Chapter 5:  Autonomic Pharmacology:  Adrenergic Drugs

Michael Gordon, Ph.D. (c) 2016

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Introduction

Adrenergic Agonists

Comparative Sympathomimetic Pharmacology2

Drug

α

β1

β2

Mechanism of action

Peripheral resistance

Renal blood flow

Mean arterial pressure

CNS stimulation

Epinephrine

Direct

+/-

Yes

Norepinephrine (Levophed)

0

Direct

No

Dopamine (Intropin)

Direct

No

Isoproterenol (Isuprel)

0

Direct

+/-

Yes

Dobutamine (Dobutrex)

0

0

Direct

NC

 

Ephedrine

Direct+Indirect

Yes

Mephentermine (Wyamine)

Direct+Indirect

Yes

Amphetamines

Indirect

Yes

Metaraminol (Aramine)

Indirect+direct

No

Phenylephrine

(Neo-synephrine)

0

0

Direct

No

-increased effect; -decreased effect

adapted from: Table 12-1 Stoelting, R.K., "Pharmacokinetics and Pharmacodynamics of Injected and Inhaled Drugs", in Pharmacology and Physiology in Anesthetic Practice, Lippincott-Raven Publishers, 1999, p. 2602

 
 
 

 

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References

  1. Hoffman, B.B and Lefkowitz, R.J, Catecholamines, Sympathomimetic Drugs, and Adrenergic Receptor Antagonists, In Goodman and Gillman's The Pharmacologial Basis of Therapeutics,(Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G.,eds) TheMcGraw-Hill Companies, Inc.,1996, pp.199-242

  2. Stoelting, R.K., "Sympathomimetics", in Pharmacology and Physiology in Anesthetic Practice, Lippincott-Raven Publishers, 1999, p. 260

  3. Carotic Baroreceptors:  CRRx:  Medicine ReEnvisioned http://www.cvrx.com/us-home/; http://www.cvrx.com/wp/wp-content/uploads/2012/04/Dr.-Bisognano-Slides.pdf .

  4. Westfall, TC and Westfall DP Adrenergic Agonists and Antagonists in Goodman and Gilman's The Pharmacological Basis of Therapeutics, eleventh editions, (Brunton LL, Lazo JS and Parker KL, eds), McGraw-Hill Medical Publishing Division, New York, 237-295, 2006.

  5. Catecholamine Biosynthesis:  The Interactive Library; Edinformatics.com:  http://www.edinformatics.com/interactive_molecules/info/adrenaline.htm .

  6. Standaert DG and Young AB Treatment of Central Nervous System Degenerative Disorders In Goodman and Gillman's The Pharmacologial Basis of Therapeutics,(Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G.,eds) TheMcGraw-Hill Companies, Inc.,1996, pp536-537.

  7. Adrenergic Neuronal Diagram adapted from http://www.drugabuse.gov/pubs/teaching/Teaching4/Teaching.html

  8. Guanetidine (Ismelin™, brand name not available in the U.S.) pharmacology:  Clinical Pharmacology, RxList:  The Internet Drug Index, http://www.rxlist.com/ismelin-drug.htm .

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