Sympathomimetic Amines – Pharmacological Actions And Therapeutic Uses Of Adrenaline

Sympathomimetic Amines – Pharmacological Actions And Therapeutic Uses Of Adrenaline

What Are Sympathomimetics? Classify Them. Describe Pharmacological Actions, Therapeutic Uses, And Side Effects Of Adrenaline.
Or
Classify Sympathomimetic Amines. Describe The Pharmacological Actions And Therapeutic Uses Of Adrenaline.
Or
Classify Sympathomimetic Drugs. Describe The Therapeutic Uses And Adverse Effects Of Adrenaline.
Or
Classify Sympathomimetics Drugs. Write Uses Of Adrenaline.
Answer:

Sympathomimetics are also known as adrenergic drugs. These are drugs with action similar to that of adrenaline or sympathetic stimulation.

Sympathomimetic Amines: Pharmacological Actions and Mechanisms

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Classification Of Sympathomimetics Or Adrenergic Drugs

1. On The Basis of their Mechanism of Action

• Direct-acting sympathomimetics: They act directly as agonists on α and/or β adrenoreceptors, for Example. are adrenaline, noradrenaline, isoprenaline, phenylephrine, methoxamine, xylometazoline, salbutamol, and many more
• Indirect-acting sympathomimetics: They act on adrenergic neurons to release noradrenaline which then acts on the adrenoreceptors, for Example. tyramine and amphetamine
• Mixed-action sympathomimetics: They act directly as well as indirectly, for Example. ephedrine, amphetamine, mephentermine

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2. On the Basis of their Chemical Structure

• Catecholamines: Sympathomimetics with catechol nuclei are called catecholamines, for Example. adrenaline, noradrenaline,
• Non-catecholamines: Sympathomimetics that lack catechol nuclei are called non-catecholamines, for Example, tyramines, ephedrine, amphetamine, phenylephrine, salbutamol, etc.

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3. Classification of Adrenergic Drugs Based on Their Therapeutic Uses

• Pressor Agents: Noradrenaline, Phenylephrine, Ephedrine, Dopamine, Methoxamine, Mephentermine.
• Cardiac Stimulants: Adrenaline, Dobutamine, Isoprenaline
• Bronchodilators: Isoprenaline, Salbutamol, Salmeterol, Formoterol, Bambuterol
• Nasal Decongestants: Phenylephrine, Naphazoline, Xylometazoline, Oxymetazoline, Pseudoephedrine
• CNS Stimulants: Amphetamine, Methamphetamine, Dexamphetamine
• Anorectics: Fenflramine, Sibutramine, Dexfenflramine
• Uterine relaxants and vasodilators: Ritodrine, Salbutamol, Isoxsuprine, Terbutaline.

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Pharmacological Actions Of Adrenaline

• Heart: Adrenaline is a cardiac stimulant. It increases heart rate, increases myocardial contractility, increases conduction velocity, and increases cardiac output as well as oxygen consumption. It also increases the excitability and can lead to cardiac arrhythmias.
• Blood vessels: It leads to the constriction of blood vessels of the skin and mucous membranes which have α1 receptors. It also leads to the constriction of mesenteric, renal, pulmonary, and splanchnic blood vessels. It dilates blood vessels of skeletal muscles and coronary blood vessels which have β2 effect.
• Blood pressure: Due to its action on α1 receptors in the heart and blood vessels it leads to an initial rise in blood pressure and this is followed by a gradual fall in blood pressure, due to the action on β2 receptors in skeletal muscles which causes vasodilatation.

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• Respiratory system: It leads to the rapid relaxation of bronchial smooth muscle due to its action on β2 receptors and has a short duration of action. It also stops the release of inflammatory mediators from mast cells. Due to its vasoconstrictor effect, it reduces secretion and relieves mucosal congestion due to the vasoconstrictor effect produced by α1 receptors.
• Gastrointestinal: Adrenaline causes gut relaxation, decreases motility, and constricts sphincters.
• Eye: Adrenergic drugs cause contraction of radial muscles of the iris thus causing mydriasis. They decrease the aqueous formation and thus decrease intraocular tension.
• CNS: Adrenaline at its therapeutic doses does not cross the blood-brain barrier and so effects on CNS are very less.
• Metabolism: It causes an increase in blood glucose levels by stimulating liver glycogenolysis; reducing the secretion of insulin and by decrease in uptake of glucose by peripheral tissues.

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Therapeutic Uses Of Adrenaline

• Anaphylactic shock: Adrenaline acts as a life-saving drug in anaphylactic shock and also in Type I hypersensitivity reaction. It should be given as 0.3 to 0.5  ml of 1:1000 solution and is given IM.
• Allergy: It reverses the manifestations of allergic disorders.
• Adrenaline along with the lignocaine due to its vasoconstrictor effect causes late absorption of local anesthetic and prolongs the duration of local anesthesia.
• Bronchial asthma: Adrenaline acts as a powerful bronchodilator in bronchial asthma. It is very useful during acute attacks. It should be given 0.3 to 0.5 ml of 1:1000 solution SC
• Hemostatic: Adrenaline acts as a local hemostatic for the control of bleeding from tooth extraction and also in various other surgical procedures.
• Cardiac arrest: Adrenaline is used in the treatment of cardiac arrest which happens due to drowning or electrocution. Adrenaline is given IV in 1:10000 concentration with other supportive measures.
• Glaucoma: Adrenaline is used in glaucoma as it shows poor penetration when it is applied locally in the eye, so it should be given as a prodrug.

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Side Effects Of Adrenaline

• It leads to tachycardia, palpitation, headache, restlessness, tremor, and a rise in blood pressure.
• It also leads to cerebral hemorrhage and cardiac arrhythmias.
• At high concentrations, it can cause acute pulmonary edema.
• On IV administration it can cause a sudden rise in blood pressure, ventricular tachycardia, anginas, myocardial infarction, and strokes.
• It also leads to hyperglycemia, hyperlactatemia, and hypokalemia.