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Gespecialiseerde farmacologie: ANS (autonoom zenuwstelsel)
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clonidine
clonidine
dit is een selectie alpha-2 agonist (adrenoceptor agonist)
(noradrenerge transmissie)
Selectieve stimulatie van α2-receptoren:
--> Stimulatie van de autoregulerende α2-receptoren in de hersenstam met verminderde sympathische impulsen naar
de periferie is de belangrijkste actie.
--> Stimulatie van presynaptische α2-receptoren op perifere postganglionische sympathische zenuwuiteinden met verminderde afgifte van noradrenaline draagt ook bij aan het effect.
EFFECT:
verminderde bloeddruk
INDICATIE:
hypertensie
bèta-3 agonist
bèta-3 agonist
(adrenoceptor agonist) (noradrenerge transmissie)
overactieve blaassymptomen behandelen
Opmerking: niet effectiever dan anticholinergica en verhoogt het risico van bijwerkingen (waaronder cardiovasculair)
phentolamine
phentolamine
dit is een niet-selectieve alpha-antagonist (adrenoceptor antagonist) (noradrenerge transmissie)
EFFECT:
- Uitgesproken VD vanwege blokkade van α1-receptoren op bloedvaten. De daling van de bloeddruk, via baroreceptoren, resulteert in verhoogde sympathische uitstroom naar de periferie.
- De verhoogde afgifte van noradrenaline resulteert, via cardiale β1-receptoren, in tachycardie.
- De auto-inhibitie op het niveau van de perifere sympathische zenuwen wordt geremd via blokkade van de presynaptische α2-receptoren.
INDICATIES :
feochromocytoom:
- In afwachting van een operatie en tijdens een operatie als behandeling voor hypertensieve episoden.
- Diagnostisch: intraveneuze infusie van fentolamine na stopzetting van antihypertensiva resulteert in een duidelijke daling van de bloeddruk
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