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Autonomic Nervous System

Drugs can be used to:

 

  Alpha 1 Alpha 2 Beta 1 Beta 2
Activator NE, Epi, Dopa NE, Epi, DA Epi, NE, Dopa Epi
Target Tissue Blood Vessels (Smooth Muscle)
Arterioles >>> Veins
SNS - Pre-synaptic Auto-receptor Heart, Kidney Lungs, Uterus, Peripheral Vessels, Liver
Stimulate Action Vasoconstriction Reduce SNS activity Increase HR & Contraction
Release Renin
Bronchodilation
Uterine relaxation
Blockade Action Vasodilation Increase SNS activity Decreased C.O.
Decrease HR
Decrease BP
Decreased renin release
no clinical rationale

 

Agonist

  Alpha 1 Alpha 2 Beta 1 Beta 2
Used For... Nasal Decongestants
Hemostasis
Limit the sympathetic outflow to the heart and blood vessels. Heart Failure
Cardiac Arrest
Shock
AV Blockade
Asthma
Delay Pre-term labor
Drugs Ephedrine
Oxymetazoline (Afrin, Neiosynephrine)
Sudafed
Clonidine
Epinephrine (B1 & B2, A1)
Isoproterenol (B1 & B2)
Dopamine (B1, high doses A1)
Dobutamine (B1)
Non-Selective
Isoproterenol
Epinephrine
Ephedrine

Selective
Albuterol (ventolin)
Metaproterenol (Alupent)
Terbutaline
Serevent

Side Effects CV-HTN, palpitaions, CNS excitation, insomnia, anxiety, rebound congestion   Tachycardia
Dysrhytmia
Angina
NS stimulate B1 receptor
Tachycardia, angina, arrhythmias, Skeletal muscle tremor, hyperglycemia
Contraindications HTN, CAD, MAO nhibitors, PVD     Due to desensitization of receptors regular dose may not work

 

Blocker

  Alpha 1 Alpha 2 Beta 1 Beta 2
Used For... Vasodilation
Benign Prostatic Hyperplasia (BPH)
Raynaud's Disease
  HTN
Angina
Dysrhythmias
MI
Migraine
Drugs Prazosin (Minipres)
Terazosin (Hytrin)
Doxazosin (Cardura)
  all the **olol's 
Side Effects Orthostatic hypotension
Reflex tachycardia
Nasal congestion
inhibition of ejaculation
  Dizziness
Decreased tolerance
Dreams
Masks Diabetes symptoms
Sexual Dysfunction
Depression
Fatugue
Cardio-Depressant
Contraindications     Need to wean because body makes more receptors.

 


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