SY - Medichem I - Adrenergic Blockers

Antiadrenergics/ sympatholytics
An adrenergic antagonist is a drug that inhibits

the function of adrenergic receptors.
 Prevent the response of effector organs to

endogenous as well as exogenous adrenaline and
noradrenaline.
 Competitive antagonist except
phenoxybenzamine, an irreversible antagonist
that binds covalently to α-adrenergic receptors.
Competitive antagonists
These are reversible antagonists. A competitive
antagonist will attach itself to the same binding
site of the receptor that the agonist will bind to.
This type of binding is reversible as increasing the

concentration of agonist will outcompete the
concentration of antagonist, resulting in receptor
activation.
Non-competitive antagonists can either bind to the
ligand site or other site called the allosteric site.
The binding of a non-competitive antagonist is
irreversible.
Eg: phenoxybenzamine
 Alpha adrenergic blockers: Tolazoline*,
Phentolamine, Phenoxybenzamine, Prazosin,
Dihydroergotamine, Methysergide.
ALPHA ADRENERGIC BLOCKERS
Cardiovascular effects:
Alpha 1 adrenergic blockers inhibit
vasoconstriction induced by endogenous
catecholamines. It will result in vasodialation.
Non cardiac effects:
Miosis
Nasal stuffness
Use of alpha 1 blockers:
High blood pressure
Raynaud's disease (reduced blood flow in response
causing discolouration of the fingers, toes, and
occasionally other areas...........hyperactivation of
sympathetic system)
Pheochromocytoma (tumor of adrenal gland)
Alpha 2 blockers:
increase adrenergic, dopaminergic and serotonergic
neurotransmitters, and induce insulin secretion
and decreases blood sugar levels.
Used to treat depression.

TOLAZOLINE
IUPAC- 2-Benzyl-4,5-dihydro-1H-imidazole
Non selective alpha blocker.

 It is a vasodilator
 Sympathomimetic effect to stimulate the
heart,stimulate gasrointestinal smooth muscles,
histaminergic action.
Uses:
Used in peripheral vascular diseases (blood

vessels outside heart and brain to narrow, block,
or spasm)
 Treat pulmonary hypertension of new born.
PHENTOLAMINE
3-[(4,5-Dihydro-1H-imidazol-2-ylmethyl)(4-
methylphenyl)amino]phenol
Nonselective α-adrenoreceptor antagonist with an
immediate onset and short duration of action.
It has weak muscarnic activity in the gastrointestinal
tract and weak to mild histaminergic activity in the
stomach.
Used in immediate heart attack.
PHENOXYBENZAMINE (DIBENZYLINE)
(RS)-N-Benzyl-N-(2-chloroethyl)-1-phenoxypropan-2-amine
Ireversible alpha antagonist.
Uses-
Pheochromocytoma (tumours of the adrenal medulla)
peripheral vascular diseases, such as Raynaud’s
syndrome.
Frostbite to improve blood flow to peripheral tissues,
Pulmonary oedema.
PRAZOSIN
[4-(4-Amino-6,7-dimethoxy-2-quinazolinyl)-1-
piperazinyl](2-furyl)methanone
Selecive alpha 1 blocker (first of this class)

Used to treat hypertension and reduce cardiac
overload
DIHYDROERGOTAMINE
Used to treat migraine headaches

METHYSERGIDE
(1-methyl-D-lysergic acid butanolamide

Prevention of migraine
Reduction in cardiac output, reduction in
blood pressure.
 Selective β1 antagonist : heart
 Selective β2 antagonist: respiratory system.
ISA- intrinsic sympathomimetic activity- some
beta antagonist show some action of beta
agonists. Eg- pindolol, labetalol.
Less dangerous to give patients of bronchial
asthma.
Membrane stabilizing action [MSA]- some beta
blockers stabilize membrane by blocking sodium
channels. Therefore produce local anaesthetic
action.
Eg- propranolol, pindolol.
SDE EFFECTS
 Rash and fever
 Worsening of asthma
 Sedation, depression
 Heart failure
 Propranolol*,
 Metipranolol, Atenolol, Betazolol, Bisoprolol,
Esmolol, Metoprolol,
 Labetolol, Carvedilol.
PROPRANOLOL ATENOLOL
METAPROLOL
PROPRANOLOL
Non selective beta blocker.
 MSA
x ISA
Uses
 cardiac arrhythmia,
 angina pectoris, due to coronary atherosclerosis
 prophylaxis of migraine headache.
Crosses blood brain barrier

METIPRANOLOL
(RS)-4-{[-2-hydroxy-3-(isopropylamino)propyl]oxy}-
2,3,6-trimethylphenyl acetate
Non selective beta blocker
Antiarrhythmic
Antihypertensive
Antiglaucoma agent
ATENOLOL
β1 selective drug .
Developed as a replacement for propranolol.
Reduces force of contraction and blood pressure.

Mainly used in the treatment of essential
hypertension.
Used to treat angina
Does not crosses BBB.

METOPROLOL
β1 selective drug
Hypertension
Angina pectoris
Tachycardia
BETAXOLOL
Greater affinity for beta1 receptors

than metoprolol.
Used to treat hypertension and glaucoma.
BISOPROLOL
Mechanism of action: beta 1 selective.
Bisoprolol has a higher degree of β1-selectivity
compared to other β1-selective beta blockers such
as atenolol, metoprolol, and betaxolol
Highly potent.
Uses; management of hypertension, stroke and

myocardial infarction.
ESMOLOL
Cardioselective beta1 receptor blocker with

rapid onset, a very short duration of action,
and no significant
intrinsic sympathomimetic or membrane
stabilising activity at therapeutic dosages.
Used during surgery to help regulate blood
pressure and heart rate
CARVEDILOL
Acts on both alpha and beta receptors.

Used to treat hypertension and congestive heart
failure
LABETALOL
Blocks β1 and β2 and α1-adrenergic receptor.

More potent β antagonist than α antagonist
Used to treat hypertension and angina.

SAR OF BETA BLOCKERS
 The aromatic ring and its substituent is the

primary determinant of β1 antagonistic activity.
The aryl group also affects the absorption,
excretion, and metabolism of the β blockers.
 Replacement of catechol hydroxyl group with
chlorine of phenyl ring system retains β blocking
activity.
Example: pronethalol, dichloroisoproterenol.
 N, N–disubstitution decreases the β blocking
activity, and the activity is maintained when the
phenyl ethyl, hydroxy phenyl ethyl, or
methoxy phenyl ethyl groups are added to
amine as a part of the molecule.
 The two carbon chains are essential for activity.
 The introduction of -OCH2 group into the

molecule between the aromatic ring and the ethyl
amine side chain provides β blocking agents, for
example, propranolol.
 Secondary amine group is necessary for optimal
activity.
The configuration of the hydroxyl bearing carbon
of the aryloxypropanolamine side chain play a
critical role in the interaction of β antagonist
drugs with β receptor. The carbon must possess
the (S) configuration for optimal affinity to the β
receptor.
The enantiomer with the (R) configuration is
typically 100 times less potent.
SOME IMP TERMS
Essential hypertension[primary hypertension]is
due to-
Genetic and environmental factors.
Secondary hypertension is due to- kidney problems,

narrowing of aorta, adrenal gland tumors.

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Antiadrenergics/ sympatholytics

An adrenergic antagonist is a drug that inhibits

 Prevent the response of effector organs to

This type of binding is reversible as increasing the

Used to treat depression.

Non selective alpha blocker.

Used in peripheral vascular diseases (blood

Ireversible alpha antagonist.

Selecive alpha 1 blocker (first of this class)

Used to treat migraine headaches

(1-methyl-D-lysergic acid butanolamide

 angina pectoris, due to coronary atherosclerosis

 prophylaxis of migraine headache.

Crosses blood brain barrier

Reduces force of contraction and blood pressure.

Does not crosses BBB.

Greater affinity for beta1 receptors

Uses; management of hypertension, stroke and

Cardioselective beta1 receptor blocker with

Acts on both alpha and beta receptors.

Blocks β1 and β2 and α1-adrenergic receptor.

Used to treat hypertension and angina.

 The aromatic ring and its substituent is the

 The introduction of -OCH2 group into the

Secondary hypertension is due to- kidney problems,

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