are substances that mimic the effects of the catecholamines epinephrine
(noradrenaline), and/or dopamine
. Such drugs are used to treat cardiac arrest
, low blood pressure
, or even delay premature labor
, among other things.
These drugs act at the postganglionic sympathetic terminal, either directly activating postsynaptic receptors, blocking breakdown and reuptake, or stimulating production and release of catecholamines.
Mechanisms of action
The mechanisms of sympathomimetic drugs can be direct-acting, such as α-adrenergic agonists
, β-adrenergic agonists
, dopaminergic agonists
; or indirect-acting, such as MAOIs
, release stimulants, and reuptake inhibitors.
Adrenergic receptor agonists
Direct stimulation of the α- and β-adrenergic receptors
can produce sympathomimetic effects. Albuterol
is a very commonly used direct-acting β2-agonist
. Other examples include phenylephrine
, and dobutamine
Stimulation of the D1 receptor
by dopaminergic agonists such as fenoldopam
is used intravenously to treat hypertensive crisis
Norepinephrine transporter blockade
Classical sympathomimetic drugs are amphetamines
, which act by blocking and reversing norepinephrine transporter
(NET) activity. NET is a transport protein expressed on the surface of some cells that clears noradrenaline and adrenaline from the extracellular space
and into cells
, terminating the signaling effects.
Inhibition of epinephrine and norepinephrine metabolism
Inhibition of norepinephrine or epinephrine metabolism can produce sympathomimetic effects. Both are mainly metabolized by the enzyme monoamine oxidase
, the monoamine oxidase inhibitor
(MAOI) drugs can induce such effects. COMT inhibitors
can also decrease metabolism of norepinephrine and epinephrine.
Substances like cocaine
also affect dopamine
, and some substances like MDMA
Norepinephrine is synthesized by the body into epinephrine, causing central nervous system stimulation. Thus, all sympathomimetic amines fall into the larger group of stimulants (see psychoactive drug chart). Many of these stimulants have therepeutic use and abuse potential, can induce tolerance, and possibly physical dependence.
" and "sympathomimetic" are similar, but not identical. For example, both cause mydriasis
, but parasympatholytics reduce accommodation
) while sympathomimetics do not.