Mechanisms Flashcards
Natural Catecholamines (endogenous):
- epinephrine
- norepinephrine
- dopamine
Synthetic catecholamines:
- Dobutamine
2. Isoproterenol
Synthetic non-catecholamines (indirect acting):
- Amphetamine
- Ephedrine
- Mephentermine
- Metaraminol
Synthetic non-catecholamines (direct acting):
- Phenylephrine
2. Methoxamine
Epinephrine receptor specificity:
alpha 1, 2
beta 1, 2
Norepinephrine receptor specificity:
alpha 1, 2
beta 1
Isoproterenol receptor specificity:
beta 1 = 2
Dopamine receptor specificity:
Dopaminergic
D1=D2
beta > alpha
Dobutamine receptor specificity:
Beta 1 > B2
Oxymetazoline receptor specificity:
alpha 1
phenylephrine receptor specificity:
“pure alpha agonist”
alpha 1 > a2
minimal beta
methoxamine receptor specificity:
alpha 1
clonidine receptor specificity:
alpha 2 agonist
Albuterol and Terbutaline receptor specificity:
beta 2 > beta 1
Salmeterol and Formoterol receptor specificity:
beta 2
amphetamine receptor specificity:
alpha, beta, CNS
indirect general agonist; releases stored catecholamines
Ephedrine and Pseudoephedrine receptor specificity:
alpha, beta, CNS
Indirect general agonist; releases stored catecholamines
This drug class has:
- rapid onset of action
- brief DOA
- not administered orally
- do not penetrate the BBB
Catecholamines
This drug class, compared to catecholamines:
- Longer DOA
- all can be administered orally
Non-Catecholamines
Name the catecholamines:
- epi
- norepi
- isoproterenol
- dopamine
- dobutamine
Name the non-catecholamines:
- phenylephrine
- clonidine
- albuterol/ terbutaline
- amphetamine
- ephedrine
- oxymetazoline
- Salmeterol/ formoterol
- methoxamine
Therapeutic uses for Epinephrine
-anaphylaxis, glaucoma (open angle) asthma hypotension w/LA in LA to increase DOA
Therapeutic uses for Norepinephrine
hypotension (decreased renal perfusion)
tx of shock
organ ischemia
Therapeutic uses for Isoproterenol
AV Block
cardiac stimulant
Therapeutic uses for Dopamine
Shock (increase renal perfusion and GFR)
HF
Hypotension
Therapeutic uses for Dobutamine
Shock
CHF
Therapeutic uses for Amphetamine
Narcolepsy
obesity (appetite control)
ADHD
CNS Stimulant
Therapeutic uses for Ephedrine
Nasal decongestant
urinary incontinence
hypotension
hypotension w/spinal or epidural
Therapeutic uses for Phenylephrine
pupil dilation vasoconstrictor Increase SVR Increase MAP nasal decongestant
Therapeutic uses for Albuterol, Terbutaline
asthma (bronchospasm -short acting)
premature labor
Therapeutic uses for Cocaine
vasoconstriction
LA
Therapeutic uses for Clonidine
HTN
decrease MAC
Increase anesthesia/analgesia
SNS of Alpha 1 on eyes
contraction of radial muscle
mydriasis
SNS of beta on eyes
ciliary muscle relaxation (far vision)
SNS of Alpha 2 and beta 2 on salivary glands
increase secretions
SNS of beta 1 on heart
Increases HR, conduction, and contractility
SNS on lungs
alpha 1 - bronchoconstriction
beta 2- bronchodilation
SNS on pancreas
alpha 1 inhibits insulin secretion
beta 2 increases insulin secretion
SNS on upper GIT
alpha 1 - sphincter contraction
beta 2 - decreased tone and motility ; relaxed
SNS on the Liver /gallbladder
alpha 2 - glycogenolysis
beta 2 gluconeogenesis
beta 3 unknown
SNS on abdominal blood vessels
alpha 1 constriction
beta 2 dilation
SNS on bladder
alpha 2 - sphincter contraction
beta 2 detrusor relaxation
“Pure alpha agonist” is
phenylephrine
alpha 1 > alpha 2
Alpha 1:
- vasoconstriction
- Increased Peripheral resistane
- increased BP
- mydriasis
- increased closure of bladder sphincter
- inhibits insulin production
Alpha 2:
inhibition of norepinephrine release
-inhibition of acetylcholine release
Beta 1:
- tachycardia
- increased lipolysis
- increased myocardial contractility
- increased renin release
Beta 2:
- vasodilation
- slight decrease in peripheral resistance
- bronchodilation
- increased muscle and liver glycogenolysis
- increased release of glucagon
- relaxed uterine smooth muscle