| Drug Name |
Category |
Mechanism, Indications, Adverse
Effects, Unique Properties |
| Dopamine |
Adrenergic Agonist, Direct |
Important in maintenance of renal blood flow.
Dopamine receptors are found in kidneys. Has Epi-like activity at high
doses. Can be used in cardiogenic shock. Can cause nausea and vomiting |
| Oxymetolazine |
Adrenergic Agonist, Direct
alpha1, alpha2 |
Topical nasal decongestant (via action on alpha1
receptors). In high doses, can paradoxically produce hypotension,
probably via alpha2 receptors. |
| Xylometolazine |
Adrenergic Agonist, Direct
alpha1, alpha2 |
Topical nasal decongestant. |
| Norepinephrine |
Adrenergic Agonist, Direct
alpha1, alpha2, beta1 |
Increase b.p. ------> reflex bradycardia.. If
reflexes are blocked by Hexamethonium, then you see a direct
tachycardia. |
| Methoxamine |
Adrenergic Agonist, Direct
alpha1-selective |
Used to maintain blood pressure during anesthesia.
Produces fewer arrhythmias than other drugs. |
| Naphazoline |
Adrenergic Agonist, Direct
alpha1-selective |
Used to induce mydriasis before ophthalmic exam. |
| Phenylephrine |
Adrenergic Agonist, Direct
alpha1-selective |
Used topically as a nasal decongestant (restrict blood
flow to nose), and to induce mydriasis for ophthalmic exam.
Not a catechol, and not broken down by COMT, thus it has longer
half-life (20 minutes) then catecholamines.
alpha-Agonist ------> increase b.p. ------> reflex bradycardia. |
| Clonidine |
Adrenergic Agonist, Direct
alpha2-selective |
Prototypical alpha2-Agonist ------> inhibit
sympathetics (and some parasympathetics). It is an indirect adrenergic
antagonist, as it decreases sympathetic outflow.
Initially it produces a transient hypertension (via alpha2
vascular receptors), followed by prolonged hypotension. |
| Guanabenz |
Adrenergic Agonist, Direct
alpha2-selective |
It is an indirect adrenergic antagonist, as it
decreases sympathetic outflow. |
| Guanfacine |
Adrenergic Agonist, Direct
alpha2-selective |
It is an indirect adrenergic antagonist, as it
decreases sympathetic outflow. |
| Methyldopa |
Adrenergic Agonist, Direct
alpha2-selective |
alpha-methyl-NE is the active form,
converted by DOPA-decarboxylase and Dopamine-beta-Hydroxylase into the
active form. alpha-methyl-NE slowly replaces endogenous NE in
pre-synaptic neurons, to induce the inhibitory physiologic effect of
decreasing sympathetic outflow. |
| Isoproterenol |
Adrenergic Agonist, Direct
beta-selective (beta1, beta2) |
Given sublingually or by inhalation. Produces
hypotension (beta2), tachycardia (beta1), and
higher CO. Rapidly metabolized by COMT in liver. |
| Albuterol |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator |
| Bitoterol |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator. Prodrug is hydrolyzed in the lung by
esterases to its active form, colterol. |
| Isoethanine |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator |
| Metaproterenol |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator |
| Pirbuterol |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator |
| Ritodrine |
Adrenergic Agonist, Direct
beta2-selective |
Used to relax the uterus during labor. |
| Terbutaline |
Adrenergic Agonist, Direct
beta2-selective |
Bronchodilator |
| Epinephrine |
Adrenergic Agonist, Direct
Non-selective (alpha1, alpha2, beta1,
beta2) |
Increase b.p. (alpha1) and direct
tachycardia (beta1). |
| Dobutamine |
Adrenergic Agonist, Direct
"Cardioselective" (B1) |
Displays some alpha1 effects. Used for
cardiogenic shock and CHF.
Increases the inotropic state, with little effect on heart-rate or
TPR (because it is modulated by alpha1 agonist). |
| Ephedrine |
Adrenergic Agonist, Indirect
Mixed-receptor agonist |
Taken orally, long duration of action. Used in asthma,
as nasal decongestant, and sometimes as a pressor.
Has direct effects (alpha1, beta1, beta2),
and indirect effects (potentiate NE release).
Uptake I is required for the indirect effects. Cocaine eliminates
this response. Tachyphylaxis is observed peripherally but not centrally. |
| Metaraminol |
Adrenergic Agonist, Indirect
Mixed-receptor agonist |
Used for the treatment of hypotension. Overall effects
similar to NE, but it is less potent and longer acting. Because of
reflex bradycardia, it actually slightly decreases cardiac output, but
increases force of contraction.
Has direct effects (alpha1, beta1, beta2),
and indirect effects (potentiate NE release).
Uptake I is required for the indirect effects. Cocaine eliminates
this response. |
| Pseudoephedrine |
Adrenergic Agonist, Indirect
Mixed-receptor agonist |
Taken orally, long duration of action. Used in asthma,
as nasal decongestant, and sometimes as a pressor.
Has direct effects (alpha1, beta1, beta2),
and indirect effects (potentiate NE release).
Uptake I is required for the indirect effects. Cocaine eliminates
this response. Tachyphylaxis is observed peripherally but not centrally. |
| Clorgyline |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
MAO Inhibitor |
MAO-A-selective inhibitor. |
| Deprenyl |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
MAO Inhibitor |
MAO-B-selective inhibitor. |
| Pargyline |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
MAO Inhibitor |
Non-selective MAO inhibitor. |
| Tranylcypromine |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
MAO Inhibitor |
Non-selective MAO inhibitor. |
| Cocaine |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
Uptake I Inhibitor |
Blocks Uptake I (NE reuptake), thus potentiating the
effects of NE. |
| Imipramine |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
Uptake-I Inhibitor, Tri-Cyclic Antidepressant |
|
| Amitriptyline |
Adrenergic Agonist, Indirect
NE-Potentiating Agent
Uptake-I Inhibitor, Tri-Cyclic Antidepressant |
|
| Tyramine |
Adrenergic Agonist, Indirect
NE-Releasing Agent |
Potentiates NE release in pre-synaptic neuron. Serves
as a false substrate for MAO. Uptake I of tyramine is required in order
for it to work, thus it is neutralized by Cocaine.
It is dangerous to eat tyramine (wine + cheese) in patients taking
MAO-inhibitors, as it can lead to hypertensive crisis. |
| Amphetamine |
Adrenergic Agonist, Indirect
NE-Releasing Agent
Amphetamine |
Promotes release of NE, Dopamine, and serotonin from
CNS neurons. Not a catechol, and not a substrate for MAO or COMT, thus
it is long-lasting. Does not require uptake I. |
| Methamphetamine |
Adrenergic Agonist, Indirect
NE-Releasing Agent
Amphetamine |
Promotes release of NE from pre-synaptic neuron. More
pronounced CNS effects than amphetamine. |
| Methylphenidate |
Adrenergic Agonist, Indirect
NE-Releasing Agent
Amphetamine |
Similar to Methamphetamine, with abuse potential. |
| Pemoline |
Adrenergic Agonist, Indirect
NE-Releasing Agent
Amphetamine |
Similar to Methamphetamine, with abuse potential. |
| Phenmetrazine |
Adrenergic Agonist, Indirect
NE-Releasing Agent
Amphetamine |
Similar to Methamphetamine, with abuse potential. |
| Doxazosin |
Adrenergic Antagonist
alpha-Antagonist, alpha1-Selective |
Similar to Prazosin but with longer half-life. |
| Prazosin |
Adrenergic Antagonist
alpha-Antagonist, alpha1-Selective |
Has less of an effect on reflex tachycardia and renin
release, because it does not block the inhibitory alpha2
receptors. It can be used to treat hypertension. |
| Terazosin |
Adrenergic Antagonist
alpha-Antagonist, alpha1-Selective |
Similar to Prazosin but with longer half-life. |
| Urapidil |
Adrenergic Antagonist
alpha-Antagonist, alpha1-Selective |
Has less of an effect on reflex tachycardia and renin
release, because it does not block the inhibitory alpha2
receptors. It can be used to treat hypertension. |
| Labetalol |
Adrenergic Antagonist
alpha-Antagonist, alpha1-Selective
beta-Antagonist, non-selective |
Causes hypotension, but is accompanied by less
tachycardia than other alpha-antagonists, because it also has
beta-antagonizing activity.
Local anesthetic membrane-stabilizing activity. |
| Yohimbine |
Adrenergic Antagonist
alpha-Antagonist, alpha2-selective |
The only alpha2-selective antagonist there
is. May be useful in autonomic insufficiency. |
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