ACH - sweat glands

dopamine - renal vascular smooth muscle

TCA

tricyclic anti-depressants

hydroxyl group at th 3

4 position of a benzene ring

TCA

tricyclinic anti-depressants

low dose- beta stimulated vasodilation

high dose - alpha stimulated vasoconstriction

rapid onset

brief duration

destroyed by COMT and MAO & metabolites excreted in urine

CNS- anxiety, fear, tension, headache, tremor

increase BP and possible cerebral hemorrhage

cardiac arrhymias

pulmonary adema- peripheral constriction & cardiac stimulation

Mainly alpha effects

reflex bradycardia

this drugs indication is some hypotensive states such as shock but it does restrict blood flow  to the kidney so other medications like dopamine are better first line agents

Dopamine pharmacokinetics

normal doses- beta and dopamine

high doses- alpha 

This drugs MOA is primarily a beta 1 agonist

increases output and heart rate w/ few vascular effects

Indication - Congestive heart failure increases output with little increase in  oxygen demand

    This drug is not used as a rescue inhaler like albuterol or metaproterenol.  It is used as a maintenance inhaler to reduce the occurrence of bronchospasms

not a therapeutic agent

found in fermented products (chianti wine, cheese)

Actions - Increases blood pressure, bronchodilation, enhances muscle contractility, CNS stimulation (increased alertness, decreased fatigue and prevent sleep)

indications of this drug are asthma (rare)

nasal decongestant (rare) 

hypotension

 Actions – The decongestant action is due to stimulation of alpha receptors of the vascular smooth muscle causing vasoconstriction

alpha blockers

reflex tachycardia

  Actions - Non-selective linking irreversibly and non-competitively to a ₁ and a ₂ presynaptic receptors

      Effects - Decreased peripheral vascular resistance to lower BP and relax bladder neck smooth muscle

       Indications - Hypertension and Benign Prostatic Hypertrophy  (BPH)

Exaggerated hypotensive that can lead to syncope especially when patient stands after sitting or lying down (orthostatic hypotension)

first dose effect

limits use in high blood pressure

Treatment of BPH - New a ₁ blocker (Apr 97) that has specific action on bladder sphincter and less on the vascular

   Uses - angina, cardiac arrhythmias, MI, CHF, glaucoma, migraine prevention

     As a class _______ lower blood pressure without causing orthostatic hypotension because they do not affect the vascular.

hypertension

glaucoma (decrease secretion)

prevention of migraines

hyperthyroidism

angina pectoris

MI

 Adverse reactions - Bronchoconstriction, arrhythmias, sexual impairment, Decreased glycogenolysis and glucagon secretion

Uses - Migraine prophylaxis; Various cardiac uses however Beta 1 selective agents are now used to a greater extent; Pheochromocytoma - used in conjunction with alpha blockers;

prototype beta blocker???

look this up

The tablets are rarely used for hypertension but this is probably the most used agent for glaucoma

which drug has a short duration and is IV use only

 “partial agonist”

These agents bind to a receptor and cause a weak response ( a response less than that produced by endogenous neurotransmitters). 

 They are clinically useful in patients who can not tolerate the other beta blockers because of bradycardia or diabetes

Protection on the SA node, protection of ionitropic response, blockage of veins and arteries

Action Alpha 1 and B non selection blocker

ratios of alpha to beta blockade are 1:3 for oral use

Pharmacological actions – Contrasts from other b- blockers in that it does not produce peripheral vasoconstriction

   Indication- Drug of Choice for HP emergency

  Can also be used in  blacks, elderly, and pregnant patients

Action – Nonselective b-blocking activity and a ₁ blocking activity.

Ratios of Alpha to Beta blockade are about equal

First agent with Beta blocking activity to be approved for congestive heart failure