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Sympathomimet
ics
Definition
Drugs that stimulate adrenoceptors and produce
actions similar to sympathetic system
Catecholamines-1
A-Natural
B-Synthetic
Non catecholamines-2
1-Ephedrine,
isoprenaline- 1
2-amphetamine,
nor adrenaline-2
dobutamine-2
adrenalin-3
3-phenylephrine
.isoetharine-3
dopamine-1
4-salbutamol.
A-Direct
catecholamines-1
phenylephrine-2
salbutamol-3
B-Indirect
Amphetamine- 1
Tyramine-2
C-Mixed (dual)
.Ephedrine-1
Catecholamine drugs
1-Adrenaline :
Mechanism of action
Stimulates directly all types of receptors
Administration of adrenaline
.S.C , Inhalation , Intra-cardiac , Eye drops
Action of adrenaline
Uses of adrenaline(indications)
1. In allergy (anaphylactic shock).
2.With local anesthetics.
3.Epistaxis (locally).
.Hypoglycemia.4
.Glaucoma (dipivifrin is better , a prodrug).5
6. Cardiac arrest (intracardiac).
.Acute
bronchial asthma.7
4.Thyrotoxicosis .
5. With local anesthetics in fingers & toes gangrene .
6.With digitalis and some general anesthetics as
halothane arrhythmias.
7. With non selective -blockers severe hypertension.
2-Noradrenaline
Mechanism of action
Stimulates directly -1 , 3 no 2
Administration of Noradrenaline
I.V. infusion.
Uses of adrenaline(indications)
3-Isoprenaline (isoproterenol)
Mechanism of action
Stimulates directly 1 , 2, 3 but no -effct
Administration of Iso prenaline.
- Sublingual, Inhalation
Uses of Isoprenaline(indications)
.
Heart block-1
.Acute
bronchial asthma-2
4-Dopamine
Mechanism of action
Stimulates directly D1 , 1 , receptors.
Administration of dopamine
I.V. infusion. It can't pass to brain.
Small dose D1 V.d. of renal & mesenteric vessels .
Moderate dose D1 and 1
Large dose 1
1-Hypovolemic,
cardiogenic &endotoxin
shock with correction of
hypervolemia.
5-Dobutamine
Mechanism of action
Stimulates directly 1 receptors
Administration
I.V. infusion
Uses of Dobutamine (indications)
.acute heart failure (cardiogenic shock)-1
6-Fenoldopa
- D1 receptor agonist which decreases P.R. by dilating arterioles .
Side effects :
1-Headache, 2-Flushing 3-Tachycardia.
1-Non-Catecholamines drugs
A) stimulants
Selective 2 agonists-1
Ex. Salbutamol
B) stimulants
Selective 1 agonists- 2
Ex. Dobutamine
A) stimulants
1-Selective 2 agonists
Salbutamol (ventolin)-1
terbutalin (Bricanyl-2
salmetrol (Serevent)-3
formoterol (foradil )-4
2- selective 1-agonists
Clinical Uses
.in bronchial asthma. (acute attack & prophylaxis) - 1
Side effects:Tremors- 1
tachycardia-2
:- Ritodrine
2 agonist, used in
1- premature labour
2-constriction ring of uterus
3- dysmenorrhea.
.nervousness- 3
Oriciprenaline-2
Used orally or
inhalation in bronchial
asthma
B) stimulants
Selective 1 agonists-1
Ex. Phenylephrine
Selective 2 agonists-2
Ex. Clonidine
Non Selective -2
agonists
EX. Adrenaline , Noradrenaline
., P.R- 2
Clinical Uses
1. Treatment of hypotension.
2.Treatment of Paroxysmal Atrial Tachycardia ( PAT).
3.mydriatic& decongestant (phenylephrine).
Nasal decongestant
B)Systemic (oral)
A)Local
1. Naphazoline (Privin)
2. Xylometazoline (otrivin, Rhinex , Balkis)
3. Tetrahydrozoline(Nazine)
4. Oxymetazoline
(Afrin ,oxymet)
B)Systemic (oral)
1-Phenylpropanolamine (coldact,Flustop ,Eskornade).
2-Pseudoephedrine.(Actifed ,Histarhine,Doldex-2):oral
common cold preparation
3-Phenylephrine (1 agonist).(Noflu , Sine up): oral
common cold preparation
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