Adrenergic Drugs

Sympathomimetics/adrenergic agonists/adrenergic drugs
1. Fight or flight response.
2. Shock and hypotension
3. Much of the same action as anticholinergics, except these drugs are more specific and have a wider therapeutic application.
4. Catecholamines: Same structure as NE, shorter duration of action
  1. Must be given parenterally
5. Noncatecholamines: Not rapidly destroyed by MAO or COMT, so longer duration of action
  1. Can be given orally
6. Most act directly by binding to and activating adrenergic receptors, but some act indirectly by causing release of NE or by inhibiting reuptake or destruction of NE
7. Effects are predictable based on which receptor subtype is stimulated. Here's what they treat:
  1. Alpha 1: Nasal congestion, hypotension, mydriasis for ophthalmic exams
    1. Alpha 2: Hypertension
      1. Beta 1: Cardiac arrest, heart failure, and shock
        Beta 2 receptor: Asthma and premature contractions
        Beta 3: Overactive bladder
8. Side effects such as tachycardia, hypertension, dysrhythmias may limit therapy
  1. CNS excitement and seizures can occur at a large dose
    1. Dry mouth, nausea, vomiting, and anorexia can also occur
Adrenergic blocking drugs/adrenergic antagonists/sympatholytics
1. Alpha-adrenergic agonists: Used for effects on vascular smooth muscle
  1. Relaxes vascular smooth muscle in small arteries, causing vasodialtion and decreasing blood pressure
  2. Can cause orthostatic hypotension, reflex tachycardia, nasal congestion, and impotence
  3. Phentolamine is used to diagnose pheochromocytoma (pg.151)
2. Greater therapeutic application.
3. Similar effect to parasympathomimetics
4. Treatment of hypertension
5. Beta-adrenergic agonists: Decrease rate and force of heart contraction and slow electrical conduction through AV node
  1. Used primarily for hypertension, but can also work for migraines, angina pectoris, dysrhythmias, heart failure, MI, and narrow angle glaucoma
  2. May exacerbate heart failure in some patients.
    1. Increases risk of hypotension and bradycardia. Can cause bronchial constriction, hypoglycemia, diarrhea, nausea, vomiting, muscle cramps, rash, blurred vision, fatigue, depression, and erectile dysfunction
  3. Abrupt discontinuation can cause acute resurgence of symptoms.

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Adrenergic Drugs

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