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ÀÚÀ²½Å°æ: 6 catecholamine

ÀÛ¼ºÀÚ ´ÚÅÍÄÚ¸®¾Æ Á¶È¸¼ö 1905

 
catecholamine

direct-acting sympathomimetic amines·Î catechol¿¡ amine±â°¡ ºÙÀº È­ÇÕ¹°ÀÇ ÃÑĪÀÌ´Ù.

 


(1) epinephrine(adrenaline)

Ձ-¿Í,β-receptor¿¡ ¸ðµÎ ÀÛ¿ëÇϸç ü³»ÀÇ È¿°ú´Â ³óµµ¿Í receptorÀÇ ÇüÅ¿¡ µû¶ó ´Ù¸£´Ù.

Áï Àú³óµµ¿¡¼­´Â β-receptorÀÇ È¿°ú°¡ ¿ì¼¼, °í³óµµ¿¡¼­´Â Ձ-receptorÀÇ È¿°ú°¡ ¿ì¼¼ÇÏ´Ù.


a. blood pressure

* ´Ù·® I.V.½Ã Ç÷¾Ð »ó½Â *

Ձ-receptor¸¦ ÀÚ±Ø vasoconstriction

β-receptor¸¦ activationÇÏ¿© ventricular constriction

* Àú³óµµ¿¡¼­´Â Ç÷¾Ð°­ÇÏ *

À̶§´Â β2-receptor(vasodilation)°¡ Ձ-receptor(vasoconstriction) º¸´Ù ¹Î°¨ÇÏ°Ô ¹ÝÀÀÇÑ´Ù.


b. smooth muscle¿¡ÀÇ È¿°ú 

epinephrineÀº gastrointestinal smooth muscle(Ձ2¿Í β-receptor stimulation)À» Áõ°¡½ÃŲ´Ù.

bronchiolar smooth muscle(β2)¸¦ ÀÌ¿Ï, Áï ±â°üÁöõ½Ä(bronchospasm)¿¡ ÁÁ´Ù.


c. heart¿¡ÀÇ È¿°ú

β1-receptorÀÇ Á÷Á¢È¿°ú·Î heart rate¸¦ Áõ°¡½ÃŲ´Ù.

cardiac output°¡ Áõ°¡


d. mydriasis : Ձ-receptorÀÇ ÈïºÐÀÛ¿ë¿¡ ÀÇÇÑ´Ù.


e. local vasoconstriction(hemostatic) :


1: 100,000 - 1: 200,000 in local anesthetic solution -> delays the absorption of infilterable

anesthetics


f. anaphylactic shock½Ã¿¡ ³ªÅ¸³ª´Â bronchiolar smooth muscleÀÇ histamine like constrictionÀÇ

antagonist·Î ÀÛ¿ëÇϸç smooth muscleÀÇ relaxationÀ¸·Î bronchiolar passage way°¡ È®ÀåµÈ´Ù.


(2) norepinephrine

epinephrine°ú À¯»çÇÑ ÀÛ¿ëÀ» ÇÑ´Ù.

a. I.V.½Ã Ձ-receptor¿¡ ÀÛ¿ëÇÏ¿© vascular smooth muscleÀÇ contriction¿¡ ÀÇÇÑ systolic ¹×

diastolic pressure¸¦ Áõ°¡½ÃŲ´Ù.

b. Ձ-receptor¿¡ °­ÇÑ ÀÛ¿ëÀ» ³ªÅ¸³»¸ç Ղ-receptorÀÇ ÀÛ¿ëÀº ´Ù¼Ò ¾àÇÏ´Ù.

Áï norepinephrine > epinephrine > isoproterenol

c. À§Àå¿îµ¿Àº ¾ïÁ¦ÇÑ´Ù.

d. mydriasis



* epinephrine°ú norepinephrineÀÇ Ä¡·áÇÐÀû ÀÀ¿ë

a. epinephrine

bronchospasmÀÇ Ä¡·á¿¡ »ç¿ëÇÑ´Ù.

anaphylactic shockÀÇ primary treatment 

to prolong the duration of infiltrative anesthesia


b. norepinephrine → ¸¶Ãë½Ã hypotensionÀÇ Ä¡·á


(3) isoproterenol - chemically synthesized


a. pharmacologic effect

¼±ÅÃÀûÀÎ β-agonist·Î¼­ Ձ-receptorÀÇ È¿°ú´Â ÀÛ´Ù.

b. bronchial¹× gastrointestinal smooth muscleÀÇ relaxation.-- ±×·¡¼­

bronchial asthma¿¡ bronchodilator·Î »ç¿ëÇÑ´Ù.

c. cardiac stimulant·Î¼­ coronary artery¸¦ È®ÀåÇÑ´Ù.(Iso > Epi > Nor)



(4) dopamine

a. norepinephrineÀÇ ÇÕ¼ºÀ» À§ÇÑ Á÷Á¢ÀûÀÎ intermediator(Àü±¸¹°Áú)ÀÌ´Ù.

b. β-receptor¿¡ ´ëÇÑ Á÷Á¢ÀûÀÎ agonist·Î¼­ ¼±ÅÃÀû cardiovascular agent·Î¼­ myocardial

stimulationÀ» ÇÑ´Ù.


(5) dobutamine(synthetic catecholamine)

a. β1(cardiac)-receptorÀÇ È°¼ºÈ­¸¦ ÅëÇÑ ½ÉÀåÀÇ (+)inotropic response(cardiac outputÀÇ Áõ°¡)°¡

ÀÖ´Ù. -- Dopa, Epi, NE, Isop.Àº tachyarrythmogenic potential µû¶ó¼­ dobutamineÀº inotropicÀÇ

¼±ÅüºÀ» Áö´Ñ´Ù.

b. °³ÀÇ °æ¿ì pentobarbitalÀÇ ¸¶Ãë½Ã myocardial functionÀ» ÁÁ°Ô ÇϱâÀ§ÇØ »ç¿ëÇÑ´Ù.

c. Ÿ ¾à¹°Àº myocardial oxygen demand¸¦ Áõ°¡½ÃŰ³ª dobutamineÀº ÃÖ¼ÒÈ­ÇϹǷΠÀåÁ¡ÀÌ

ÀÖ´Ù.--> ±×·¡¼­ ¿ïÇ÷¼º ½ÉºÎÀüÁõ¿¡ »ç¿ëÇÑ´Ù.

"°á·ÐÀ¸·Î cardiac outputÀº Áõ°¡, total peripheral resistance´Â °¨¼ÒÇÑ´Ù"