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Lecture (3)
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11.
Capillaries:
Adrenaline reduces capillary permeability due to
widening of the endothelial cells that decreases the
pores.
Noradrenaline and Isoprenaline have no effect.
Note: endothelial cells are separated by pores everywhere
inside human body except: BBB, placenta, eyes and prostate
where they have junctions in between.
Note: Increased permeability is due to direct effect of
adrenaline on the cell membrane "not" by Beta effect.
12.
Bronchiolar smooth muscle :
Adrenaline and Isoprenaline cause powerful
bronchiodilation ( effect).
Noradrenaline has no effect. (Because there are no
lpha receptors in the bronchiolar smooth muscles).
13.
Gastrointestinal Tract:
Noradrenaline (lpha action) , Adrenaline (alpha and
beta action) and Isoprenaline (eta action) cause
relaxation .
Important Note: it's the only site where alpha and beta act
on the same direction.
14.
Pregnancy uterus :
Noradrenaline (alpha action ) causes contraction.
Adrenaline and Isoprenaline (beta action) causes
relaxation.
15.
Radial muscles of the iris :
Adrenaline (alpha action) causes contraction of radial
muscles (mydriasis).
Noradrenaline has little effect because it is not
absorbed (causes severe vasoconstriction).
Isoprenaline has no effect.
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16.
Blood glucose: (increased by all)
Adrenaline has significant hyperglycemic effect
because it :
- increases glycogenolysis in the liver (beta effect)
and
- increases the release of glucagon (beta effect) and
- Decreases the insulin (alpha effect on Beta cells of
Pancreas).
Iso. cause increase in blood suger ( effect).
Nor. may increase blood suger.
17.
Lipolysis:
Adrenaline initiates Lipolysis (through its agonist
activity on BETA receptors).
The increased Lipolysis induced by Isoprenaline is not
clinically significant.
Lipolysis is least increased by Noradrenaline.
18.
Serum pottasium k:
Adrenaline & Isoprenaline lead to hypokalemia
because the biochemical pump that shifts k into the
cells is activated by beta agonists.
However Noradreanline may cause hyperkalemia
through alpha effect.
19.
Release of mediators from mast cells :
The release is inhibited by Adrenaline & Isoprenaline
(beta effect)
Noradrenaline has no effect.
20.
Muscle tremor :
Adrenaline & Isoprenaline cause muscle tremor (beta
effect) while it less with Noradrenaline.
Note: Adrenaline constricts skin blood vessels and
dilates skeletal muscle blood vessels.
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3) Glaucoma :
Adrenaline solution may be used topically to reduce
intraocular pressure in open angle glaucoma.
It reduces the production of aqueous humor by
vasoconstriction of the ciliary body blood vessels and
by enhanced outflow of aqueous humor.
In closed angle glaucoma mydriasis (including
Adrenaline)are contraindicated .
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Pharmacokinetics:
Catecholamines have a t of 2 minutes (very short) because
they are rapidly metabolized by MAO & COMT; therefore,
they are given in continuous I.V. infusion.
Dopamine:
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Adverse effects :
1) tachycardia
2) Angina worsening
3) arrhythmia
4) Vomiting (because of the stimulation of chemoreceptors
triggers on in the area of postrima and pituitary gland
outside blood brain barrier )
5) Tissue necrosis (subcutaneous leakage)
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