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INTRODUCTION

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This chapter is a combination of Chapter 12 Adrenergic Agonists and Antagonists and Chapter 13 5-Hydroxytryptamine (Serotonin) from Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. An understanding of the material in those chapters will be helpful in following the material presented in this chapter. Further details of the therapeutic use of the drugs mentioned in this chapter can be found in subsequent chapters. In addition to the material presented here the above chapters in the 12th Edition include:

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  • Table 12-1 Chemical Structures and Main Clinical Uses of Important Sympathomimetic Drugs

  • A detailed discussion of the pharmacology of the endogenous catecholamines epinephrine (E), norepinephrine (NE), and dopamine (DA)

  • The pharmacology of miscellaneous sympathomimetic amines, including amphetamine, methamphetamine, methylphenidate, and ephedrine

  • A discussion of the therapeutic uses of sympathomimetic drugs in shock, hypotension, cardiac arrhythmias, nasal decongestion, allergic reactions, narcolepsy, weight reduction, and attention deficit/hyperactivity disorder (ADHD)

  • Details of the physiological functions of serotonin, including the multiple receptor subtypes of 5-HT

  • A discussion of the pharmacology of ergot and the ergot alkaloids, including lysergic acid diethylamide (LSD)

  • The physiological functions of dopamine, including a detailed discussion of dopamine receptor subtypes

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LEARNING OBJECTIVES

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  • Understand the pharmacology of the major adrenergic and serotonergic agonists and antagonists.

  • Know the mechanisms of action of the adrenergic and serotonergic agonists and antagonists.

  • Know the therapeutic uses, adverse effects, toxicities, and contraindications of the adrenergic and serotonergic agonists and antagonists.

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DRUGS INCLUDED IN THIS CHAPTER

  • Acebutolol (SECTRAL, others)

  • Albuterol (VENTOLIN-HFA, PROVENTIL-HFA, others)

  • Alfuzosin (UROXATRAL)

  • Almotriptan (AXERT)

  • Alosetron (LOTRONEX)

  • Apomorphine (APOKYN)

  • Apraclonidine (IOPIDINE)

  • Arformeterol (BROVENA)

  • Aripiprazole (ABILIFY)

  • Atenolol (TENORMIN, others)

  • Betaxolog (BETAOPTIC, others)

  • Betaxolol (LOKREN, KERCONE, others)

  • Bitolterol (TORNALATE)—discontinued in the United States

  • Brimonidine (ALPHAGAN, others)

  • Bromocriptine (PARLODEL)

  • Bucindolol (SANDORMIN)

  • Bunazosin—not available in the United States

  • Buspirone (BUSPAR, others)

  • Cabergoline (DOSTINEX)

  • Carteolol (OCCUPRES, others)

  • Carvedilol (COREG)

  • Celiprolol (SELECTOL)

  • Citralopam (CELEXA)

  • Clonidine (CATAPRES, others; Transdermal, CATAPRES-TTS)

  • Clozapine (FAZACLO)

  • Desvenlafaxine (PRISTIQ)

  • Dexmedetomide (PRECEDEX)

  • Dexmethylphenidate (FOCALIN, FOCALIN XR)

  • Dextroamphetamine (DEXIDRINE, ADDERAL XR, others)

  • Dobutamine (DOBUTREX)

  • Dolasetron (ANZEMET)

  • Dopamine

  • Dopexamine (DOPACARD)—not currently available in the United States

  • Doxazosin (CARDURA, others)

  • Duloxetine (CYMBALTA)

  • Eletriptan (RELPAX)

  • Ephedrine

  • Epinephrine (solution for injection, EPIPEN)

  • Escitralopam (LEXAPRO)

  • Esmolol (BREVIBLOC, others)

  • Fenoldopam (CORLOPAM)

  • Fenoterol (BEROTEC)—withdrawn from market

  • Fluoxetine (PROZAC, others)

  • Fluvoxamine (LUVOX, others)

  • Formoterol (FORADIL, others)

  • Frovatriptan (FROVAL)

  • Granisetron (KYTRIL, others)

  • Guanabenx (WYTENSIN)

  • Guanfacine (TENEX, others; INTUNIV, sustained release)

  • Indoramin—not available in the United States

  • Isocarboxazid (MARPLAN)

  • Isoetharine (BRONKOSOL)—no longer marketed in the United States

  • Isoproterenol (ISUPREL)

  • Ketanserin (SUFREXAL)—not available in the United States

  • Levalbuterol (XOPENEX)

  • Levobetaxolol (BETAXON, others)

  • Levobunolol (BETAGAN, others)

  • Lisdexamfetamine (VYVANASE)

  • Mephentermine—discontinued in the United States

  • Metaproterenol (ALUPENT, orciprenaline in Europe)

  • Metaraminol

  • Methamphetamine (DESOXYN)

  • Methyldopa (ALDOMET, others)

    Methylphenidate (RITALIN, RITALIN SR, CONCERTA, META-DATE, others; DAYTRANA, transdermal)

  • Methylsergide (SANSERT)

  • Metipranolol (OPTIPRANOLOL, others)

  • Metoprolol (LOPRESSOR, others)

  • Midodrine (PROAMATINE, others)

  • Milnacipran (SAVELLA)

  • Modafinil (PROVIGIL)

  • Naphazoline (PRIVINE, NAPHCON, others)

  • Naratriptan (AMERGE)

  • Nebivolol (NEBILET, BYSTOLIC)

  • Norepinephrine (LEVOPHED)

  • Olanzapine (ZYPREXA)

  • Ondansetron (ZOFRAN, others)

  • Oxymetazoline (AFRIN, OCU-CLEAR, others)

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