ATC Group: C01CA Adrenergic and dopaminergic agents

The World Health Organization's ATC classification organizes medical drugs based on therapeutic properties, chemical composition, and anatomy. It helps make essential medicines readily available globally and is widely used in the pharmaceutical industry.

Position of C01CA in the ATC hierarchy

Level Code Title
1 C Cardiovascular system
2 C01 Cardiac therapy
3 C01C Cardiac stimulants excl. cardiac glycosides
4 C01CA Adrenergic and dopaminergic agents

Group C01CA contents

Code Title
C01CA01 Etilefrine
C01CA02 Isoprenaline
C01CA03 Norepinephrine
C01CA04 Dopamine
C01CA05 Norfenefrine
C01CA06 Phenylephrine
C01CA07 Dobutamine
C01CA08 Oxedrine
C01CA09 Metaraminol
C01CA10 Methoxamine
C01CA11 Mephentermine
C01CA12 Dimetofrine
C01CA13 Prenalterol
C01CA14 Dopexamine
C01CA15 Gepefrine
C01CA16 Ibopamine
C01CA17 Midodrine
C01CA18 Octopamine
C01CA19 Fenoldopam
C01CA21 Cafedrine
C01CA22 Arbutamine
C01CA23 Theodrenaline
C01CA24 Epinephrine
C01CA25
C01CA26 Ephedrine
C01CA27
C01CA28
C01CA30 Combinations
C01CA51 Etilefrine, combinations

Active ingredients in C01CA

Active Ingredient Description
Amezinium metilsulfate
Denopamine
Dobutamine

Dobutamine is a synthetic, sympathomimetic amine, structurally related to isoproterenol and dopamine, and is administered as racemate. The positive inotropic effect is primarily based on the agonistic effect on cardiac beta1-receptors but also on cardiac alpha1-receptors.

Dopamine

Dopamine exerts positive inotropic and chronotropic effects on the myocardium, acting as an agonist at beta-adrenergic receptors. Depending on the vascular bed being studied and the dose administered, dopamine can cause relaxation or contraction of vascular smooth muscle.

Droxidopa

Droxidopa is a synthetic amino acid analog that is directly metabolized to norepinephrine by dopa-decarboxylase, which is extensively distributed throughout the body. Droxidopa is believed to exert its pharmacological effects through norepinephrine and not through the parent molecule or other metabolites. The exact mechanism of action of droxidopa in the treatment of neurogenic orthostatic hypotension is unknown.

Ephedrine

Ephedrine is a sympathomimetic amine acting directly on the alpha and beta receptors and indirectly by increasing the release of noradrenaline by the sympathetic nerve endings. As with any sympathomimetic agent, ephedrine stimulates the central nervous system, the cardiovascular system, the respiratory system, and the sphincters of the digestive and urinary systems.

Epinephrine

Epinephrine is a direct acting sympathomimetic agent, which exerts effects on both α and β adrenoceptors. It has more pronounced effects on β than on α adrenoceptors, although α effects prevail at high doses. The effects of adrenaline include increased rate and force of cardiac contraction, cutaneous vasoconstriction and broncho-dilatation.

Etafedrine

Etafedrine, a sympathomimetic agent that acts on the sympathetic receptors of the bronchial tree relaxing spasm in a manner similar to that of ephedrine, is a bronchodilator and a selective β2-adrenoreceptor agonist. Etafedrine also belongs to the family of medications called decongestants. It works by narrowing blood vessels in the nasal passages, helping to relieve nasal stuffiness.

Fenoldopam

Fenoldopam is a rapid-acting vasodilator. It is an agonist for D1-like dopamine receptors and binds with moderate affinity to α2-adrenoceptors. Fenoldopam may increase norepinephrine plasma concentration.

Isoprenaline

Isoprenaline is a potent non selective beta-adrenergic agonist with low affinity for alphaadrenergic receptors. Isoprenaline acts primarily on the heart and on smooth muscle of bronchi, skeletal muscle vasculature and the gastrointestinal tract.

Metaraminol

Metaraminol is a potent sympathomimetic amine that increases both systolic and diastolic blood pressure, is an adrenergic receptor alpha-1 agonist. Metaraminol is indicated for prevention and treatment of the acute hypotensive state occurring with spinal anesthesia. It is also indicated as adjunctive treatment of hypotension due to hemorrhage, reactions to medications, surgical complications, and shock associated with brain damage due to trauma or tumor. Metaraminol is also used in the treatment of priapism, in spite of this application was not approved, it appears to be effective.

Midodrine

Midodrine is the rapidly absorbed pro-drug of the pharmacologically active constituent desglymidodrine. Desglymidodrine is a sympathicomimetic with a direct and selective effect on the peripheral α1-adrenergic receptors. This α1-stimulative effect induces vasoconstriction of the venous system.

Noradrenaline

Noradrenaline provides a strong stimulation of alpha receptors in blood vessels at which these are counter-extracted. Noradrenaline also has an effect on beta-1 receptors in the heart leading to a positive inotropic and initially positive chronotropic effect. The increase in blood pressure may cause a reflex reduction in heart rate.

Octopamine

Octopamine is an organic chemical closely related to norepinephrine. In many types of invertebrates it functions as a neurotransmitter. Octopamine is known to exert adrenergic effects in mammals although specific octopamine receptors have been cloned only in invertebrates. It has been shown that octopamine can stimulate alpha(2)-adrenoceptors (ARs) in Chinese hamster ovary cells transfected with human alpha(2)-ARs. Octopamine stimulates lipolysis through beta(3)-rather than beta(1)-or beta(2)-AR activation in white adipocytes from different mammalian species. Octopamine activates only beta(3)-ARs and is devoid of alpha(2)-adrenergic agonism. Thus, octopamine could be considered as an endogenous selective beta(3)-AR agonist. In humans Octopamine is a trace amine found endogenously in the human brain where it interacts with signalling of catecholamines; it is structurally similar to synephrine and tyramine, being a metabolite of the latter (via dopamine β-hydroxylase) and substrate for the synthesis of the former (via phenethanolamine N-methyltransferase3) while being perhaps the closest in structure to noradrenaline.

Phenylephrine

Phenylephrine is a sympathomimetic agent with mainly direct effects on adrenergic receptors. It has predominantly alpha adrenergic activity and is without stimulating effects on the central nervous system. The sympathomimetic effect of phenylephrine produces vasoconstriction which in turn relieves nasal congestion.

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