Clinical Uses of Sympathomimetics
EPINEPHRINE
(1) To treat bronchospasm, eg in acute asthma &
anaphylactic shock.
(2) As primary treatment of anaphylaxis, to relieve
hypersensitivity reactions.
(3) To reduce regional blood flow (via vasoconstriction);
(a) For achieving hemostasis in surgery.
(b) For reducing diffusion of local anesthetics
away form administration site.
(c) For reducing mucous memb. congestion.
(4) To restore cardiac activity in cardiac arrest.
(5) To facilitate aqueous drainage in chronic open- angle glaucoma.
NOREPINEPHRINE
As a pressor agent in hypotension, to preserve cerebral &
coronary blood flow, eg in;
(1) Severe hemorrhage.
(2) Spinal cord injury.
(3) Overdosage of antihypertensives or CNS depres-sants.
(4) During anesthesia.
Isoproterenol
(1) As a cardiac stimulant, eg in cardiogenic shock,
complete heart block, & cardiac arrest.
(2) As a bronchodilator, eg in asthma.
Dopamine
(1) Shock esp. cardiogenic shock.
(2) Chronic refractory congestive heart failure.
Dobutamine
To improve myocardial function in congestive heart failure
& cardiogenic shock.
Fenoldopam
As an antihypertensive agent postoperatively, to treat
hypertensive crisis.
Apraclonidine & Brimonidine
For the lowering of intraocular pressure in patients with
open-angle glaucoma or ocular hypertension.
Phenylephrine
(1) As a pressor agent.
(2) As a local mucous memb. decongestant, eg in nose to
relieve hay fever & common cold.
(3) As an adjunct for local anesthesia (to reduce
regional blood flow).
(4) To treat paroxysmal atrial tachycardia.
(5) As a mydriatic agent to facilitate examination of retina,
& in diagnosis of Horner’s syndrome.
Methoxamine
(1) As a pressor agent.
(2) To treat paroxysmal atrial tachycardia.
Ephedrine
(1) As a nasal decongestant.
(2) To treat bronchial asthma.
(3) As a pressor agent in spinal anesthesia.
(4) As a mydriatic.
(5) To treat stress incontinence.
Amphetamine, Methamphetamine & Methyl- phenidate
(1) To treat narcolepsy.
(2) To treat attention-deficit hyperkinetic syndrome of
children.
Hydroxyamphetamine
(1) As a mydriatic
(2) As a decongestant
(3) As a pressor agent
(4) To diagnose Horner’s syndrome.
Metaraminol
To treat hypotension.
Metaproterenol & Albuterol
To treat bronchospasm, eg in asthma.
Terbutaline & Ritodrine
(1) To treat bronchospasm.
(2) To reduce uterine contractions in premature labor.
Xylometazoline, Oxymetazoline, &
Phenylpropanolamine
As a topical decongestant.
