Sympathomimetic

Generic and Trade Names:

Albuterol		Proventil, Ventolin
Epinephrine	Adrenalin
Isoetharine		Dey-Lute
Isoproterenol		Isuprel
Metaproterenol		Alupent, Metaprel
Pirbuterol			Maxair
Salmeterol		Serevent
Terbutaline		Brethaire, Brethine

Description:

Sympathomimetics (adrenergics) form a class of drugs which mimic the autonomic nervous system.
Sympathomimetic drugs are used primarily for bronchodilation. They relieve bronchospasm by relaxing the smooth muscles of the bronchioles. They are used in the treatment of asthma, bronchitis, and emphysema. Some of these drugs also have other uses, for example as vasopressors and in the treatment of glaucoma. Isoproterenol is an example of a sympathomimetic, it dilates constricted bronchial tubes, stimulates the heart muscle, and dilates blood vessels. (Facts and Comparisons 1999)

Nutritional Considerations:

Can cause hyperglycemia (Smith 1992). Limit sugar and monitor diabetics (see under diabetes).

Electrolytes should be maintained (especially potassium) (Pronsky 1999).

Albuterol may affect vitamin B6 absorption (Martinez 1996).

Avoid alcohol.

Avoid caffeine. (Pronsky 1999)

Herbal Considerations:

Ephedra (Ma Huang) has approval status by the German Commission E regarding its sympathomimetic action. However, this action may be potentiated if taken in combination with MAO inhibitors. (Blumenthal 1998)

An extensive list of herbs with sympathomimetic action has been compiled by Newall:

Herb
                        
Agnus Castus                                        
Aniseed (Anise), Anethole
Arnica        Betaines, choline
Black Cohosh        
Bloodroot        
Blue Cohosh        
Bogbean        
Boldo        
Borage        
Broom        
Calamus        
Capsicum        
Centaury        
Cereus        
Cola        
Coltsfoot        
Comfrey        
Cornsilk        
Echinacea        
Eyebright        
Fenugreek, Choline
Fumitory        
Gentian        
Ginseng, Panax        
Goldenseal        
Gravel Root        
Hawthorn        
Horehound        
Hydrocotyle        
Ispaghula        
Jamaican Dogwood        
Liferoot        
Lobelia        
Mate        
Mistletoe, Histamine release
Motherwort        
Nettle        Choline
Parsley, Myristicin
Passionflower        
Plantain        
Pleurisy Root, Sympathomimetic
Pokeroot        
Prickly Ash        
Quassia        
Sassafras        
Shepherd's Purse
Skunk Cabbage        
St. John's Wort        
Stone Root        
Valerian        
Vervain        
Yarrow
        
References:

Bolinger AM, Young KYL, Gambertoglio JG et al: Influence of food on the absorption of albuterol Repetabs. J Allergy Clin Immunol 1989; 83:123-126.

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.

Martinez de Haas MG, Poels PJ, de Weert CJ, et al. Subnormal vitamin B6 levels in theophylline users. Ned Tijdschr Geneeskd 1997;141:2176-79 [in Dutch].

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.

Osol, Arthur. 1980. Remington's Pharmaceutical Sciences. Mack Publishing Company, Pennsylvania.

Product Information: Ventolin(R), albuterol. Allen & Hanburys, Division of Glaxo, Research Triangle Park, NC, 1996.

Pronsky, Zaneta. Food Medication Interactions. 11th edition. 1999.

Smith AP, Banks J, Cheong, B, Gunawardena: Mechanisms of abnormal glucose metabolism during the treatment of acute severe asthma. Quart J Med. 1992; NS82:71-80.

Warren JB, Dalton N & Turner C: Effect of a 2 week course of oral salbutamol on adrenomedullary function in normal subjects. Br J Clin Pharmacol 1983; 15:67-70.