action of alpha 1
-blood vessel constriction
action of alpha 2
- surface of presynaptic neurons
- inhibition of catecholamine release
action of beta 1
-increase heart rate and force
action of beta 2
-bronchodilation and adds to the pathogenicity of migraines
beta 1 blockade
- reduced heart rate and contractility
- reduction on the work load of the heart is desireable for people that have suffered MI’s/heart failure
propanolol
-problems
- nonselective beta blocker
- can block beta 2, leading to bronchoconstriction and problems in people with pulmonary disorders
atenolol and metoprolol
-selective beta1 blockers
anxiolytic effects of beta blockers
- off label
- manages social phobias without impairing cognitive ability
- nonselective beta blockers seem to work the best
- improves somatic symptoms of anxiousness
class of autonomic nervous system effecting meds used for hypertension
-sympatholytics
serotonin metabolite, how can it be used?
- 5-HIAA
- can be used in a 24 hour collection of urine to diagnose carcinoid tumor
aberrant serotonin levels are involved in
- depression
- flushing of the face
- migraine headaches
- sleep
medications that boost serotonin have been developed to treat
- sleep
- depression
- migraines
sumatripan
- imitrex
- agonist of certain serotonin receptors
- results in vasoconstriction used to acutely treat migraine headaches
- should not be used prophylacticly as it can precipitate migraines
ergot alkaloids
- mimics serotonin
- causes peripheral vasoconstriction and some CNS stimulant activity
- can lead to convulsive erotism and hallucinations
- used for acute treatmetn of migraines
- ovoided in patients with ischemic heart disease
ondansteron (zofran)
- antagonist of certain serotonin receptors
- blockade of this receptor type is associated with reduction of nausea and vomiting
- used on patients undergoing chemotherapy
- constipation is a fairly common side effect
melatonin
- derivative of serotonin which helps maintain a sleep wake cycle
- over the counter
ramelteon
-more potent melatonin-like agent that is only available by prescription
phases of migraines
- 1: not enough blood flow to the brain due to vasoconstriction which is brought on by a spike in serotonin
- 2: compensatory vasodilation (rebound effect), characterized by throbbing pain which eventually subsides to a dull tension-like headache
removal of neurotransmitter effecting drugs
-must do so gradually or else you may precipitate the condition in which you were attempting to treat
