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Norepinephrine (Levophed)
- Potent vasoconstrictor and inotropic agent
- More a that B activity
- glycogenolysis-inhibvition of insulin release and lipolysis
- Reflex bradicardia
- doesn't increase myocardial O2 consumption
- decreases blood flow to abdominal organs and skeletal muscle, while coronary blood flow is increased indirectly due to alpha stimulation
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Epinephrine (adrenalin)
- -used as a cardiac stimulant and bronchodilator
- -Potent alpha and Beta agonist (non-selective adrenergic agonist)
- -a1- arteriolar vasoconstriction
- -a2- leads to decreased NE release from neurons
- -B1- increased HR and contractililty
- -B2- arteriolar vasodilation, bronchial smooth muscle relazation and increased glycogenolysis. also decreases mast cell histamine release
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Isoproterenol (Isoprel)
- -potent bronchodilator and inotrop
- -potent B agonist (non-selective)
- -increases blood flow (vasodilation) and relaxes GI smooth muscles
- -used for bronchospasms, bradycardia, and asthma
-
Dobutamine HCL
- -Inotrope
- -selective B1 agonist (minor B2 or a effects)
- -stimulates HR and contraction of heart, increasing CO
- -increased coronary blood flow and myocardial O2 demand
- -half life 2 min
- -used in cardiac surgery,cardiogenic shock, and heart failure
-
Dopamine HCL
- -at low doses, dilates renal arterioles and increase renal blood flow and GFR
- -at mod doses, stimulates B1 receptors, stimulating the heart (while maintaining vasodilation)
- -at high doses, a receptors stimulated, increasing TPR
-
Metaproterenol Sulfate
- more B2 selective
- -bronchodilator
- -used for COPD, asthma and chronic bronchospasms
-
Albuterol (ventolin)
- Selective B2 agonist
- -indications: bronchospasm in patients w obstructive airway disease, asthma
- -adverse reaction: nervousness, tremor, tachycardia, palpitations
-
Pirbuterol (maxair)
- Selective B2 agonist
- used for asthma and bronchospasms
-
Salmeterol (Serevent)
- B2 agonist
- used for chronic tx of asthma
- SE: tachycardia, palpitations hypersensitivity, tremor and H/A
-
Terbutaline Sulfate
- B2 agonist
- used for bronchospasms and asthma, emphysema
- SE: Tremor, nervousness, tachycardia, palpitations, N/V
-
Clonidine (Catapres)
- Selective A2 agonist
- more CNS activity than peripheral
- a2 stimulation in CNS leads to decreased sympathetic outflow, increased parasymp outflow
- used for HTN
- SE: dry mouth, skin irritation, sedation and xerostomia
-
Phenylephrine
- A agonist
- used as vasoconstrictor to maintain blood press during surgery, decongestant, mydriatic
- -contraindicated in narrow angle glaucoma, V-tach, aneurisms
- SE: bradycardia, decreased CO, arrhythmias, angina, dizziness, CNS excitation
-
Metaraminol Bitartrate
- -potent vasoconstrictor (a1)
- -used to prevent surgical (spinal anesthesia) hypotension and shock
- -adverse reactions include anxiety, cardiac arrhythmias and HTN
-
Methyldopa
- -Form a-methyl NE- acts as a false transmitter
- -used to treat HTN
- -contraindicated in patients w hepatic disease
- -SE: angina, CHF, orthostatic hypotension, bradycardia
-
Cocaine
- -inhibits amine re-uptake, thus cause increased stimulation
- -LA
- -potent vasoconstrictor
- -SE: vaso constriction, mydriasis, nervousness, resp failure, cardiac arrest, general CNS stimulation
-
Amphetamine (Adderal, Dexedrine)
- -Indirect adrenergic agonist
- -Triggers NE release
- -used for narcolepsy, ADD and obesity
- -contraindicated in any cardiac disease, HTN, and hyperthyroidisn
- -Adverse reactions: palpitations, tachycardia, increase BP, psychoses, insomnia, H/A, tremor and general CNS stimuation
-
Ephedrine
- -Indirect adrenergic agonist
- -stimulates both a and B receptos
- -relaxation of smooth muscle
- -cardiac stimulation
- -increases systolic and diastolic BP
-
Pseudoephedrine (sudafed)
- -indirect adrenergic agonist
- -potent sympathomimetic, possess a1, B1 and B2 activity in addition to triggering release of catecholamines
- -used for asthma
- Contraindicated in CV disease, HTN
- SE: CNS excitation, tremors, insomnia, nervousness, palpitations, tachycardia, cardiac arrhythmias, H/A, sweating
-
Tyramine
- -indirect adrenergic agonists
- -triggers release of neurotransmitter from neuron
- -taken up into nerve terminal and converted to false transmitter leading to decreased symp tone
-
Phenoxybenzamine (Dibenzyline)
- -a1 and a2 antagonist
- -most effective at smooth muscle and exocrine glands
- -used for preop tx of pheochromocytoma to block hypertensive crisis during surgery, vasospastic disorders and frostbite therapy
- SE: dizziness, decreased ejaculation ability, fatigue, miosis, orthostatic hypotension, tachycardia
-
Phentolamine (Regitine)
- -a1 and a2 competitive antagonist
- -used for pheochromocytoma dx, pheochromocytomectomy, MAO induced hypertensice crisis, impotence
- SE: dizziness, decreased ejaculation ability, flushing, hypotension, ST
-
Prazosin (minipress)
- Selective a1 antagonist
- used for treating HTN
- SE: dizziness, H/A, drowsiness, palpitations, tachycardia, orthostatic hypotension and fluid retention
-
Terazosin (Hytrin)
- Selective a1 antagonist
- used to treat HTN and BPH (benign prostatic hypertrophy)
-
Doxazosin (Cardura)
- -selective a1 antagonist
- -used to treat HTN and BPH
-
Alfuzosin (Uroxatral)
- -selective a1 antagonist
- used to treat BPH-relaxes smooth muscle in bladder neck and prostate
-
Tamsulosin (Flomax)
- -selective a1 antagonist
- -treats BPH
-
Yohimbine
- -selective competitive a2 antagonist
- -blocks central a2 receptors leading to increased BP and HR, poss. aphrodiasiac prop
- SE: antidiuretic effects, CNS excitation, HTN, tachycardia, increased motor activity, nervousness, irritability, N/V
-
Propanolol (Inderal)
- -B blocker
- -nonselective B1 and B2 antagonist
- -used for HTN, angina, arrythmias, migranes, pheochromocytoma
- -contraindicated in shock, baradycardia, asthma and CHF
- -SE: bradycardia, CHF, hypotension, heart block, insomnia, hallucinations and bronchospasms
-
Nadolod (Corgard)
- non-selective B antagonist
- -used for treating angina, HTN
- -contraindicated in bradycardia, bronchial asthma, shock, heart block, MI
- SE: bradycardia, cardiac failure, conduction disturbances, arrythmias, dizziness, bronchospasm, diarrhea, impotence, decreased libido, blurred vision
-
Timolol ( Timoptic)
- -non-selective B antagonist
- -used for treating HTN, ocular HTN (wide angle glaucoma)
- -contraindications: asthma, COPD, bradycardia, heart failure
- SE: fatigue, bradycardia, dizziness, cold hands and feet
-
Pindolol
- -non-selective B antagonist w some symp agonist activity
- -vasodilatory B blocker (d/t strong B2 agonist activity)
- -used to treat HTN
- -contraindications: bradycardia, COPD, heart failure
- SE: fatigue, dizziness, diarrhea, cardiac failure
-
Labetalol HCL
- -a1, B1 and B2 antagonist (non-selective)
- -partial agonist at some B2 receptors
- -used for treating HTN
- -Contraindications: asthma, cardiac failure, severe bradycardia
- SE: postural hypotension, sweating, dizziness, N/V, nasal stuffiness, bradycardia, impotence
-
Carvedilol (Coreg)
- -a1, B1, and B2 antagonist
- -indications: angina, heart failure, HTN
- -Contraindications: bronchospasm, emphysema, bradycardia, DM, heart failure, liver disease, pheochromocytoma
- Adverse effects: bronchospasm, diarrhea, dyspnea, fatigue, H/A, hypotension, peripheral edema, bradycardia, syncope
-
Metoprolol (Lopressor)
- B1 antagonist
- -used to treat HTN and angina pectoris
- -contraindications: bradycardia, heartblock, shock, MI
- -SE: dizziness, bradycardia, nightmares, CHF, peripheral edema, brochospasms, nausea, diarrhea
-
Acebutelol (Sectral)
- Mostly B1 blockade, but also partial sympathetic agonist (non-selective)
- -used for HTN and to control ventricular arrhythmias
- SE:alopecia, dizziness, angina, fatigue, heart failure
-
Atenolol (Tenormin)
- Blocks B1 mostly
- -used to treat HTN, acute MI, angina pectoris
- -Contraindicated: bradycardia, heart block, shock, cardiac failure
- Adverse reactions: bradycardia, dizziness, fatigue
-
Esmolol (Brevibloc)
- B1 antagonist
- used for a-fib/flutter, paroxysmal SVT
- contraindications: bronchospasms, bradycardia, shock
- SE: AV block, cardiac arrest, hypotension, bradycardia
-
Metyrosine (Demser)
- used for pheochromocytoma
- contraindicated in hepatic disease, Parkinsons's disease
- Adverse reaction: anxiety, confusion, crystalluria, depression, Parkinsonism, salivation
-
Bretylium Tosylate
- blocks catecholamine release from nerve terminal
- used for v-tach, prophylaxis v-fib
- adverse reactions: hypotension, bradycardia
-
Reserpine (serpalan)
- inhibits storage of catecholamines leading to depletion
- -used for HTN, schizophrenia
- -contraindications: mental depression, peptic ulcer, ulcerative colitis
- SE: vomiting, diarrhea, dry mouth, syncope, angina
-
Digoxin (Lanoxin)
used to treat heart failure
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