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SympathomimeticsDefinition

Drugs that stimulate adrenoceptors and produce

actions similar to sympathetic system

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1-Catecholamines 2-Non catecholamines

A-Natural B-Synthetic

1-dopamine

2-nor adrenaline

3-adrenalin

1-isoprenaline

2-dobutamine

3-isoetharine.

1-Ephedrine,

2-amphetamine,3-phenylephrine

-salbutamol!

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Mechanism of action of sympathomimetics

A-Direct

1-catecholamines

2-phenylephrine

3-salbutamol

1-Amphetamine

2-"yramine

1-Ephedrine.

B-#ndirect C-$i%ed &dual'

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Catecholamine drugs

1-Adrenaline(

Mechanism of action

Stimulates directly all types o) receptors * + Administration of adrenaline

S!C , #nhalation , #ntra-cardiac , Eye drops.

Action of adrenaline

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Uses of adrenaline(indications)

1! #n allergy &anaphylactic shoc'!

2!.ith local anesthetics!

3!Epista%is &locally'!

4./ypoglycemia.5.0laucoma &dipii)rin is better , a prodrug'.

! Cardiac arrest &intracardiac'!

7.Acute bronchial asthma.

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Contraindications of adrenaline(-

1! /ypertension!

2.Arrhythmia.

3.Angina pectoris.

!"hyroto%icosis!

! .ith local anesthetics in )ingers 4 toes 5 gangrene !

!.ith digitalis and some general anesthetics ashalothane 5 arrhythmias!

6! .ith non selectie -blocers 5 seere hypertension!

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2-Noradrenaline

Mechanism of action

Stimulates directly *-1 ,3 no 2

Administration of Noradrenaline

#!7! in)usion!

Uses of adrenaline(indications)

hypotension Infusion( should not be stopped suddenly).

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3-soprenaline (isoproterenol)

Mechanism of action

Stimulates directly 1 ,2,3 but no *-e))ct

Administration of so prenaline!

- Sublingual, #nhalation

Uses of soprenaline(indications)

1-/eart bloc.

2-Acute bronchial asthma.

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"-Dopamine

Mechanism of action

Stimulates directly D1, 1, * receptors!

Administration of dopamine

#!7! in)usion! #t can8t pass to brain!

Small dose 5 9 D1 5 7!d! o) renal 4 mesenteric essels !$oderate dose 59 D1 and 1 9 /!:!, 9 C!;!, 9 systolic pressure !

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Uses ofDopamine (indications)

1-/ypoolemic,

cardiogenic 4endoto%in

shoc >ith correction o)

hyperolemia!

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#-Do$utamine

Mechanism of action

Stimulates directly 1receptors

Administration#!7! in)usion

Uses of Do$utamine (indications)

1-acute heart )ailure &cardiogenic shoc'.

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%-&enoldopa

- D1

receptor agonist >hich decreases =!:! by dilating arterioles!

- #t is gien by #!7! drip in emergency hypertension !

'ide effects (

1-/eadache, 2-?lushing 3-"achycardia!

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1-Non-Catecholaminesdrugs

A) stimulants *)+ stimulants

1-'electi,e 2agonists

.! 'al$utamol

3-Non 'electi,e agonists

.! Adrenaline

1-'electi,e +1agonists

.! /henylephrine

2-'electi,e +2 agonists

.! Clonidine2-'electi,e 1 agonists

Ex. Dobutamine3-Non 'electi,e + agonists

0! Adrenaline Noradrenaline

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1-'electi,e 2agonists

A) stimulants

3-Non selecti,e -agonists

1-Salbutamol &entolin'

2-terbutalin &Bricanyl3-salmetrol &Sereent'

4-)ormoterol &)oradil '

2- selecti,e 1-agonists

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Action of selecti,e 2 agonist

1- =roduce broncho dilatation,

2- @ bronchial secretions 4 @ release o) allergic

mediators )rom mast cells!

3- :ela% uterus 4 produce 7!D!

- @ B!=! 4 produce mild tachycardia &re)le% and >ea

1e))ect'!

- 9 glycogenolysis4 insulin release !

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Clinical Uses

1-in bronchial asthma! &acute attac 4 prophyla%is'.

'ide effects(-

1-"remors 2-tachycardia 3-nerousness.

itodrine:-

2agonist, used in

1- premature labour

2-constriction ring o) uterus

3- dysmenorrhea!

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Non selecti,e -agonists

1-so.suprine 2-riciprenaline

sed in1-ascular disease

2-constriction ring o) uterus.

sed orally or

inhalation in bronchialasthma

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B' * + stimulants

1-'electi,e +1agonists

.! /henylephrine

2-'electi,e +2 agonists

.! Clonidine2-Non 'electi,e +

agonists0! Adrenaline Noradrenaline

1-/henylephrineoral, local, inection!

2-Midodrineoral &prodrug'!

3-Metho.amineinection!

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Action of 'electi,e +1 agonist1-=roduce 7!C! 5 decongestant

2-=!:.,3-B!=! &systolic 4 diastolic'! 5 re)le% bradycardia

-Actie mydriasis & e

3!mydriatic4 decongestant &phenylephrine'!

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Nasal decongestant

A'4ocal *)'ystemic (oral)

1! Napha5oline&=riin'

2! 0ylometa5oline (otriin, :hine% , Balis)

3! 6etrahydro5oline&Naine)

"! .ymeta5oline&A)rin ,o%ymet'

Non irritant nasal drops and sprays (less re$ound congestion)!

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*)'ystemic (oral)

1-/henylpropanolamine&coldact,?lustop ,Esornade'!

2-/seudoephedrine!(Acti)ed ,/istarhine,Dolde%-2)7oral

common cold preparation

3-/henylephrine &*1agonist'!&No)lu , Sine +up'(oral

common cold preparation

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THAN !"#Dr. Mohammad dammage