Sympathetic Nervous System

Selective α1 antagonists
M: SM relaxation in bladder neck & prostate
Art/ven vasodilation = TPR + BP

Tamsulosin I: BPH

Prazocin I: HTN, BPH, Raynaud’s

Noradrenaline
Selective α1 agonist (tiny bit of α2)
M: art/ven vasoconstriction = BP
I: vasopressor. Shock, hypotension

Phenoxybenzamine
Phenylephrine Non-selective α1 + (α2) antagonist
Non-selective α agonist Irreversible, long-acting
M: constrict vascular SM (esp. in nose) M: art/ven vasodilation = BP
I: decongestant, mydriasis, hypotension, Reflex tachycardia from α2 blockade
neurogenic hypotension, priapism I: phaeochromocytoma

Selective α2 antagonists Phentolamine

M: symp. outflow from CNS = BP, sedation Non-selective α antagonist
Reversible, short-acting
Clonidine I: sedation, ADHD, HTN, pain,
M: art/ven vasodilation = BP
insomnia, opioid WD Reflex tachycardia from α2 blockade
Dexmedatomidine I: Sedation (mostly in I: phaeochromocytoma, erectile dysfunction
*Not marketed in Aus but may be available through SAS
intubated patients)

Selective β1 antagonists
Adrenaline M: BP HR

Non-selective β + (α1) agonist Metoprolol I: HTN, HFrEF, tachyarrhythmias,

M: HR/contractility/conduction/renin (β1) AMI, migraine prevention

Vasoconstriction (α1) Atenolol I: HTN, angina, tachyarrhythmias,
I: Inotrope: hypotension, anaphylaxis, AMI, migraine prevention
asthma, shock, peripheral vasoconstriction
Esmolol I: AF/flutter (short term rate control),
Ultra-short-acting sinus tachycardia, HTN, refractory SVT

Dopamine
Non-selective β1 + D1 + (α) agonist
M: BP HR
I: Inotrope: acute HF, cardiogenic/septic shock Non-selective β + α1 antagonists
M: BP HR (β), vasodilation (α1)

Carvedilol I: HTN, HFrEF, ok in DM

Dobutamine
Labetolol I: HTN (incl. in pregnancy)
Selective β1 agonist
M: BP HR
I: Inotrope: acute HF, cardiogenic/septic shock

Non-selective β antagonists
Propranolol M: general β blockade
Isoprenaline I: HTN, angina, tachyarrhythmias, TOF, AMI,
migraine prevention, essential tremor,
Non-selective β agonist
phaeochromocytoma
M: HR, sBP, PVR = dBP
I: heart block, bradycardia (unstable), Timolol M: (ciliary epithelium) = aqueous humour
adjunct in cardio/septic/hypovolaemic shock I: glaucoma, ocular HTN

Salbutamol
Selective β2 agonist
M: bronchodilation
I: bronchospasm, hyperkalaemia
 Selective Selective
agonists antagonists

Noradrenaline* Selective α1 antagonists

Selective α1 agonist (tiny bit of α2) M: SM relaxation in bladder neck & prostate
M: art/ven vasoconstriction = BP Art/ven vasodilation = TPR + BP
I: vasopressor. Shock, hypotension
Tamsulosin I: BPH
At higher doses, acts more like adrenaline
(non-selective) - with actions on β as well Prazocin I: HTN, BPH, Raynaud’s

Selective α2 antagonists
M: symp. outflow from CNS = BP, sedation

Clonidine I: sedation, ADHD, HTN, pain,

insomnia, opioid WD

Dexmedatomidine I: Sedation (mostly in

intubated patients)

Selective β1 antagonists
M: BP HR

Metoprolol I: HTN, HFrEF, tachyarrhythmias,

AMI, migraine prevention
Dobutamine
Selective β1 agonist
Atenolol I: HTN, angina, tachyarrhythmias,
AMI, migraine prevention
M: BP HR
I: Inotrope: acute HF, cardiogenic/septic shock Esmolol I: AF/flutter (short term rate control),
Ultra-short-acting sinus tachycardia, HTN, refractory SVT

Salbutamol
Selective β2 agonist
M: bronchodilation
I: bronchospasm, hyperkalaemia
 Non-selective Non-selective
agonists antagonists

Phenoxybenzamine
Phenylephrine Non-selective α1 + (α2) antagonist
Non-selective α agonist Irreversible, long-acting
M: constrict vascular SM (esp. in nose) M: art/ven vasodilation = BP
I: decongestant, mydriasis, hypotension, Reflex tachycardia from α2 blockade
neurogenic hypotension, priapism I: phaeochromocytoma

Phentolamine
Non-selective α antagonist
Reversible, short-acting
M: art/ven vasodilation = BP
Reflex tachycardia from α2 blockade
I: phaeochromocytoma, erectile dysfunction
*Not marketed in Aus but may be available through SAS

Adrenaline
Non-selective β + (α1) agonist
M: HR/contractility/conduction/renin (β1)
Vasoconstriction (α1)
I: Inotrope: hypotension, anaphylaxis,
asthma, shock, peripheral vasoconstriction

Dopamine
Non-selective β1 + D1 + (α) agonist
M: BP HR
I: Inotrope: acute HF, cardiogenic/septic shock Non-selective β + α1 antagonists
M: BP HR (β), vasodilation (α1)

Carvedilol I: HTN, HFrEF, ok in DM

Labetolol I: HTN (incl. in pregnancy)

Non-selective β antagonists
Propranolol M: general β blockade
Isoprenaline I: HTN, angina, tachyarrhythmias, TOF, AMI,
migraine prevention, essential tremor,
Non-selective β agonist
phaeochromocytoma
M: HR, sBP, PVR = dBP
I: heart block, bradycardia (unstable), Timolol M: (ciliary epithelium) = aqueous humour
adjunct in cardio/septic/hypovolaemic shock I: glaucoma, ocular HTN