NON CATECHOLAMINES - Dr.D.RAJESH;M.D . DEPARTMENT Of PHARMACOLOGY
NON CATECHOLAMIN
ES-
Dr.D.RAJESH;M.D.
DEPARTMENT Of PHARMACOLOG
YRIMS ONGOLE
Definition
Classification
Drugs
• Compounds lacking catechol hydroxyl groups are called non catecholamines
• CharacteristicsLonger half lives – long duration of actionIncreased lipid solubility – access to CNSEffective orally
CLASSIFICATION
I. Acc. To MOA:1. Direct acting – Phenylephrine, Methoxamine,
Oxymetazoline, Clonidine, Metaproterenol, Salbutamol, Terbutaline, Salmeterol
2. Indirect acting – Amphetamines, Tyramine
3. Mixed action – Ephedrine, Pseudoephedrine, metaraminol
II. Acc. To therapeutic uses:
1. Vasopressor agents: phenylephrine, methoxamine, ephedrine, mephenteramine
2. Bronchodilators – salbutamol, terbutaline, salmeterol, formeterol, bambuterol
3. Nasal decongestants – phenyephrine, naphazoline, oxymetazoline, xylometazoline, pseudoephedrine, phenylpropanolamine
4. CNS stimulants – amphetamine, methamphetamine, dexamphetamine
5. Anorectics – fenfluramine, dexfenflramine, sibutramine
6. Uterine relaxants – ritodrine, isoxsuprine, salbutamol, terbutaline
III.Receptor action:1. α1 agonists – phenylephrine,
methoxamine, metaraminol, mephenteramine
2. α2 agonists – clonidine, apraclonidine
3. β2 agonists – salbutamol, terbutaline, isoetharine, ritodrine
4. β3 agonists – BRL 37344, AD 9677
PHENYLEPHRINE• Selective α1 agonist
• Vasoconstrictor - SBP, DBP
• Reflex bradycardia
• Uses:– Hypotension, shock– Nasal decongestant– Mydriatic
METHOXAMINE• Selective α1 agonist
• Inc. total peripheral resistance
• Not arrythmogenic
• Uses:– Hypotension– PSVT– Nasal decongestant
METARAMINOL• Selective α1 agonist• More direct action, also release NA• Inc. force of contraction, CO, raise BP• Gradual onset, longer duration• Uses:– Ac. hypotensive states – SA/ Shock–Nasal decongestant– PAT
MEPHENTERAMINE
• Acts both directly and indirectly
• BP, cardiac rate and contraction
MIDODRINE
• Prodrug converted to desglymidodrine
• Vasoconstriction
• Use: postural hypotension
OXYMETAZOLINE• Stimulates both α receptors
• Acts on BV of nasal mucosa & conjunctiva
• Use – Eye drops– Nasal decongestant
• SE – nervousness, HA, burning of nasal mucosa, sneezing
Naphazoline, Xylometazoline
• Local vasoconstriction
• Longer duration of action
• SE: atrophic rhinitis, anosmia–Systemic – CNS depression, rise
BP
AMPHETAMINES• It is phenyl isopropylamine• Indirectly acting sympathomimetic• CNS actions: CNS stimulant– Inc. mental & physical activity, euphoria– Clinical dose – wakefulness, dec. fatigue– Larger doses – tremor, restlessness,
confusion
• CVS: Inc. SBP, DBP
• Smooth muscle: contracts bladder sphincter, relax bronchial muscle
• Appetite: suppress appetite – wt. loss
• Weak analgesic, anticonvulsant, anti emetic
• ADR :palpitations, restlessness, HA, anxiety, psychosis
• Ac. Toxicity:– CNS – restlessness, tremors, irritability– Behavior – delirium, confusion, psychosis,
suicidal/ homicidal tendencies– ANS instability – angina, arrythmias, HTN– GI – anorexia, vomiting, abd. Cramps–Mx – symptomatic,• Diazepam• α blocker phentolamine• Peritoneal dialysis
• Dependence: psychological – euphoria, mental confusion, wt loss
• Withdrawal symptoms– Chr. Fatigue, depression– GI disturbances– Drowsiness– Intense craving
• Uses:– ADHD–Narcolepsy
• Only CNS effects
• Piperidine derivative• Used in ADHD
METHAMPHETAMINE
METHYLPHENIDATE
TYRAMINE• Indirect action
• Normal byproduct of tyrosine metabolism
• Metabolized by MAO
• CHEESE REACTION – inc. BP
• Not used clinically
EPHEDRINE• Alkaloid obtained from Ephedra vulgaris• Acts on both α, β receptors
• CVS: BP, CO. – Repeated adm.- tacyphylaxis
• Smooth muscle: relax
• CNS – stimulation – tremors, insomnia, anxiety
• Eye: mydriasis• Metabolic: inc metabolic rate, O2 consump.• SE: GI upset, insomnia, rarely psychosis• Uses:– Br.asthma–Nasal decongestion–Hypotension– Stokes Adams syndrome–Mydriatic–Narcolepsy–Misc. – myasthenia gravis, allergic
bronchospasm
PSEUDOEPHEDRINE• Stereo isomer of ephedrine• Vasoconstriction sp. Mucosa & skin• Use:–Nasal & sinus congestion– Allergic rhinitis– Blocked eustachian tubes–URTI
β2 STIMULANTS• Longer duration of action• Bronchodil, Vasodil, Uterine relax• Uses:– Br. Asthma–Uterine relaxants
• SE: muscle tremor, tachycardia– Less likely arrythmias
ISOXSUPRINE• Smooth muscle relaxant• Use: – Threatened abortion– Dysmenorrhea– Premature labor– Peripheral disease
• SE: nausea, tachycardia, hypotension
ANORECTIC AGENTS• Cause central release of NA/DA
• Inhibit reuptake of NA & DA
β3 agonists
• Polymorphism in β3 receptor gene is related to risk of obesity
• Targets for anti obesity drugs
• BRL 37344 – No FDA clearance• AD 9677 – Phase III CT