Etilefrine

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Etilefrine
Etilefrine.svg
Clinical data
Other names(2-ethylamino-1-(3'-hydroxy-phenyl)ethanol
AHFS/Drugs.com International Drug Names
ATC code
Identifiers
  • (RS)-3-[2-(ethylamino)-1-hydroxyethyl]phenol
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.010.829 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C10H15NO2
Molar mass 181.235 g·mol−1
3D model (JSmol)
Chirality Racemic mixture
  • CCNCC(O)c1cc(O)ccc1
  • InChI=1S/C10H15NO2/c1-2-11-7-10(13)8-4-3-5-9(12)6-8/h3-6,10-13H,2,7H2,1H3 Yes check.svgY
  • Key:SQVIAVUSQAWMKL-UHFFFAOYSA-N Yes check.svgY
   (verify)

Etilefrine is a cardiac stimulant used as an antihypotensive. It is a sympathomimetic amine of the 3-hydroxy-phenylethanolamine series used in treating orthostatic hypotension of neurological, cardiovascular, endocrine or metabolic origin. Intravenous infusion of this compound increases cardiac output, stroke volume, venous return and blood pressure in man and experimental animals, suggesting stimulation of both α and β adrenergic receptors. [1] [2] [3] [4] [5] However, in vitro studies indicate that etilefrine has a much higher affinity for β1 (cardiac) than for β2 adrenoreceptors. [6]

Intravenous etilefrine increases the pulse rate, cardiac output, stroke volume, central venous pressure and mean arterial pressure of healthy individuals. Peripheral vascular resistance falls during the infusion of 1–8 mg etilefrine but begins to rise at higher dosage. Marked falls in pulse rate, cardiac output, stroke volume and peripheral bloodflow, accompanied by rises in mean arterial pressure, occur when etilefrine is infused after administration of intravenous propranolol 2,5 mg. These findings indicate that etilefrine has both β1 and α1 adrenergic effects in man.

Related Research Articles

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Adrenergic receptor Class of G protein-coupled receptors

The adrenergic receptors or adrenoceptors are a class of G protein-coupled receptors that are targets of many catecholamines like norepinephrine (noradrenaline) and epinephrine (adrenaline) produced by the body, but also many medications like beta blockers, beta-2 (β2) agonists and alpha-2 (α2) agonists, which are used to treat high blood pressure and asthma, for example.

Isoprenaline Medication for slow heart rate

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Nebivolol Chemical compound

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Amrinone

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Dopexamine Chemical compound

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Adrenergic antagonist

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Alpha blocker Class of pharmacological agents

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Landiolol

Landiolol (INN) is an ultra short-acting, β1-superselective intravenous adrenergic antagonist, which decreases the heart rate effectively with less negative effect on blood pressure or myocardial contractility. In comparison to other beta blockers, landiolol has the shortest elimination half-life, ultra-rapid onset of effect, and predictable effectiveness with inactive metabolites. The pure S-enantiomer structure of landiolol is believed to develop less hypotensive side effects in comparison to other β-blockers. This has a positive impact on the treatment of patients when reduction of heart rate without decrease in arterial blood pressure is desired. Landiolol was developed by modifying the chemical structure of esmolol to produce a compound with a higher rate of cardioselectivity and a greater potency without increasing its duration of action. It is sold as landiolol hydrochloride. Based on its positive benefit risk profile, landiolol has been granted the marketing authorization and introduced to the European markets under the brand names Rapibloc, Raploc, Runrapiq, Landibloc mid 2016. Landiolol is available in Japan under the brand names Onoact (50 mg) and Corbeta.

History of catecholamine research

The catecholamines comprise the endogenous substances dopamine, noradrenaline (norepinephrine), and adrenaline (epinephrine) as well as numerous artificially synthesized compounds such as isoprenaline. Their investigation comprises a major chapter in the history of physiology, biochemistry, and pharmacology. Adrenaline was the first hormone extracted from an endocrine gland and obtained in pure form, before the word hormone was coined. It was also the first hormone whose structure and biosynthesis were clarified. Apart from acetylcholine, adrenaline and noradrenaline were the first neurotransmitters to be discovered and the first intercellular biochemical signals to be found in intracellular vesicles. The β-adrenoceptor was the first G protein-coupled receptor, the gene of which was cloned. Goal-directed catecholamine research began with the preparation by George Oliver and Edward Albert Sharpey-Schafer of a pharmacologically active extract from the adrenal glands.

Norepinephrine (medication) Therapeutic use of norepinephrine

Norepinephrine, also known as noradrenaline, is a medication used to treat people with very low blood pressure. It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids. It is the same molecule as the hormone and neurotransmitter norepinephrine. It is given by slow injection into a vein.

Dopamine (medication)

Dopamine, sold under the brandname Intropin among others, is a medication most commonly used in the treatment of very low blood pressure, a slow heart rate that is causing symptoms, and, if epinephrine is not available, cardiac arrest. In newborn babies it continues to be the preferred treatment for very low blood pressure. In children epinephrine or norepinephrine is generally preferred while in adults norepinephrine is generally preferred for very low blood pressure. It is given intravenously or intraosseously as a continuous infusion. Effects typically begin within five minutes. Doses are then increased to effect.

Epinephrine (medication) Hormone used as a medicine

Epinephrine, also known as adrenaline, is a medication and hormone. As a medication, it is used to treat a number of conditions, including anaphylaxis, cardiac arrest, asthma, and superficial bleeding. Inhaled epinephrine may be used to improve the symptoms of croup. It may also be used for asthma when other treatments are not effective. It is given intravenously, by injection into a muscle, by inhalation, or by injection just under the skin.

Angiotensin II (medication) Treatment for low blood pressure

Angiotensin II is a medication that is used to treat hypotension resulting from septic shock or other distributive shock. It is a synthetic vasoconstrictor peptide that is identical to human hormone angiotensin II and is marketed under the brand name Giapreza. The Food and Drug Administration approved the use of angiotensin II in December 2017 to treat low blood pressure resulting from septic shock.

References

  1. Nusser E, Donath H, Russ W (August 1965). "[On the circulatory action of depot-Effortil in patients with hypotonic regulation circulator disorders]". Die Medizinische Welt (in German). 32: 1824–7. PMID   5320529.
  2. Mellander S (1966). "Comparative effects of acetylcholine, butyl-nor-synephrine (Vasculat), noradrenaline, and ethyl-adrainol (Effonti) on resistance, capacitance, and precapillary sphincter vessels and capillary filtration in cat skeletal muscle". Angiologica. 3 (2): 77–99. doi:10.1159/000157650. PMID   4380206.
  3. von Limbourg P, Just H, Lang KF (1973). "Positive inotrope Wirkung von Etilefrinhydrochlorid (EffortilR)". Kardiol. 586: 1.
  4. Tarnow J, Brückner JB, Eberlein HG, Patschke D, Reinecke A, Schmicke P (1973). "Experimentelle Untersuchungen zur Beeinflussung der Hämodynamik in tiefer Halothannarkose durch Dopamin, Glucagon, Effortil, Noradrenalin und Dextran". Anaesthesist. 22: 8–15.
  5. Carrera AL, Aguilera AM (1973). "Algunos effectos circulatorios de la m− oxifenil etanol etilmaina y sus modificaciones por el bloqueo α y β adrenergico". Arch. Inst. Cardiol. Mexico. 43: 279–287.
  6. Offermeier J, Dreyer AC (March 1971). "A comparison of the effects of noradrenaline, adrenaline and some phenylephrine derivatives on alpha-, beta- and beta- adrenergic receptors". South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde. 45 (10): 265–7. PMID   4396765.