VOLATILE AGENTS
SYMPATHOMIMETICS
| |Agent |Noradrenaline |Adrenaline |Dopamine |Isoprenaline |Dobutamine |
| | | | | | | |
| | | | | | | |
| | | | | | | |
| | | | | | | |
| | | | | | | |
|Drug | | | | | | |
| |Class |Endogenous |Endogenous catecholamine |Endogenous catecholamine |Synthetic catecholamine|Synthetic catecholamine|
| | |catecholamine | | | | |
| |Structure | | | | |(Isoprenaline deriv) |
| | | | | | | |
| | | | | | | |
| |Formulation | | | | | |
| | | | | | | |
| |Isomers |Levo=10x dextro |Levo = 10 x dextro | | | |
| |Direct |4+ |4+ |4+ |4+ |3+ |
| | | | | | | |
|Action | | | | | | |
| |α1 (IP3, DAG) |+++ |++ |1-5 |5-10 |>15 |
| | | |(2-10xNA) |D1 |+ |+++ |
| |Dose | |0.5ml/kg 1:1000 neb | |20mcg iv bolus | |
| | | |Cardiac arrest 1mg, | | | |
|Admin | | |kid 10mcg/kg | | | |
| | | |anaphylaxis 1-2mcg/kg | | | |
| |Infusion |0.05-0.3mcg/kg/min |0.01-0.1mcg/kg/min | |1-20mcg/min |0.5-15mcg/kg/min |
| |Onset (min) | | | | |Cpss 10min ivi |
| |Duration (min) | | | | | |
| |Uptake |Uptake 1 |Uptake 2 |Uptake 1 | | |
| | | | | | | |
|P/kin | | | | | | |
| |Lipid solubility (CNS |Low |Low |Low | | |
| |penetration) | | | | | |
| |Oral bioav |Low |Low |Low | |Low |
| |Metabolism |MAO |MAO |MAO |COMT (liver) |COMT |
| | |COMT |COMT |COMT | | |
| |Excretion |Urine 95% VMA |Urine (VMA) |Urine (HVA) |Urine |Urine, |
| | |> +ve |
| | | |↓SVR→↓dia/MAP |excr |GIT→↓SVR→↓BP |chronotrope |
|CVS | | | | | | |
| | |↑VR→↑preload→ reflex |2-10mcg/min → β2, β1 |D rec → ↑GIT Q |+ve inotrope |↑CO→↑UO |
| | |↓HR |↑HR, ↑contr,↑sys | |+ve chronotrope | |
| | |↑PVR |>10mcg/min →β2, β1, α | |↑CO | |
| | |↓renal Q |v/c skin, gut, kidney | | | |
|Resp | |Minimal b/d |Potent b/d |Activate carotid bodies |b/d | |
| | | |Mast cell stabiliser |↓response to hypoxia | | |
|CNS | |Minimal |Minimal |CTZ → nausea |Stimulation |stimulation |
|Other | |↓hepatic Q |↑glucose, lactate, FFA |↓prolactin, aldosterone |↓GIT tone, motility | |
| | |↓splanchnic Q |↓insulin, ↑glucagon |natriuresis (direct |↑glucose | |
| | |↑BSL |↓ K+ |tubular effect) |↑FFA | |
| | |↑contraction gravid |↑BMR 20-30% | | | |
| | |uterus |Uterus | | | |
| | |Contraindicated in |- non gravid relax | | | |
| | |pregnancy |- 1st tri contract | | | |
| | | |- last month relax | | | |
|SEs | |Headache |Anxiety, tremor |Nausea, vomiting |Tachycardia |HT |
| | |Photophobia |Headache |Arrhythmias |Hypotension |Risk RVR in AF |
| | |Chest pain |Palpitations |Headache |Angina |↑AV conduction |
| | |N&v |Arrhythmias |angina |Palpitations | |
| | |Mesenteric infarction |Cerebral haemorrhage | |Flushing | |
| | |Renal failure |APO | |Arrhythmias | |
|Uses | |1) septic shock |1) with LAs |1) ?periop renal |1) bradyarrhythmias |1) CCF |
| | |2) cardiogenic shock |2) anaphylaxis |protection |2) heart block |2) AMI low output |
| | | |3) asthma / croup |2) low CO states | |3) post CPB |
| | | |4) cardiac arrest | | | |
D1 rec – post-synaptic →v/d renal, mesenteric, coronary, cerebral, via ↓cAMP
D2 rec – pre-synaptic →Inhibit release NA, n&v
SYMPATHOMIMETICS
| |Agent |Ephedrine |Metaraminol |Phenylephrine |Clonidine |Dexmedetomidine |
| | | | | | | |
| | | | | | | |
| | | | | | | |
| | | | | | | |
| | | | | | | |
|Drug | | | | | | |
| |Class |Natural non |Synthetic non |Synthetic |Imidazoline | |
| | |catecholamine |catecholamine |non-catecholamine | | |
| |Structure | | | | | |
| | | | | | | |
| | | | | | | |
| |Formulation | | | | | |
| | | | | | | |
| |Isomers | | | | | |
| |Direct |2+ |1+ |4+ | | |
| | | | | | | |
|Action | | | | | | |
| |α1 (IP3, DAG) |+ |++ |++ |1 |1 |
| |α2 (↓cAMP) | | | |39 |1300 |
| |β1 (↑cAMP) |+++ |++ | | | |
| |β2 (↑cAMP) |++ | | | | |
| |Indirect |3+ |3+ | | | |
| |Dose |3-30mg |0.5-5mg |0.1mg | | |
| | | | | | | |
|Admin | | | | | | |
| |Infusion | | | | | |
| |Onset (min) |1min |1-2min iv |1-2min | | |
| | | | ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- guidelines for the management of acute stroke
- postural orthostatic tachycardia syndrome
- lippincott williams wilkins
- volatile agents
- for medical school use only
- attachment product information ephedrine hydrochloride
- blood pressure management in acute stroke
- drug effects on the fetus and breast fed infant
- rajiv gandhi university of health sciences
- albert einstein healthcare network
Related searches
- new york life agents salary
- children s book agents accepting submissions
- publishing agents for new authors
- new york life agents near me
- agents accepting unsolicited manuscripts
- literary agents accepting submissions
- literary agents accepting submissions 2019
- australian literary agents children s books
- christian literary agents children s books
- children s literary agents accepting work
- literary agents children s books submissions
- literary agents accepting new authors