Historical philosophical, theoretical, and legal foundations of special and i...
Sympathomimetic Drugs.ppt
1.
2. Epinephrine
1-(3,4-dihydroxyphenyl)-N-methylaminoethanol
Non-selective
α1 agonist, β1 agonist, α2 agonist, β2 agonist.
Inactive when given by oral route as it undergoes enzymatic
degradation and first pass metabolism.
Uses:
In acute bronchial asthma
In cardiac arrest
In glaucoma
As adjuanct with local anesthetic
Side Effects
Hypertension, Tachycardia, Palpitation, Gangrene
3. Non-selective α1 agonist, β1 agonist, α2 agonist.
Little effect on β2 receptor.
Less potent than epinephrine
Uses
Vasoconstrictive so can be used as cardiac stimulant.
As adjuanct to local anesthetic.
4. Selective α1 agonist and no β activity
Orally active
Duration of action is twice as epinephrine because it lacks
catechol loeity so not metabolised by COMT.
Use
In Hypotension
As Nasal decongestant.
As adjuanct to local anaesthetic to decrease absorption
5. Selective α1 agonist.
Belong to 2-arylimidazolines
Vasoconstrictive effect
Nasal and opthalamic decongestant
2-(1-naphthylmethyl)imidazoline Oxymetazoline
T/t of facial erythema
6. Selective α2 agonist.
Structural resemblance with L-DOPA thus produce α-methyl nor
epinephrine so instead of nor-epinephrine, it binds with receptor and
will not increase sympathetic outflow, thus lower B.P.
Inhibit enzyme DOPA decarboxylase.
Useful as antihypertensive agents in combination with diuretic.
7. 2-[(2,6-dichlorophenyl)amino]-2-imidazoline
Selective α2 agonist.
Orally as well as I/v active
Interact specifically with α2 receptor and decrease sympathetic outflow.
Used as anti-hypertensive agent and in migraine also.
T/t of tourette syndrome (neuropsychiatric disorder with onset in childhood)
For clonidine, basicity of guanidine group is decreased to 8 because of
inductive and resonance effect of dichlorophenyl ring. Thus, it will exist in non-
ionized form required to enter CNS and thus produce sedative effect
(Premedication before surgery)
8. Selective β1 agonist.
Used in the treatment of heart failure and cardiogenic shock on
the basis of its positive inotropic action.
Active when given I/v
9. Also known as isoprenaline.
Non-Selective β agonist.
No activity against alpha adrenergic receptors
Treatment of bradycardia, heart block, and rarely for asthma.
10. Selective β2 adrenergic receptor agonist.
Used in management of asthma symptoms
As Tocolytic (anti-contraction medication) to delay preterm labor for
up to 48 hours.
Tertiary butyl group in terbutaline makes it more selective
for β2 receptors. Since there is no hydroxy group on position 4 of the
benzene ring, the molecule is less susceptible to metabolism by the
enzyme catechol-O-methyl transferase
11. 2- t-butylamino-1-[(3-hdroxymethyl-4-hydroxy)phenyl]ethanol
Selective β2 adrenergic receptor agonist.
Used in management of asthma symptoms and COPD
Salbutamol has been used to treat acute hyperkalemia, as it stimulates
potassium flow into cells, thus lowering the potassium in the blood
As Tocolytic (anti-contraction medication)
Tertiary butyl group makes it more selective for β2 receptors. Since there is no
hydroxy group on position 4 of the benzene ring, the molecule is less
susceptible to metabolism by the enzyme catechol-O-methyl transferase
12. Selective β2 adrenergic receptor agonist.
Used in relief of bronchospasm in conditions such
as asthma and COPD.
13. Drug that stimulates the sympathetic nervous system to release
adrenaline and nor-adrenaline.
Hydroxyamphetamine
Used medically in eye drops to dilate pupil (mydriasis), so that
the back of the eye can be examined.
Used as diagnostic agent for testing Horner’s syndrome
(damage of nerves of eyes)
14. Optical active isomer of Ephedrine. Contains 2 chiral atoms so exist
in 4 optical isomers.
α- and β2-adrenergic receptors, to cause vasoconstriction and
relaxation of smooth muscle in the bronchi, respectively.
Decrease symptoms of nasal congestion (α- action) .
Activation of β2-adrenergic receptors produces relaxation of smooth
muscle of the bronchi causing bronchial dilation and thus helpful in
asthma.
Also use as anti-tussive.
15. Used as nasal decongestant, appetite suppressant,
and psychostimulant medication
16. Act directly on receptor and also effect release of nor-epinephrine.
Ephedrine, a sympathomimetic amine, acts on part of
the sympathetic nervous system (SNS).
It cause indirect stimulation of the adrenergic receptor system by
increasing the activity of norepinephrine at the postsynaptic α and β
receptors.
Used to prevent low blood pressure during spinal anesthesia.
Bronchodilator
It has also been used for obesity by inducing thermogenesis.
17. Metaraminol, also known as metaradrine, a stereoisomer of meta-
hydroxynorephedrine is a potent sympathomimetic amine used in
the prevention and treatment of hypotension.
It is an α1-adrenergic receptor agonist with some β effect.
Metaraminol is also used in the treatment of priapism (condition in
which a penis remains erect for hours in the absence of stimulation
or after stimulation has ended)