Sympathomimetic drug
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EpinephrineNorepinephrineDopamineChemical structures of catecholamines.Sympathomimetic drugs are substances that mimic the effects of the catecholamines, epinephrine (adrenaline), norepinephrine (noradrenaline), and/or dopamine. Such drugs are used to treat cardiac arrest, low blood pressure, or even delay premature labor, among other things.
These drugs act at the postganglionic sympathetic terminal,[1] either directly activating postsynaptic receptors, blocking breakdown and reuptake, or stimulating production and release of catecholamines.
Contents [hide]
1 Mechanisms of action
1.1 Direct-acting
1.1.1 Adrenergic receptor agonists
1.1.2 Dopaminergic agonists
1.2 Indirect-acting
1.2.1 Norepinephrine transporter blockade
1.2.2 Inhibition of epinephrine and norepinephrine metabolism
2 Cross-reactivity
3 Comparison
4 See also
5 References
6 External links
[edit] Mechanisms of action
The mechanisms of sympathomimetic drugs can be direct-acting, such as α-adrenergic agonists, β-adrenergic agonists, dopaminergic agonists; or indirect-acting, such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors.
[edit] Direct-acting
[edit] Adrenergic receptor agonists
Main article: Adrenergic agonist
Direct stimulation of the α- and β-adrenergic receptors can produce sympathomimetic effects. Albuterol is a very commonly used direct-acting β2-agonist. Other examples include phenylephrine, isoproterenol, and dobutamine.
[edit] Dopaminergic agonists
Stimulation of the D1 receptor by dopaminergic agonists such as fenoldopam is used intravenously to treat hypertensive crisis.
[edit] Indirect-acting
[edit] Norepinephrine transporter blockade
Classical sympathomimetic drugs are amphetamines (including MDMA), ephedrine and cocaine, which act by blocking and reversing norepinephrine transporter (NET) activity. NET is a transport protein expressed on the surface of some cells that clears noradrenaline and adrenaline from the extracellular space and into cells, terminating the signaling effects.
[edit] Inhibition of epinephrine and norepinephrine metabolism
Inhibition of norepinephrine or epinephrine metabolism can produce sympathomimetic effects. Both are mainly metabolized by the enzyme monoamine oxidase, the monoamine oxidase inhibitor (MAOI) drugs can induce such effects. COMT inhibitors can also decrease metabolism of norepinephrine and epinephrine.
[edit] Cross-reactivity
Substances like cocaine also affect dopamine, and some substances like MDMA affect serotonin.
Norepinephrine is synthesized by the body into epinephrine, causing central nervous system stimulation. Thus, all sympathomimetic amines fall into the larger group of stimulants (see psychoactive drug chart). Many of these stimulants have therepeutic use and abuse potential, can induce tolerance, and possibly physical dependence.
[edit] Comparison
"Parasympatholytic" and "sympathomimetic" are similar, but not identical. For example, both cause mydriasis, but parasympatholytics reduce accommodation (cycloplegia) while sympathomimetics do not.
[edit] See also
Sympathetic nervous system
[edit] References
^ "Dorlands Medical Dictionary:sympathomimetic". http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/eight/000103504.htm  .
[edit] External links
MeSH Amines,+Sympathomimetic
Sympathomimetic+amine at eMedicine Dictionary
Sympathomimetic at eMedicine Dictionary
[show]v d eReceptor agonists, antagonists, and reuptake inhibitors
BA/M 5-HT (serotonin) receptor Serotonin receptor agonist (5-HT4) Serotonin antagonist (5-HT3) Serotonin uptake inhibitor (SSRI)
Dopamine receptor Dopamine agonist Dopamine antagonist Dopamine reuptake inhibitor
Adrenergic receptor Adrenergic agonist (Alpha, Beta 1/2) Adrenergic antagonist (Alpha 1/2, Beta) Adrenergic uptake inhibitor
Histamine receptor Histamine agonist Histamine antagonist (H1, H2, H3)
AA GABA receptor GABA agonist GABA antagonist
Glutamate receptor NMDA receptor (NMDA receptor antagonist) AMPA receptor (Ampakine) Excitatory amino acid agonist Excitatory amino acid antagonist
ANS Acetylcholine receptor Cholinergic (Muscarinic, Nicotinic) Anticholinergic (Muscarinic, Nicotinic/Ganglionic blocker/Neuromuscular-blocking drugs) Acetylcholinesterase inhibitor
Adrenergic receptor (SANS onlysee above for details)
PANS Parasympathomimetic (Cholinergic, Acetylcholinesterase inhibitor) Parasympatholytic (Anticholinergic, Ganglionic blocker)
SANS Sympathomimetic (Adrenergic agonist, Monoamine oxidase inhibitor) Sympatholytic (Adrenergic antagonist, Alpha blocker, Ganglionic blocker)
Other RAs Endothelin Angiotensin II NK1 Cannabinoid Vasopressin
[show]v d eSympathomimetic amines (R01, A08 and others)
α-PPP Aminorex d-Amphetamine l,d-Amphetamine d-Methamphetamine l-Methamphetamine BZP Cathinone CFT Chlorphentermine Clobenzorex Cocaine Cocaethylene Cyclopentamine 2-DPMP Diethylpropion Ephedrine (EPH) 4-FMP 4-MTA Fencamfamine Fenfluramine Fenproporex Mazindol MDPV 4-MAR Methylone (bk-MDMA) Methylphenidate (MPH) Ethylphenidate Naphazoline Pemoline Phendimetrazine Phenmetrazine Phentermine Phenylephrine Pipradrol Pseudoephedrine Pyrovalerone Sibutramine Synephrine
See also amphetamines
[show]v d ePsychoanaleptics: psychostimulants, agents used for ADHD and nootropics (N06B)
Centrally acting sympathomimetics Amphetamine Amphetaminil Atomoxetine Dextroamphetamine Dextromethamphetamine Fencamfamine Fenozolone Fenethylline Methylphenidate Mesocarb Pemoline Pipradrol Prolintane
Xanthine derivatives Caffeine Propentofylline
Glutamate receptor Racetams Aniracetam Nefiracetam Oxiracetam Phenylpiracetam Piracetam Pramiracetam
Ampakines CX-516 CX-546 CX-614 CX-691 CX-717 IDRA-21 LY-404,187 LY-503,430 PEPA
Eugeroics / Benzhydryl compounds Adrafinil Armodafinil Modafinil
Histamine H3 receptor antagonists A-349,821 ABT-239 Ciproxifan GSK-189,254
GABAA α5 inverse agonists α5IA L-655,708 PWZ-029 Suritozole
Other psychostimulants and nootropics Acetylcarnitine Adafenoxate Bifemelane Carbenoxolone Citicoline Cyprodenate Ensaculin Idebenone Ispronicline Deanol Dimebon Fipexide Leteprinim Linopirdine Meclofenoxate Nizofenone Pirisudanol Pyritinol Sulbutiamine Taltirelin Tricyanoaminopropene Vinpocetine
[show]v d eDecongestants and other nasal preparations (R01)
Topical Sympathomimetics, plain Cyclopentamine Ephedrine Phenylephrine Oxymetazoline Tetryzoline Xylometazoline Naphazoline Tramazoline Metizoline Tuaminoheptane Fenoxazoline Tymazoline Epinephrine
Antiallergic agents,
excluding corticosteroids Spaglumic acid
histamine antagonists (Levocabastine, Antazoline, Thonzylamine)
mast cell stabilizer (some are also antihistamines) (Cromoglicic acid, Nedocromil, Azelastine, Olopatadine)
Corticosteroids Beclometasone Prednisolone Dexamethasone Flunisolide Budesonide Betamethasone Tixocortol Fluticasone Mometasone furoate Triamcinolone Ciclesonide
Other nasal preparations Calcium hexamine thiocyanate Retinol Ipratropium bromide Ritiometan Mupirocin Hexamidine Framycetin Hyaluronic acid
Systemic use:
Sympathomimetics Phenylpropanolamine Pseudoephedrine Phenylephrine Phenylpropylamine
[show]v d eOphthalmologicals: antiglaucoma preparations and miotics (S01E)
Sympathomimetics Apraclonidine Brimonidine Clonidine Dipivefrine Epinephrine
Parasympathomimetics muscarinic Aceclidine Pilocarpine
muscarinic/nicotinic Acetylcholine Carbachol
Acetylcholinesterase inhibitors Demecarium Ecothiopate Stigmine (Fluostigmine, Neostigmine, Physostigmine) Paraoxon
Carbonic anhydrase inhibitors/
(sulfonamides) Acetazolamide Brinzolamide Diclofenamide Dorzolamide Methazolamide
Beta blocking agents Befunolol Betaxolol Carteolol Levobunolol Metipranolol Timolol
Prostaglandin analogues (F2α) Bimatoprost Latanoprost Tafluprost Travoprost Unoprostone
Other agents Dapiprazole Guanethidine
[show]v d eOphthalmologicals: mydriatics and cycloplegics (S01F)
Anticholinergics/antimuscarinics Atropine - Scopolamine - Methylscopolamine - Cyclopentolate - Homatropine - Tropicamide
Sympathomimetics Phenylephrine - Ephedrine - Ibopamine
Retrieved from "http://en.wikipedia.org/wiki/Sympathomimetic_drug" ;
Categories: Sympathomimetics
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