ANS Drugs Flashcards
Bethanecol
Direct M agonist
Neostigmine
Indirect Nm agonist
Pyridostigmine bromide
indirect Nm agonist
Atracurium besylate
Nm antagonist (reversible)
Atropine sulfate
M antagonist, competitive
Glycopyrrolate
M antagonist
synthetic atropine
Oxybutynin
M antagonist
Isoprotenerol
B1 and B2 agonist
Epinephrine
B2 > a1 agonist
also does B1
Norepinephrine
a1»_space;> B1 agonit
Dopamine
DA > B1 > a1 agonist
Phenylephrine
a1 agonist
Dobutamine
B1 agonist
Albuterol, Clenbuterol, Terbutaline
B2 agonist
Phenylpropanolamine
mixed agonist
long term drug
Ephedrine sulfate
mixed agonist
based off pH
Prazosin
competitive a1 antagonist
Phenoxybenzamine
noncompetitive a1 antagonist
Atenolol
B1 antagonist
Esmolol
B1 antagonist
Metoprolol
B1 antagonist
Propanolol
B1 and B2 antagonist
Sotalol
B1 and B2 antagonist
Timolol
B1 and B2 antagonist
M receptor locations
ALL parasympathetics (not innervated in vasculature)
Sympathetics of sweat glands
a1 receptor locations
vasculature, GI, trigone of bladder, male genitalia, piloerector muscles
B1 receptor locations
HEART
GI, bladder, kidney, uterus
B2 receptor locations
LUNGS
some heart, skeletal vasculature, liver, pancreas, fat cells
Dopamine receptor locations
renal and mesenteric vasculature
a1 ___, while B2 and DA ___
a1 vasoconstricts
B2 and DA vasodilate
M receptors are in ___ of heart
SA node
B1 receptors are in ___ of heart
ventricles
why it affects both HR and contractility
Bethanecol indications
Treats what?
GI and GU effects
decreased bladder contractions
GI (avoid) cecal displacement in cows and gastric ulcers in horse
Bethanecol adverse effects
overextension of therapeutic effect
colic in horses
Main Bethanecol contraindications
Hypotension (bad if M receptor drug gets in bloodstream)
Blocked urethra
GI impaction
Bradycardia (since this will decrease HR more)
Neostigmine indications
LABELED - GI/bladder atony in livestock
Nm block reversal
ELDU - DX Myasthenia syndrome
Neostigmine adverse effects
Cholinergic Crisis
aka decrease BP/HR, vasodilate, bronchoconstrict, lots of urination
Pyridostigmine bromide indications
LABELED Myasthenia syndrome
Pyridostigmine bromide adverse effects
intussusception aka GI telescope due to enhanced GI motility
tolerance may also occur
Atracurium besylate important information
Paralysis has specific order
head and neck muscles -> tail muscles -> larger/limb muscles -> laryngeal, abdominal intercostals, deglutt -> respiratory muscles
Spontaneous breakdown
Reverse with Neostigmine
NO PAIN RELIEF
Atropine sulfate indications
pre-anesthetic to decrease secretions
sinus bradycardia
SA arrest
Atropine sulfate adverse effects
dry mouth, less bronchial secretions, less GI motility, colic in horses, increase IOP, mydriasis
Oxybutynin indications
Detrusor (pee a lot)
Hyperreflexia in dog and cat
Oxybutynin adverse effects
increase IOP (avoid in glaucoma pt)
tachycardia, bronchodilate
Isoprotenerol indications
B1 bradycardia
B2 bronchoconstriction
Isoprotenerol adverse effects
decrease BP (B2), tachycardia (B1), central effects
Why does Isoprotenerol decrease BP, but increase HR?
Baroreceptor reflex
Epinephrine LOW dose indications
asystole
give every 2 min
Epinephrine LOW dose adverse effects
decrease BP, tachycardia
acts like Isoprotenerol
B2 > a1
Epinephrine HIGH dose indications
anaphylaxis (allergic reaction)
Epinephrine HIGH dose adverse effects
increase HR and contractility due to B2
a1 vasoconstricts, causing increased BP
acts like Norepinephrine
Norepinephrine indication
hypotension
Norepinephrine adverse effects
hypertension (increased BP), bronchoconstrict
slight B1 causes very slight increase HR
Dopamine indication
hypotension
Dopamine LOW dose effect
renal and mesenteric vessel dilation
Dopamine HIGH dose effect
increased heart function, vasoconstrict
Phenylephrine indications
hypotension (dec BP), opthalmic solution (cause mydriasis)
Phenylephrine adverse effects
reflex bradycardia (due to major BP increase), hypertension, colic, hemorrhage, necrosis
Dobutamine indications
ER drug for acute heart failure
Dobutamine adverse effects
tachyphylaxis within 48-72 hours
aka rapid tolerance
tachycardia, arrhythmia, seizures
Albuterol, Clenbuterol, Tertbutaline indication
bronchoconstriction
Albuterol, Clenbuterol, Tertbutaline adverse effects
increase HR and contractility, vasodilate, decrease BP
Phenylpropanolamine indication
long term for urinary incontinence
Phenylpropanolamine adverse effects
CNS, urine retention (fix dosing), tachycardia (B1/2), hypertension (a1)
tachyphylaxis (since not infinite norepi amount in nerves, dec effect)
Phenylpropanolamine contraindications
MOST CONCERNED ABOUT B EFFECTS SINCE LONG TERM
glaucoma (B increases IOP), cardiovascular disease, hyperthyroidism (hypertension)
Ephedrine indications
hypotension post-op in dogs and cats
rarely for urinary incontinence (since meth precursor)
What is Ephedrine half life based on?
urine pH!
t1/2 = 3hrs when pH = 5
t1/2 = 6hrs when pH = 6.3
Ephedrine adverse effects
same as Phenylpropanolamine
CNS, urine retention (fix dosing), tachycardia (B1/2), hypertension (a1)
tachyphylaxis (since not infinite norepi amount in nerves, dec effect)
Prazosin indications
urethrospasm (not peeing right), hypertension
Prazosin relaxes ___ and __
prosate
trigone of bladder
Phenoxybenzamine indication
pheochromocytoma (adrenal tumor)
since tumor releases lots of norepinephrine
Phenoxybenzamine adverse effects
hypotension!! reflex tachycardia, increased GI motility, miosis, increased IOP, inhibit ejaculation
List the B1 antagonists
Atenolol
Esmolol
Metoprolol
List the B1/B2 antagonists
Propanolol
Sotalol
Timolol
What do B antagonists treat?
cardiac arrhythmias
B antagonists adverse effects
bradycardia, bronchoconstriction, exercise intolerance, acute hypertension, chronic hypotension
Timolol indication
glaucoma
What do Metoprolol and Propanolol have in common?
mild local anesthetics