Adrenergic Activators and Inhibitors

Inhaltsangabeof Part II.- Section IV: Effects on Organ Systems Other Than the Nervous and the Cardiovascular System.- 1 Systemic Pharmacology of Adrenergic Activators and Inhibitors: Effects on the Respiratory System.- A. Introduction.- B. Epinephrine: A Unique Example of Direct Activator of Alpha- and Beta-Adrenoceptors.- I. Alpha- and Beta-Receptors in the Respiratory System.- 1. Upper Respiratory Tract.- 2. Lower Respiratory Tract.- 3. Pulmonary Circulation.- 4. Bronchial Circulation.- 5. Ventilation - Perfusion Relationship.- II. Antiasthmatic Use and Airway Resistance.- 1. Classic Physiologic Concept.- 2. Recent Biochemical Concepts.- III. Adverse Effects on the Pulmonary Circulation.- 1. Pulmonary Arterial Hypertension.- 2. Acute Pulmonary Edema.- IV. Tachyphylaxis and Status Asthmaticus.- V. Epinephrine as Neurohumoral Transmitter of the Airways.- C. Direct Activator of Alpha-Receptors.- I. Norepinephrine.- 1. Pulmonary Vasoconstriction and Pulmonary Edema.- 2. Uptake of Norepinephrine in the Pulmonary Circulation.- II. Dopamine.- III. Phenylephrine.- IV. Methoxamine.- V. Nasal Decongestants.- D. Direct Activators of Beta-Receptors.- I. Isoproterenol.- 1. Antiasthmatic Use and Airway Resistance.- 2. Paradoxical Bronchospasm.- 3. Pulmonary Vasodilation and Venous Admixture.- 4. Toxicity of Aerosol Propellants.- II. Protokylol.- III. Ethylnorepinephrine.- E. Bronchoselective Beta-Activators.- I. Isoetharine.- II. Metaproterenol.- III. Terbutaline.- 1. Bronchomotor System.- 2. Pulmonary Circulation.- IV. Salbutamol.- V. Carbuterol.- VI. Pirbuterol.- VII. Bronchoselective Drugs Under Clinical Investigation.- 1. Albuterol.- 2. Hexoprenaline.- 3. Ibuterol.- 4. Rimiterol.- 5. Zimterol.- F. Adrenergic Transmitter Releasing Agents.- I. Ephedrine as an Antiasthmatic Drug.- II. Pseudephedrine and Phenylpropanolamine as Oral-Nasal Decongestants.- III. Mephentermine and Metaraminol as Vasopressor Agents.- IV. Aminorex and Chlorphentermine as Anorexigenics.- G. Adrenergic Alpha-Receptor Blocking Agents.- I. Phenoxybenzamine and Acute Pulmonary Insufficiency.- 1. Correction of Pulmonary Vascular Consequences of Hypoxemia.- 2. Blockade of Pulmonary Vasoconstriction Induced by Catecholamines.- II. Tolazoline and Chronic Pulmonary Hypertension.- III. Phentolamine and Acute Ventricular Failure.- IV. Thymoxamine and Acute Bronchial Asthma.- H. Adrenergic Beta-Receptor Blocking Agents.- I. Nonselective Adrenergic Beta-Receptor Blocking Agents.- 1. Propranolol.- 2. Sotalol.- 3. Pindolol.- 4. Dichloroisoproterenol.- II. Cardioselective Beta-Receptor Blocking Agents.- 1. Practolol.- 2. Acebutolol.- 3. Atenolol.- 4. Bunitrolol.- I. Adrenergic Neuron Blocking Agents.- I. Bretylium.- II. Reserpine.- III. Guanethidine.- IV. Methyldopa.- J. Concluding Remarks.- 1. Nasal Congestion and Decongestion.- 2. Bronchial Mucosal Decongestion.- 3. Bronchodilation.- 4. Bronchoconstriction.- 5. Pulmonary Vasodilation.- 6. Pulmonary Vasoconstriction, Congestion, and Edema.- 7. Bronchial Circulation.- References.- 2 Effects of Adrenergic Activators and Inhibitors on the Skeletal Muscles.- A. Introduction.- B. Direct Action on Contractions of Nonfatigued Muscles.- I. Fast-Contracting Muscles.- II. Slow-Contracting Muscles.- III. Other Sympathomimetic Amines and Adrenoceptor Blocking Drugs.- IV. Adrenoceptors.- V. Electrical and Ionic Changes.- 1. Resting Membrane Potential.- 2. Action Potentials.- VI. Effect of Anaesthetic.- VII. Mechanism of Action.- C. Muscle Spindles.- D. Human Muscles.- I. Evoked Contractions.- II. Tremor.- 1. Unwanted Effect of Sympathomimetic Bronchodilators.- 2. Parkinsonian Tremor.- 3. Some Other Types of Tremor.- III. Therapy of Spasticity.- IV. Therapy of Hyperkalaemic Familial Periodic Paralysis.- E. Effects on Chronically Denervated Muscles.- I. Fibrillation.- II. Membrane Potential.- F. Actions on Neuromuscular Transmission.- I. Endplate Potential and Miniature Endplate Potentials.- II. Mechanisms of Action.- G. Effects on Fatigued Muscles.- H. S