Receptor Adrenergic Agonists

The ability of receptors to couple to G-proteins and initiate GTPase activity may also be independent of ligand. Thus, specific mutations in a- and P-adrenergic receptors have led to receptors that mediate agonist-independent activation of adenylyl cyclase (69,70). These mutations presumably mimic the conformational state of the ligand-activated receptor when they are activated conventionally by ligands. 

Ephedrine, which is not a catecholamine, has weak oral activity as a bronchodilator and although it has some direct action at adrenergic receptors, its predominant mode of action is by displacing norepinephrine from storage vesicules. 2"Agonists which are in use or are under investigation are the result of quests for improved selectivity, retention of potency, oral activity, and longer duration of action. 

Aerosol adniinistration of isoproterenol produces a prompt (2—5 minutes) intense bronchodilatation of relatively short (1 h) duration. The lack of P2-selectivity leads, in many cases, to tachycardia and blood pressure elevation. Also, use of isoproterenol, like all other known P-agonists, results in a down-regulation, or desensitization, of P-adrenergic receptors. This desensitization is only partial, and after time (depending on dose, patient, and agent), a stable, less responsive state is achieved in which P-agonists remain effective. Isoproterenol has been widely used for many years. 

Agonists as well as antagonists of (3-adienergic receptors are used for the treatment of a variety of conditions. (3-Adrenergic receptor antagonists belong to the most frequently used classes of dtugs. 

Adrenergic receptor agonists are also used to treat premature labour by causing uterine relaxation. Fenoterol and ritodrine are frequently used. The effectiveness of long-term tocolysis is controversial, since both desensitization of the receptors and the symptomatic nature of this treatment may limit their effects to 1-2 days according to one large study. 

Adrenergic receptor agonists, in particular clen-buterol, have been used for their hypertrophic effects on skeletal and also cardiac muscle. They can increase muscle growth in cattle (illegal in many countries) but have also been used by body-builders and athletes as anabolic dtugs. 

Non-selective (3-adrenergic receptor agonists, particularly adrenaline (qunephrine), are used in cardiovascular... 

Adrenergic receptor 2 Amino acid variants appear to be associated with receptor function and agonist induced down regulation. Some variants may predispose to some types of asthma and modulate action of (3-2-adrenergic drugs. 

Brimonidine tartrate is an alph -adrenergic receptor agonist used to lower IOP in patients with open-angle glaucoma or ocular hypertension. This drug acts to reduce aqueous humor production and increase the outflow of aqueous humor. 

A. Miklavc, D. Kocjan, J. Mavri, J. Roller and D. Hadzi, On the fundamental difference in thermodynamics of agonist and antagonist interactions with P-adrenergic receptors and the mechanism of entropy-driven binding. Biochem. Pharmacol., 40 (1990) 663-669. 

Another mechanism to maintain CO when contractility is low is to increase heart rate. This is achieved through sympathetic nervous system (SNS) activation and the agonist effect of norepinephrine on P-adrenergic receptors in the heart. Sympathetic activation also enhances contractility by increasing cytosolic calcium concentrations. SV is relatively fixed in HF, thus HR becomes the major determinant of CO. Although this mechanism increases CO acutely, the chronotropic and inotropic responses to sympathetic activation increase myocardial oxygen demand, worsen underlying ischemia, contribute to proarrhythmia, and further impair both systolic and diastolic function. 

Corticosteroids are the most potent anti-inflammatory agents available for the treatment of asthma. The efficacy of corticosteroids is due to their ability to affect multiple inflammatory pathways, resulting in the suppression of inflammatory cell activation and function, prevention of microvascular leakage, decreased mucus production, and upregulation of P2-adrenergic receptors.10,18 Clinically, corticosteroids decrease airway inflammation, decrease AHR, decrease mucus production and secretion, and improve the response to P2-agonists.18 Corticosteroids for the treatment of asthma are available in inhaled, oral, and injectable dosage forms. 

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