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Antiadrenergic agents

Last updated: November 20, 2018

Summary

Antiadrenergic agents inhibit the activity of the sympathetic nervous system. They act by blocking adrenergic receptors in target organs or by inhibiting the synthesis, storage, or release of endogenous catecholamines (mainly norepinephrine). This class of medications is most commonly used for the treatment of ischemic heart disease and hypertension, although antiadrenergic agents may also be used for urinary retention secondary to benign prostatic hyperplasia and for psychiatric conditions such as anxiety disorders and post-traumatic stress disorder.

Beta blockers are discussed in detail in a separate article.

General mode of action

All antiadrenergic agents reduce sympathetic tone by inhibiting the production, storage, or release of catecholamines (especially norepinephrine).

All drug groups that directly inhibit the sympathetic nervous system (i.e., alpha blockers, beta blockers, and drugs that reduce sympathetic tone) are treatment options for arterial hypertension!
References:[1][1][2][3][4][5][6][7][8]

Alpha blockers

Indication Side effects
Doxazosin
Terazosin
Tamsulosin
Alfuzosin
Silodosin
Prazosin
Phenoxybenzamine

Alpha blockers are usually only second-line drugs for the treatment of hypertension, since they do not improve prognosis!References:[1][9]

Alpha-2 adrenergic agonists

Indication Side effects
Clonidine
Methyldopa
Tizanidine
Guanfacine
Dexmedetomidine
  • Sedation

Sympathetic blockers are usually used in antihypertensive combination regimens!

References:[1][4][10][11][12][13][14]

References

  1. Katzung B,Trevor A. Basic and Clinical Pharmacology. McGraw-Hill Education ; 2014
  2. Stein MB, Roy-Byrne PP, Hermann R. Pharmacotherapy for Posttraumatic Stress Disorder in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/pharmacotherapy-for-posttraumatic-stress-disorder-in-adults.Last updated: February 3, 2017. Accessed: February 23, 2017.
  3. Kannam JP, Aroesty JM, Gersh BJ. Beta blockers in the management of stable ischemic heart disease. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/beta-blockers-in-the-management-of-stable-ischemic-heart-disease.Last updated: September 21, 2016. Accessed: February 23, 2017.
  4. Giovannitti JA, Thoms SM, Crawford JJ. Alpha-2 adrenergic receptor agonists: a review of current clinical applications. Anesth Prog. 2015; 62 (1): p.31-39. doi: 10.2344/0003-3006-62.1.31 . | Open in Read by QxMD
  5. Alpha receptors. http://pharmacologycorner.com/alpha-receptors-1-2/#alpha%202%20receptors. Updated: February 23, 2017. Accessed: February 23, 2017.
  6. Reserpine. https://medlineplus.gov/druginfo/meds/a601107.html. Updated: November 15, 2015. Accessed: November 9, 2017.
  7. Drugs@FDA: FDA Approved Drug Products. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&applno=009838. . Accessed: November 9, 2017.
  8. UpToDate. Reserpine (United States: not available): Drug information. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/reserpine-united-states-not-available-drug-information.Last updated: January 1, 2017. Accessed: November 9, 2017.
  9. Clonidine. https://www.drugs.com/pro/clonidin. Updated: November 1, 2017. Accessed: March 10, 2018.
  10. Methyldopa Side Effects. https://www.drugs.com/sfx/methyldopa-side-effects.html. . Accessed: March 10, 2018.
  11. Tizanidine. https://www.drugs.com/pro/tizanidine.html. Updated: October 1, 2017. Accessed: March 10, 2018.
  12. Guanfacine. https://www.drugs.com/pro/guanfacine.html. Updated: November 1, 2017. Accessed: March 10, 2018.
  13. Dexmedetomidine. https://www.drugs.com/pro/dexmedetomidine-hydrochloride-injection.html. Updated: July 1, 2017. Accessed: March 10, 2018.
  14. Kaplan SA. Side effects of alpha-blocker use: retrograde ejaculation. Rev Urol. 2009; 11 (Suppl 1): p.S14-8.
  15. Herold G. Internal Medicine. Herold G ; 2014
  16. Karow T, Lang-Roth R. Allgemeine und Spezielle Pharmakologie und Toxikologie 2016. Dr. med. Thomas Karow ; 2015