Adrenergic agents Adrenergic Blocking agents Autonomic Nervous System

Adrenergic agents Adrenergic Blocking agents

Autonomic Nervous System

Communication by Neurotransmitters are released from one axon and received by another neuron’s dendrites.

І. Adrenomimetics 1. - і -adrenomimetics (adrenalin hydrochloride, noradrenalin hydrotartrate) 2. dopamine-, -adrenomimetics (dopamine) 3. -adrenomimetics (mesatone, naftizin, galazoline) 4. -adrenomimetics (isadrine, salbutamol, phenoterol, terbutalin, dobutamine) ІІ. Sympathomimetics (ephedrine hydrochloride) ІІІ. Adrenoblockers 1. -adrenoblockers (phentolamine, tropaphen, prasosine, pyroxan) 2. -adrenoblockers (anaprilin, athenolol, talinolol, acebutolol) 3. - і -adrenoblockers (labetalol) ІІІ. Sympatholytics (reserpine, octadine)

Adrenomimetcs

Adrenalin (epinephrine) is a hormone of medullar layer of adrenal glands which is used in a form of a remedy adrenaline hydrochloride It is an adrenomimetic which stimulates 1, - 2 - and 1, 2 -adrenoreceptors Administration sudden stoppage of heart, for example, during surgical narcosis electric trauma shock and collapse conditions bronchial spasm hypoglycemic coma treatment of open-angle glaucoma

Noradrenalin hydrotartrate (norepinephrine) Is an adrenomimetic of direct action which stimulates 1 -, 2 - and 1 -adrenal receptors Administration in cases of acute decreasing of blood pressure shock and collapse conditions, surgeries, traumas The drug is absolutely contraindicated for subcutaneous and intramuscular introductions

Dopamine Drug of choice for treatment of shock and collapse of different etiology, including cardiogenic and hemorrhagic

Mesaton (phenilefrin) Is a synthetic a 1 -adrenomimetic drug of direct action Administration • acute hypotensive conditions, • prophylaxis of decreasing of blood pressure in case of infectious diseases, poisonings, • decreasing of blood pressure during narcosis with fluorothan and cyclopropan • nose drops in case of rhinits

Naphtisin Xylometazolin are a 2 -adrenomimetics of direct action Usage for rhinitis in a form of nose drops – 1 -2 drops 2 -3 times a day It is not recommended to use the drug in case of chronic cold

Isadrin (isoprenalin, novodrin, euspiran) – is a synthetic catecholamine, which is a strong stimulant of b 1і b 2 -adrenal receptors Administration • bradycardia, atrio-ventricular blockade • bronchial spasm • complex therapy of some kinds of shock (if the patient doesn’t have hypovolemia) Side effects • nausea, hands tremor, dryness in mouth, • in patients with ischemic heart disease – attack of stenocardia, • heavy cardiac tachyarrhythmias, even fibrillation of ventricles

Salbutamol (ventolin) selective b 2 -adrenomimetic of direct action Administration • inhalations during attacks of bronchial asthma and bronchial spasms of other etiology, • передчасних child delivery, бурхливій child delivery

Terbutalin (brikanil) and phenoterol (berotek, partusisten) are stimulants of mostly 2 -adrenal receptors. They posses broncholytic and tokolytic activity

Dobutamin Is a synthetic 1 -adrenomimetic Cardiotonic effects of dobutamin is 5 times stronger than action of dopamine Administration some forms of acute and chronic cardiac insufficiency intravenous dropping infusion with the speed of 2, 5 -10 mcg / (kg. min)

Sympathomimetics Ephedrine hydrochloride (Ephedrini hydrochloridum) It is an alkaloid of plants of Ephedra family, which has indirect a -, b-adrenomimetic (sympathomimetic) action Administration • collapse conditions, for prophylaxis of decreasing of blood pressure before spinal anesthesia, infectious diseases • treatment of rhinitis (2 %, 3 % solution to drop into nose). • prophylaxis and elimination of bronchial spasm (inhalations 0, 5 %-1 % solutions of drug) SIDE EFFECTS • неспокій, excitement, tremor, inconsiderable euphoria, insomnia, seizures • drug addiction • tachyphylaxy

Adrenoblockers Alfa-adrenoblockers

Phentolamine, tropaphen are synthetic a 1, 2 -аdrenoblockers administration • diagnostics and symptomatic treatment of feochromocytoma • disturbances of peripheral blood circulation in case of endarteritis, Reino’s disease, trophic ulcers, decubitus • complex treatment of hypertensive crises, acute cardiac insufficiency • complex therapy of hypovolemic and cardiogenic shock

Prasosin Selective a 1 - adrenoblocker Administration • treatment of essential hypertension • stabile cardiac insufficiency Side effects “phenomenon of first dose”: sudden decreasing of blood pressure and even development of orthostatic collapse after first administrations of the drug Prophylaxis: administration of half-dose before sleep

Betaadrenoblockers Anaprilin Is a selective b 1 - і b 2 -adrenoblocker Administration • ischemic heart disease • essential hypertension • cardiac tachyarrhythmias • acute myocardium infarction

Talinolol or cordanum is a cardioselective b-adrenoblocker Administration • disorders of cardiac rhythm (extrasystolies, paroxysmal tachycardia, fibrillation and scintillation of atria) • stenocardia • arterial hypetension.

Atenolol (tenormin) cardioselelctive -adrenoblocker of long action Indications for administration • ischemic heart disease • essential hypertension • cardiac arrhythmias • acute myocardium infarction

Acebutolol (sectral) 1 -adrenoblocker with internal sympathomimetic activity Indications • disorders of cardiac (tachyarrhythmias) • hypertension • ischemic heart disease rhythm

Labetolol -, -adrenoblocker. The drug blocks 1, 2, 1 and 2 -adrenoreceptors Administration • treatment of patients with essential hypertension • hypertensive crisis Contraindications Atrio-ventricular blockade, cardiac insufficiency

• Nebivolol – Nebilet • Stimulates NO synthesis in endothelium

Sympatholytics Reserpine Adelfan - Еsidrex Rauwolfia Serpentina (Reserpine, dihydralazine, hydrochlorothiazide)

Reserpin is a sum of (plant) alkaloids. Maximal hypotensive action develops after 5 -7 days of regular administration of the drug. After the treatment coarse effect can still stay for two weeks. Administration treatment of different forms of essential hypertension (combined drugs trirezid, cristepin, adelfan, brinerdin) Side effects • manifestations of parkinsonism • somnolence, depression, • bradycardia • increasing of motor and secretory activity of GIT • acute attacks of ulcer disease, diarrhea • swelling of nose mucous membrane with complication of nose breathing

Octadin Is a sympatholytic with strong hypotensive effect. During administration of the drug decreasing of blood pressure develops gradually, after 2 -3 days. After quitting of drug administration the effect still stays for 2 weeks. Administration heavy forms of arterial hypertension Side effects general weakness, nausea, vomiting, swelling of nose mucous membrane, diarrhea, storing of liquid in the organism, orthostatic collapse.

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