Which medications in the drug class Alpha/Beta Adrenergic Agonists are used in the treatment of Calcium Channel Blocker Toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Answer

Alpha/Beta Adrenergic Agonists

These agents augment blood pressure by stimulating dopamine, alpha-adrenergic receptors, and beta-adrenergic receptors. This extracellular effect is transduced across the cell membrane and activates adenylyl cyclase in the cell to form cyclic adenosine monophosphate (cAMP). The activation induces calcium inflow from the endoplasmic reticulum, which initiates muscle cell contraction. Sympathomimetics lead to vasoconstriction and increased cardiac inotropy, chronotropy, and dromotropy.

Norepinephrine (Levophed)

Norepinephrine stimulates beta1- and alpha-adrenergic receptors, which, in turn, increase cardiac muscle contractility, heart rate, and vasoconstriction. As a result, systemic blood pressure and coronary blood-flow increases. Mix 4 mg in 500 mL of 5% dextrose in water (D5W) to yield 8 mcg/mL.

Epinephrine (Adrenalin)

Epinephrine has alpha-agonist effects, which include increased peripheral vascular resistance, reversed peripheral vasodilatation, systemic hypotension, and vascular permeability. The drug's beta-agonist effects include bronchodilatation, chronotropic cardiac activity, and positive inotropic effects. Mix 1 mg in 250 mL D5W to yield 4 mcg/mL.


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