Mechanism: prototypical agent of alpha and beta receptors.

Treatment: analphylactic shock (a+b), acute asthma attacks (b), prolong action of the anesthetics (a), topical hemostatic (a), cardiac arrest (a)

Side-effects: marked hypertension, arrythmias, angina, necrosis following extravasation, special precaution for hyperthyroid patients or patients on beta-blockers

Mechanism: alpha and beta-1 receptors

Treatment: pressor effects although used uncommonly

Side-effects: Tolerance over time and may worsen long-term outcome for CHF (resistance to catecholamines)

Mechanism: beta receptor agonist

Treatment: induce bronchodilation, mitigate bradycardia or heart block

Side-Effects: Tolerance over time and may worsen long-term outcome for CHF (resistance to catecholamines)

Mechanism: Beta-1>Beta-2; inotropic more prominent than chronotropic effects

Treatment: CHF

Side-effects: Tolerance over time and may worsen long-term outcome for CHF (resistance to catecholamines)

Mechanism: D1, D2, some B-1, few alpha effects; D1 response is vasodilation of renal, mesenteric, and coronary beds; selectivity by dose/therapeutic dose (alpha>beta>D1)

Treatment: Heart stimulation with positive effects on renal output

Side-effects: careful monitoring for severe vasoconstriction (no B-2), ischemia of peripheral tissues. Tolerance over time and may worsen long-term outcome for CHF (resistance to catecholamines)

Mechanism: direct acting noncatecholamine alpha-1,alpha-2 agonists with vasoconstrictive effects

Treatment: hypotension, shock, nasal decongestion (topical), mydriasis (topical)

Mechanism: direct acting noncatecholamine alpha-2, alpha-1 agonist that penetrates CNS, inhibits sympathetic tone producing hypotension, bradycardia, and sedation

Treatment: Hypertension and diminish cravings in narcotic, alcohol, and nicotine withdrawal

Mechanism: direct acting noncatecholamine beta-2, beta-1 agonist, causes bronchodilation or uterine muscle relaxant. Inhalation causes less systemic effects

Treatment: asthma, COPD, delay preterm labor

Mechanism: indirect acting noncatecholamines enters CNS releases catecholamines including dopamine. Elevates mood and alertness, suppresses appetite

Treatment: Narcolepsy, weight loss, ADHD

Mechanism: vasoconstriction and local anesthesia through blocking of NE reuptake

Treatment: 

Side-effects:  Hypertensive response

Mechanism: mixed indirect and direct noncatecholamine, some CNS penetration, mild stimulant, orally available, excreted unchanged, long DOA

Treatment: Nasal decongestant, bronchodilator (cold meds)

Mechanism: nonspecific alpha blocker, predominant effect is vasodilation, hypotensive response blunted by increased CO, requires bioactivation (lag in onset), covalent, irreversible (>24 hour duration)

Treatment: pheochromocytoma

Side effects: orthostatic hypotension, nasal stuffiness, tachycardia

Mechanism: nonspecific alpha blocker, predominant effect is vasodilation, hypotensive response blunted by increased CO, competitive (shorter duration)

Treatment: short term treatment of pheochromocytoma, iatrogenic alpha-agonist reversal and for hypertensive crisis (abrupt clonidine withdrawal, tyramine +MAO inhibitor)

Mechanism: alpha1 blockers, decreases BP, preload and afterload; relaxes SM in prostate, urethra and bladder neck, promotes urine flow

Treatment: hypertension and BPH

Mechanism: alpha1 blocker, promotes urine flow

Treatment: BPH

Mechanisms of beta blockers (Propranolol)

CV, BP, Pulmonary, Eye, Metabolism

1. CV: decrease HR and myocardial contractility

Short term: decrease CO, increase PR

Long term: PR normalizes

Net effect: decrease myocardial O2 consumption

 2. Blood Pressure: decreases HT

3. Pulmonary: bronchoconstriction (contraindicated in COPD and asthma)

4. Eye: Decreases aqueous humor production

5. Metabolic: antagonizes glycogenolysis, slows lipolysis (increases VLDL, lowers HDL)

1. Angina

2. Hypertension

3. Supraventricular and ventricular arrhythmias

4. MI

5. Hyperthyroidism

6. Glaucoma

7. Neurological: migraine

8. Heart failure (Carvedilol)

1. Heart failure

2. Bradycardia

3. COPD and asthma

4. Abrupt withdrawal - angina, sudden death

5. Blunt recovery from hypoglycemia

6. Adverse plasma lipoprotein profiles

7. CNS effects (sleep disturbances and depression)

Selectivity: none

ISA (partial agonist activity): no

MSA (local anesthetic properties): yes

Lipid solubility: high

PROTOTYPIC AGENT

Selectivity: beta1

ISA (partial agonist activity): no

MSA (local anesthetic properties):no

Lipid solubility: low

Half-life: 10 minutes (IV)

Selectivity: beta1

ISA (partial agonist activity): yes

MSA (local anesthetic properties): yes

Lipid solubility: low

Selectivity: none

ISA (partial agonist activity): no

MSA (local anesthetic properties): no

Lipid solubility: unknown

Other: Some alpha1 blockage

Selectivity: none

ISA (partial agonist activity): yes

MSA (local anesthetic properties): yes

Lipid solubility: moderate

Selectivity: beta1

ISA (partial agonist activity): no

MSA (local anesthetic properties): no

Lipid solubility: low

Selectivity: none

ISA (partial agonist activity): no

MSA (local anesthetic properties): no

Lipid solubility: moderate