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The liver is richly endowed with COMT and MAO; it therefore contributes significantly to the degradation of circulating norepinephrine and epinephrine. The end product of the combined actions of MAO and COMT is vanillylmandelic acid. Adrenoceptors fall into three major groups, designated ?1, ?2, and ?, within each of which further subtypes can be distinguished pharmacologically.
Increased protein catabolism with atrophy of skeletal musculature (thin extremities), osteoporosis, growth retardation in infants, skin atrophy. Sequelae of the intrinsically weak, but now manifest, mineralocorticoid action of cortisol: salt and fluid retention, hypertension, edema; KCl loss with danger of hypokalemia.


To ensure a reasonably long-lasting local effect with minimal systemic action, a vasoconstrictor (epinephrine, less frequently norepinephrine or a vasopressin derivative;) is often co-administered in an attempt to confine the drug to its site of action.
Heparin is present (together with histamine) in the vesicles of mast cells; its physiological role is unclear. Therapeutically used heparin is obtained from porcine gut or bovine lung. Heparin molecules are chains of amino sugars bearing -COO– and -SO4 groups; they contain approx. 10 to 20 of the units depicted in (B); mean molecular weight, 20,000.


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