Sympathomimetics topical

Phenylephrine hydrochloride LD50 in mice, 1000 mg/kg. Medical use Sympathomimetic. Topically as a vascoconstrictor, mydriatic, and nasal decongestant. 

Closed-angle glaucoma Topical anticholinergics Topical sympathomimetics Systemic anticholinergics Heterocyclic antidepressants Low-potency phenothiazines Antihistamines Ipratropium... 

Topical and systemic decongestants are sympathomimetic agents that act on adrenergic receptors in the nasal mucosa to produce vasoconstriction, shrink swollen mucosa, and improve ventilation. Decongestants work well in combination with antihistamines when nasal congestion is part of the clinical picture. 

Phenylephrine is a nasal decongestant that mimics the sympathetic system, thereby increasing the heart rate and blood pressure. It may aggravate conditions such as diabetes, hypertension and glaucoma. Patients with hypertension, ischaemic heart disease, hyperthyroidism, diabetes and glaucoma are therefore given topical nasal sympathomimetics rather than systemic sympathomimetics. Both topical and systemic sympathomimetics are contraindicated in patients taking monoamine oxidase inhibitors, because concurrent administration of the two products may lead to a hypertensive crisis. 

Pharmacology Epinephrine, a direct-acting sympathomimetic agent, acts on and receptors. Topical application, therefore, causes conjunctival decongestion (vasoconstriction), transient mydriasis (pupillary dilation), and reduction in intraocular pressure (lOP). It is believed lOP reduction primarily is caused by reduced aqueous production and increased aqueous outflow. The duration of decrease in lOP is 12 to 24 hours. 

The iris, because it is easily visible and responsive to topical sympathomimetics, is a convenient assay tissue in the patient. 

Cocaine Same as above also has sympathomimetic effects Same as above Procedures requiring high surface activity and vasoconstriction Topical or parenteral duration 1-2 h Toxicity CNS excitation, convulsions, cardiac arrhythmias, hypertension, stroke... 

Stevia Stevia rebaudiana) Uses Natural sweetener, hypoglycemic and hypotensive properties Actions Multiple chemical components sweetness d/t glycoside, stevioside hypotensive effect may be d/t diuretic action or vasodilation action Available forms Liq extract, powder, caps Notes/SE HA, dizziness, bloating Interactions T Hypotensive effects W/ antihypertensives esp CCB, diuretics EMS Monitor BP does not encourage dental caries may -1-glucose St. John s Wort (Hypericum perforatum) Uses Mild-mod depression, anxiety, anti-inflammatory, immune stimulant/anti-HIV/antiviral, gastritis, insomnia, vitiligo Action MAOI in vitro, not in vivo bacteriostatic bactericidal, T capillary blood flow, uterotonic activity in animals Efficacy Variable benefit w/ mild-mod depression in several trials, but not always seen in clinical practice Available forms Teas, tabs, caps, tine, oil ext for topical use Dose 2-4 g of herb or 0.2-1 mg of total hypericin (standardized extract) daily Notes/SE Photosensitivity (use sunscreen) rash, dizziness, dry mouth, GI distress Interactions Enhance MAOI activity, EtOH, narcotics, sympathomimetics EMS T Risk of photosensitivity Rxns t effects of opioids and sympathomimetics... 

Topical beta-blockers can precipitate asthma and therefore must not be used to treat this patient s glaucoma. Topical prostaglandin analogues (e.g. latanoprost drops) are used as first-line treatment of glaucoma together with a sympathomimetic agent, brimonidine, as an alternative to beta-blockers in asthmatic and COPD patients. 

ACE INHIBITORS, ADRENERGIC NEURONE BLOCKERS SYMPATHOMIMETICS i hypotensive effect. Note there is a risk of interactions even with topical sympathomimetics (eye and nose drops) Adrenergic neurone blockers act mainly by preventing the release of norepinephrine. Sympathomimetics stimulate adrenergic receptors, which causes a rise in BP Monitor BP at least weekly until stable... 

Carteolol is a noncardioselective P-blocker similar to timolol, levobunolol, and metiptanoloLAs with levobunolol and metipranolol, a primary metaboUte of carteolol, 8-hydroxycarteolol, is also an ocular P-blocker. In contrast to other topical P-adrenoceptor antagonists, carteolol possesses intrinsic sympathomimetic ISA.The mechanism of carteolol s ocular hypotensive effect is a reduction in aqueous humor production, without any apparent effect on outflow. 

Diggory P, Cassels-Brown A, Vail A, Abbey LM, Hillman JS. Avoiding unsuspected respiratory side-effects of topical timolol with cardioselective or sympathomimetic agents. Lancet 1995 345(8965) 1604-6. 

Phenylephrine is a sympathomimetic aj adrenoceptor agonist capable of producing mydriasis in some species by iris dilator muscle contraction. In the horse, topical application of a 10% solution has been shown to have no effect on the pupil diameter in the normal eye. However, 10% phenylephrine in combination with topical atropine is reported to be useful in reversing pupillary spasm in some stubborn cases of anterior uveitis, although there is no pharmacological evidence to support any additive mydriatic effect when the two agents are used together. 

CO-beneldopa benserazide levodopa. cocaine (ban, usan] (cocaine hydrochloride (jan, usan)) is an ester of benzoic acid and methylecgonine and the principal alkaloid of Erythroxylum coca and other Erythroxylum spp. (Erythroxylaceae). It is a LOCAL ANAESTHETIC (used topically because of toxicity), and has pronounced indirect-acting SYMPATHOMIMETIC actions by virtue of being an UPTAKE INHIBITOR (interferes with Uj active uptake of noradrenaline into noradrenergic nerve terminals). It is a VASOCONSTRICTOR and can be used as a topical mydriatic and ocular diagnostic agent. It is a powerful CNS stimulant (similar in action to amphetamine), with considerable abuse potential, cocaine hydrochloride cocaine. 

NIH 7343) is one of the phenylpiperidine series, an OPIOID RECEPTOR AGONIST, with OPIOID ANALGESIC activity, dipivefrine [ban, inn] (diplvefrin hydrochloride [usan] Propine and many other names) is a sympathomimetic that chemically is a prodrug which is converted within the eye into adrenaline. It can be used therapeutically in topical... 

Inapsine droperidol. indanazoline [inn] is an imidazoline related to naphazoline. It is a sympathomimetic with vasoconstrictor properties, formerly used as a topical nasal decongestant. indapamide [ban.inn.jan, usan) (LozoI Natrilix etc.) is a (thiazide-related) DIURETIC, which can be used in antihypertensive therapy. 

---