Sympatholytics

Sympatholytics are drugs that suppress the activity of the sympathetic nervous system. They block adrenergic reactions by direct and indirect action. We divide them into alpha and beta sympatholytics according to which receptors they block.

Directly acting sympatholytics[edit | edit source]

Alpha-sympatholytics[edit | edit source]

We have been using ergot alkaloids for the longest time. Indications are most often peripheral blood circulation disorder, hypertension , pulmonary edema and as a premedication before anesthesia.

Non-selective alpha-sympatholytics[edit | edit source]

They block both alpha-1 and alpha-2 receptors
synthetic alpha-sympatholytics are tolazoline , phentolamine , phenoxybenzamine
ergot alkaloids were formerly used for migraines , dihydroergocristine
synthetic: HCl stimulation, for pheochromocytoma , treatment of urinary retention

Alpha-1-sympatholytic[edit | edit source]

they lower blood pressure
they are used for hypertension and heart failure, urinary tract obstruction, prostate hyperplasia
substances used are prazosin , terazosin , metazosin , urapidil , indoramin , alfuzosin

Alpha-2-sympatholytics[edit | edit source]

the substance used is yohimbine
increases the release of noradrenaline, has vasodilating effects in the pelvic area
used for erectile dysfunction (psychotic shock)

Beta-sympatholytics[edit | edit source]

See the β-blockers page for more detailed information .

The mechanism of action of sympatholytics is in limiting the influence of the sympathetic system on the heart (reduction in strength and frequency, reduction in conductivity, thus reducing oxygen consumption by the myocardium). Furthermore, they also antagonize the adverse effect of the sympathetic system on lipolysis and glycogenolysis .

Indication[edit | edit source]

[[hypertension – they improve the prognosis in the long term due to the regression of left ventricular hypertrophy
arrhythmia
angina pectoris
glaucoma , pheochromocytoma, migraine prevention...

Adverse effects[edit | edit source]

There are changes in plasma lipid levels, bronchoconstriction, allergies, arrhythmias. A so-called rebound phenomenon (rapid increase in blood pressure) may occur upon sudden withdrawal.

Division[edit | edit source]

If the medicine does not have a picture of a pill, the medicine is not currently registered on the Czech market.

Beta-sympatholytics are divided into selective and non-selective. We further divide them according to the presence of internal sympathomimetic activity (VSA).

Non-selective beta-sympatholytics without VSA

We include propranolol, sotalol and metipranol.

Non-selective beta-sympatholytics with VSA

We include pindolol and bopindolol here.

Selective beta-1-sympatholytics

They are very important especially for use in angina pectoris and hypertension. They have fewer side effects. We include substances without VSA ( atenolol , metoprolol , betaxolol , esmolol ) and substances with VSA ( acebutol , celipropol).

Selective beta-2-sympatholytics

These drugs are rather only experimental.

This includes bisoxamine.

Alpha/Beta − combined sympatholytics[edit | edit source]

These include labetalol , carvedilol , delevalol

Indirectly acting sympatholytics[edit | edit source]

We include three groups of substances:

false precursors – alpha-methyldopa
substances leading to the depletion of catecholamines - reserpine
substances that block the release of catecholamines from nerve endings - guanethidine, guanadrel and bretylium

Links[edit | edit source]

External links[edit | edit source]

Sympatholytics (English Wikipedia)

References[edit | edit source]

HYNIA, Sixtus. Pharmacology in a nutshell. 2nd edition. Prague: Triton, 2001. 520 pp. ISBN 80-7254-181-1 .

https://www.sukl.cz/namelove-alkaloidy-omezeni-pouziti ?