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Adrenergic Drugs
Adrenergic Drugs
Mosby items and derived items 2011, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Overview
Mimic the effects of SNS neurotransmitters
(catecholamines)
Norepinephrine (NE)
Epinephrine (EPI)
Dopamine
Adrenergic Receptors
Alpha 1 Receptors
All vascular smooth muscle,
GI & urinary sphincters
Dilator muscle of the iris
Arrector pili muscle of hair follicles
Alpha 2 Receptors:
Located on secretory terminals of
postsynaptic adrenergic neurons.
Adrenergic Receptors
Beta 1 Receptors
Cardiac pacemaker
Myocardium
Salivary gland ducts
Eccrine and apocrine sweat glands
Beta 2 Receptors:
gastrointestinal tract
urinary bladder
skeletal muscle arteries
bronchial tree
some coronary vessels
Beta 3 Receptors:
on the smooth muscle cells of the urinary bladder
Beta-Adrenergic Receptors
Dopaminergic Receptors
Stimulated by dopamine
Causes dilation of the following blood vessels,
Dopaminergic Receptors
D1 Receptors:
Smooth muscles of pulmonary artery, kidney,
smooth muscles of various organs e.g sphincters of
stomach., proximal tubule of nephron, brain
D2 receptors:
Brain, Substantia nigra, neostraital pathway,
pulmonary artery, kidney
D3,D4,D5:
These are primarily present in brain. D4 receptors
are expressed in atrial wall. dopamine increases
myocardium contractility.
Adrenergic Receptors
Activation of alpha 1 and beta 1 receptors
Responses to Stimulation
Catecholamines
Endogenous substances:
Epinephrine.
Norepinephrine.
Dopamine.
Exogenous substances:
Dobutamine.
Phenylephrine.
Indications
Respiratory indications
Indications for topical nasal decongestants
Ophthalmic indications
Cardiovascular indications
Respiratory indications
1- as bronchodilators
Nasal congestion
Indications (contd)
Treatment of nasal congestion
Alpha1-adrenergic receptors
Examples: epinephrine, ephedrine, naphazoline,
oxymetazoline, phenylephrine, and tetrahydrozoline
Ophthalmic indications
CVS indications
Support the cardiovascular system during cardiac
failure or shock.
Epinephrine/ adrenaline
Dopamine
Dopamine
At doses < 2 mcg/kg/min, stimulates
dopamine receptors, vasodilatation and
increase renal perfusion .
At doses between 5 and 10 mcg/kg/min,
stimulates beta-1 adrenergic receptors,
resulting in increased cardiac output.
At doses > 10 mcg/kg/min, dopamine
stimulates alpha-adrenergic receptors,
leading to vasoconstriction, which
increases the systemic vascular
resistance and increase BP
Dobutamine
Dobutamine
Primarily stimulates beta-1 receptors,
leading to increased inotropic and
chronotropic effects to al lesser extent
Dobutamine also stimulates beta-2
adrenergic receptors, leading to
vasodilatation.
This combination of effects contributes to
increased cardiac output with decreased
systemic vascular resistance.
Dobutamine is typically used for patients
with cardiogenic shock.