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  • Compare and Contrast The Pharamcology of Ephedrine and Noradrenaline

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    Noradrenaline and ephedrine are sympathomimetic amines used as vasopressors. Noradrenaline acts directly as an alpha- and beta- agonist at higher doses, is metabolized by COMT and MAO, has a short half-life, and is only given intravenously. Ephedrine has direct and indirect alpha- and beta-agonist effects, is not metabolized by COMT or MAO, has a longer half-life, and can be given intravenously, intramuscularly or orally. Both are used to treat hypotension and shock, but ephedrine's ability to be given non-intravenously and longer duration of action make it preferable

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    compare and contrast the pharamcology of ephedrine and noradrenaline

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    Noradrenaline and ephedrine are sympathomimetic amines used as vasopressors. Noradrenaline acts directly as an alpha- and beta- agonist at higher doses, is metabolized by COMT and MAO, has a short half-life, and is only given intravenously. Ephedrine has direct and indirect alpha- and beta-agonist effects, is not metabolized by COMT or MAO, has a longer half-life, and can be given intravenously, intramuscularly or orally. Both are used to treat hypotension and shock, but ephedrine's ability to be given non-intravenously and longer duration of action make it preferable

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    Compare and Contrast The Pharamcology of Ephedrine and Noradrenaline

    Uploaded by

    DonkeyMan
    Noradrenaline and ephedrine are sympathomimetic amines used as vasopressors. Noradrenaline acts directly as an alpha- and beta- agonist at higher doses, is metabolized by COMT and MAO, has a short half-life, and is only given intravenously. Ephedrine has direct and indirect alpha- and beta-agonist effects, is not metabolized by COMT or MAO, has a longer half-life, and can be given intravenously, intramuscularly or orally. Both are used to treat hypotension and shock, but ephedrine's ability to be given non-intravenously and longer duration of action make it preferable

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    of 1

    Noradrenaline Ephedrine

    Pharmaceutics
     MOA  Direct agonist, at lower  Direct and indirect action,
    doses alpha selectivity, at mainly alpha1, some beta
    higher doses beta activity  Not metabolised by COMT –
     Structure  Metabolised by COMT – OH no C3 OH group
    group on C3  Not metabolised by MAO –
     Metabolised by MAO – no alkyl group on alpha C
    alkyl group on alpha C  Indirect activity – alkyl group
     Less beta effect – no group on alpha C
    on terminal amine  Increased lipid solubility/CNS
    effects – no substitutions on
    benzene ring
     Alkyl substitution on
    terminal amine – beta effect
    Pharmacokinetics  IV only (metabolised in GIT)  IV, IM, PO
     Poorly lipid soluble, does  More lipid soluble, can cross
    not cross BBB BBB
     Metabolised by COMT and  Not metabolised by MAO or
    MAO COMT, 35% hepatic
     97% excreted renally as metabolism, 65% excreted
    VMA, 3% normetanephrine unchanged in urine
     T1/2b 2 mins  T1/2b 5 hrs
     Onset <1 min, duration 5  Onset 1 min, duration 1hr
    mins
    Pharmacodynamics
     CVS  Alpha effects low dose –  Alpha and beta effects,
    vasoconstriction, decrease in increase vasoconstriction,
    HR due to BRR, potential inotropy, HR. Indirect action
    decrease in CO. Beta effects can cause tachyphylaxis if
    at higher dose – increased NAdr stores depleted
    inotropy and HR
     Respiratory  Increased PVR,  Similar
    bronchodilator, respiratory
    stimulant
     CNS  Decreased CBF from  Does cross BBB, thus can get
    vasoconstriction. Mydriasis. agitation, confusion,
    Does not cross BBB increased MAC requirement
     Other  Decreases RBF, splanchnic BF  Similar
    flow, uterine BF. Increases
    BGL, FFA, renin release
     Side effects  Tissue necrosis if  Can be given IM and
    extravasation (thus use CVC), peripherally, HTN crisis if on
    effects prolonged if on MAOi
    MAOis, metabolic acidosis,
    HTN crisis, tachyarrythmia,
    MI
     Uses  Vasopressor in critically  treat hypotension (e.g. with
    ill/vasodilatory shock GA or regional),
    bronchospasm, nasal
    decongestant, narcolepsy

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