- –Heart failure- increased dose
- –Renal failure- low dose
- •Actions depend on dose
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Dopamine ADR
- Tachycardia
- –Angina
- –Dysrhythmias
- –Necrosis
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Dopamine- drug interactions
•MOAI and TCA
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Dobutamine
- Activates beta 1 receptors
- •Used to treat heart failure (in ICU)
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Dobutamine- ADR
Tachycardia Use with caution in patients with hyperthyroidism, HTN And angina
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Dobutamine- drug interactions
MAOI and TCA
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Non-catecholamine- Phenylephrine (Neosynephrine) (& ADR)
- –nasal spray
- -Activate alpha 1 receptors
- –Used to increase blood pressure, reduce nasal congestion, and mydriasis for eye exams
- –ADR: necrosis due to extravasation
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Non-catecholamine-Terbutaline (Brethine)- no real use in cardiac
- –Activates beta 2 receptors
- –Used to treat asthma and delay preterm labor
- –ADR: most common is tremor
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