Page 169 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 9 Adrenoceptor Agonists & Sympathomimetic Drugs 155

PREP AR A TIONS REFERENCES
A V AIL ABLE * Callaway CW: Epinephrine for cardiac arrest. Curr Opin Cardiol 2013;28:36.
Cotecchia S: The α 1 -adrenergic receptors: Diversity of signaling networks and
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GENERIC NAME AVAILABLE AS DeWire SM, Violin JD: Biased ligands for better cardiovascular drugs: Dissecting
Amphetamine, racemic mixture Generic G-protein-coupled receptor pharmacology. Circ Res 2011;109:205.
1:1:1:1 mixtures of amphetamine Adderall Gurevich EV et al: G-protein-coupled receptor kinases: More than just kinases and
sulfate, amphetamine aspartate, not only for GPCRs. Pharmacol Ther 2012;133:40.
dextroamphetamine sulfate, and Hawrylyshyn KA et al: Update on human alpha1-adrenoceptor subtype signaling
dextroamphetamine saccharate and genomic organization. Trends Pharmacol Sci 2004;25:449.
Apraclonidine Iopidine Hollenberg SM: Vasoactive drugs in circulatory shock. Am J Respir Crit Care Med
Armodafinil Nuvigil 2011;183:847.
Brimonidine Alphagan Holmes A, Lachowicz JE, Sibley DR: Phenotypic analysis of dopamine receptor
knockout mice: Recent insights into the functional specificity of dopamine
Dexmedetomidine Precedex receptor subtypes. Neuropharmacology 2004;47:1117.
Dexmethylphenidate Focalin Insel PA: β(2)-Adrenergic receptor polymorphisms and signaling: Do variants
Dextroamphetamine Generic, Dexedrine influence the “memory” of receptor activation? Sci Signal 2011;4:pe37.
Dobutamine Generic, Dobutrex Johnson JA, Liggett SB: Cardiovascular pharmacogenomics of adrenergic receptor
signaling: Clinical implications and future directions. Clin Pharmacol Ther
Dopamine Generic, Intropin 2011;89:366.
Droxidopa Northera Johnson M: Molecular mechanisms of β2-adrenergic receptor function, response,
Ephedrine Generic and regulation. J Allergy Clin Immunol 2006;117:18.
Epinephrine Generic, Adrenalin Chloride, Lefkowitz RJ, Shenoy SK: Transduction of receptor signals by beta-arrestins.
Primatene Mist, Bronkaid Mist, Science 2005;308:512.
EpiPen, Auvi-Q Minzenberg MJ, Carter CS: Modafinil: A review of neurochemical actions and
effects on cognition. Neuropsychopharmacology 2008;33:1477.
Fenoldopam Corlopam Philipp M, Hein L: Adrenergic receptor knockout mice: Distinct functions of
Hydroxyamphetamine Paremyd (includes 0.25% 9 receptor subtypes. Pharmacol Ther 2004;101:65.
tropicamide)
Sandilands AJ, O’Shaughnessy KM: The functional significance of genetic
Isoproterenol Generic, Isuprel variation within the beta-adrenoceptor. Br J Clin Pharmacol 2005;60:235.
Metaraminol Aramine Simons FE: Anaphylaxis. J Allergy Clin Immunol 2008;121:S402.
Methamphetamine Desoxyn Vincent J-L, De Backer D: Circulatory shock. N Engl J Med 2013;369:1726.
Methylphenidate Generic, Ritalin, Ritalin-SR Whalen EJ, Rajagopal S, Lefkowitz RJ: Therapeutic potential of β-arrestin- and
G protein-biased agonists. Trends Mol Med 2011;17:126.
Midodrine ProAmatine
Mirabegron Myrbetriq
Modafinil Provigil
Naphazoline Generic, Privine
Norepinephrine Generic, Levophed
Olodaterol Striverdi respimat
Oxymetazoline Generic, Afrin, Neo-Synephrine
12 Hour, Visine LR
Phenylephrine Generic, Neo-Synephrine
Pseudoephedrine Generic, Sudafed
Tetrahydrozoline Generic, Visine
Tizanidine Zanaflex
Xylometazoline Generic, Otrivin
* α 2 Agonists used in hypertension are listed in Chapter 11. β 2 Agonists used in asthma
are listed in Chapter 20. Norepinephrine transporter inhibitors are listed in Chapter 30.
C ASE STUD Y ANSWER

The clinical picture is that of autonomic failure. The best this patient was given the α blocker tamsulosin. Conversely,
indicator of this is the profound drop in orthostatic blood these patients are hypersensitive to the pressor effects of
pressure without an adequate compensatory increase in α agonists and other sympathomimetics. For example, the
heart rate. Pure autonomic failure is a neurodegenerative α agonist midodrine can increase blood pressure signifi-
disorder selectively affecting peripheral autonomic fibers. cantly at doses that have no effect in normal subjects and
Patients’ blood pressure is critically dependent on whatever can be used to treat their orthostatic hypotension. Caution
residual sympathetic tone they have, hence the symptomatic should be observed in the use of sympathomimetics (includ-
worsening of orthostatic hypotension that occurred when ing over-the-counter agents) and sympatholytic drugs.