1 / 21

بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. AUTONOMIC NS DRUGS (2) Dr: Samah Gaafar Al- shaygi. ADRENERGIC AGONIST. DIRECT ACTING ADRENERGIC AGONIST: Epinepherine : Synthesized in the adrenal medulla. At low doses has β vasodilatation effect. At high doses has α vasoconstriction effect. Action:

amish
Télécharger la présentation

بسم الله الرحمن الرحيم

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. بسم الله الرحمن الرحيم AUTONOMIC NS DRUGS (2) Dr: SamahGaafar Al-shaygi

  2. ADRENERGIC AGONIST • DIRECT ACTING ADRENERGIC AGONIST: • Epinepherine: • Synthesized in the adrenal medulla. • At low doses has β vasodilatation effect. • At high doses has α vasoconstriction effect. • Action: • CVS: β1 +veinotropic & chronotropic effect, COP & O2 demand. • Renal: β1 Renin release, blood flow is decreased.

  3. Blood vessels: α1constrict arterioles to skin, mucous membranes & viscera. β 2 dilate vessels to liver & muscles. • Respiratory: β2 bronchodilataion. • Hyperglycemia: β2 increases glycogenolysis & glucagon secretion. • α2 decrease release of insulin. • Lipolysis.

  4. P.kinetics: • Rapid onset & short duration of action. • Metabolized by MAO & COMT into metanephrine & venillymandilic acid. • i.m, i.v, s.c, inhalation & endotracheal.

  5. Therapeutic uses: • Emergency bronchospasm.choice • Anaphylactic shock.choice • Cardiac arrest. • Anesthesia. • Control bleeding from mucous membranes. • A.E: • CNS disturbances. • Hemorrage. • Cardiac arrythmia. • Pulmonary oedema.

  6. NOREPINEPHERINE: • Is the neurotransmiter. Therapeuticaaly has α activity. • action: • CVS: • Vasoconistriction. • Baroreceptor reflex. • If atropin is given first it inhibits the vagus so N.e causes tachycardia. • P.kinetics: • i.v, poor s.c absorption, short duration of action.

  7. Therapeutic uses: • Only in shock. • A.E: as epi.+ extravasation. • ISOPROTERENOL: • β receptors. • Action: • CVS: • Heart: +veino & chronotrpic effect. • Peripheral vasodilationβ2, slight increase in SBP due to action on heart.

  8. pulmonary stopped, metabolic action. • Used in cardiac arrest. • A.E: as epi. • DOPAMINE: • High doses α1 • Low doses β1 • D1, D2 in mesenteric & renal vascular bed vasodilation.

  9. Action: • CVS: +veinotropic & chronotropic effect, vasoconistriction. • Renal & splanhinic vasodilatation. Therapeutic uses: • In cardiogenic & septic shock, hypotension, severe CCF with oliguria. • Metabolized by MAO & COMT to homovanillic acid. • A.E as sympathetic stimulation.

  10. Dobutamine: • Selective β1 agonist used to COP in CCF & inotropic support after cardiac surgery. • Phenylepherine: • α1 agonist, rasis the BP, reflex bradycardia. • Used topically as nasal decongestant & for ocular mydriasis. • Used in SVT. • A.E hypertensive headache &arrythmias.

  11. Albuterol & terbutaline: • Short acting β2 agonist, used as bronchodilators. • A.E tremor, interaction with MAOIs. • Salmeterol & formoterol: • Long acting β2 agonist. • Used with steroid mainly for nocturnal asthma.

  12. INDIRECT ACTING ADRENERGIC AGONISTS • Enhances the release of epi. Presynaptically or inhibit the uptake. • AMPHETAMINE: • Acts on α1 so BP. • On β stimulates the heart.Note • ADHS, appetite control, narcolepsy. • TYRAMINE: • Normal byproduct of tyrosine. • Oxidized by MAOI in the gut. • COCAINE: • Inhibits the reuptake. • α1 β effects.

  13. MIXED ACTION ADRENERGIC AGONIST • EPHEDRINE & PSEUDOEPHEDRINE: • Long duration of action (poor COMT & MAO substrates). • Ephedrine • increases BP by systoilc & diastolic BP & cardiac stimulation. • CNS stimualtion. atheletic performance. • Pseudoehedrine:nasal,sinus decongestion.

  14. ADRENER α GIC ANTAGONIST • α ADRENERGIC BLOCKING AGENT • Mainly affecting the BP. • Reflex tachycardia. • Phenoxybenzamine: • Acts on α1 & α2 receptors. • peripheral resistance, reflex tachycardia, COP & restore the decrease in BP. • Obsolete in hypertension management. • It’s an epinephrine reversal. • Used in pheochromocytoma, Raynaud disease.

  15. A.E: nasal stiffness, hypotension. • Contraindicated in patients with coronary perfusion. • PHENTOLAMINE: • Action as phenoxybenzamine. • Used for • short treatment of pheochromocytoma. • Norepinephrine administration. • Hypertensive crisis with clonidine & tyramine- MAOI.

  16. Selective α1 inhibitors • prazosin, doxazosin, tamsulosin. • Used for: HTN, CCF, BPH. • A.E: nasal congestion, headache, orthostatic hypotension.

  17. Β-adrenergic blocking agent • All are competitive antagonist. • Act on both β1 & β2 or are selective β1. • Non-selective antagonists: • Propranolol: • CVS: COP, work, O2 consumption. • Blocks β2 peripheral vasodilatation (no postural hypotension). • Bronchoconstriction. • Hypoglycemia.

  18. P.K: • First-pass effect, Cross BBB. • Uses: • HTN. • Hyperthyroidism. • Angina pectoris. • M.I. • A.E: • bronchoconstriction, arrythmias, drug interactions. • Timolol in chronic open-angle glucoma.

  19. Selective antagonist β1 • Atenolol, metoprolol, bisoprolol. • HTN, diabetes, asthma. • Antagonist with partial agonist activity: • E.gpindolol & acebutolol. • Hypertensive with moderate bradycardia, DM. • Antagonist of both α & βarenoreceptors: • Labetalol, carvedilol. • Produce peripheral vasodilatation. • HTN, PIH, HF.

  20. Drugs affecting neurotransmitter release or uptake • resrpine: move dopamine, serotonin & NE into the vesicles. • Guanethidine: displaces NE from the vesicles. • Cocaine: inhibits reuptake.

  21. Thank you

More Related