ANS drugs Flashcards
adrenergic drug:
MOA: inhibit storage in vesicles
inhibit NE and Dopamine response
Reserpine
cant be stored kay naa ngpa Reserve
MOA: inhibit release of catecholamines (2) examples
Guanethedine ,Brethylium
when u use adrenaline.. ma Gua imo Breth
MOA: stimulate sympathetic response (4) examples
amphetamine, metamphetamine, ephedrine, tyramine
[Amp! Phred Met Tyra]
Class?
MOA: Produce sympathetic response by causing an increase in the concentration of NE in the synaptic clef
Indirect-acting sympathomimetics
class?
MOA: stimulate directly adrenergic receptors
Direct acting sympathomimetics
Catecholamines is degraded by?
COMT
(Catechol-O-methyl transferase, found in the GI)
enumerate (2) common metabolite of catecholamines
metanephrine
Vanillyl mandelic acid (VMA)
Vanillyl mandelic acid (VMA) is seen in what condition?
Pheochromocytoma
enumerate (3) natural catecholamines
Epinephrine
Norepinephrine
Dopamine
[END]
decreased catecholamine concentration stimulates (?) receptors?
Beta receptors
increased catecholamine concentration stimulates (?) receptors?
alpha receptors
Endogenous source of epinephrine, what site?
adrenal medulla
Indication: ACLS, anaphylaxis, shock
epinephrine
Pivalic ester derivative of epinephrine given as opthalmic drops for glaucoma
Dipivefrin
catecholamine affinity with receptor a1 and b1 ( no effect on a2 b2)
norepinephrine
first line mgt of septic shock
norepinephrine
receptor for vasodilation of renal and splanchnic blood vessels
D1
[D shape like a kidney]
receptor for inotropic agent for shock
B1
receptor for vasoconstriction
a1
selective b1 agonist drug (1)
dobutamine
selective b2 agonist drug (rapid and short acting)
fenoterol albuterol salbutamol terbultaline
[FAST]
selective a1 agonist drug
phenylephrine, prophylhexedine, oxymetazoline
-ephrine, -edine, -zoline
selective a2 agonist drug
useful in HPN mgt
Clonidine, Methyldopa, Guanfancine, Guanbenz
[GMC]
Receptor: Suppression of release of norepinephrine (noradrenaline) by negative feedback
A2
nonselective B agonist
isoproterenol
selective b2 agonist drug ( slow and low acting)
bambuterol, salmeterol
[BS, this is BS gi asthma na ko ang hina ng effect!]
indication: 1. bronchial asthma, COPD 2. tocolytic
3. mgt of hyperkalemia
Selective b2 agonists
SE of Selective b2 agonists (3)
hypokalemia
muscle tremors
tachycardia
Clinical use: A2 agonist, local nasal decongestant
Clonidine
Clinical use: A2 agonist, mgt of HPN especially among pregnant patients
Methyldopa
SE: of methyldopa
(+)COOMB’S TEST(immune mediated hemolytic anemia)
hepatotoxicity
sedation
drug used pre-operatively in patients with pheochromocytoma
Phenoxybenzamine
clinical use:
drug selective a-1 blockers
alternative mgt of hpn
Phentolamine
Phentolamine SE
“FIRST DOSE” phenomenon
-orthostatic hypotension
Beta blockers known SE
bronchospasm
Muscarininc receptor for ciliary muscles, glands
M3
Muscarininc receptor for cardiac nerves
M2
Muscarininc receptor for nerve endings
M1
Nicotinic receptor for ganglia
N1
Nicotinic receptor for end plate/ skeletal muscle
N2
Direct acting cholinomimetics
choline esters (acetylcholine, metacholine) M,N alkaloid (pilocarpine M, muscarine M, nicotine N)
indirect acting cholinomimetics
alcohol (5-15 mins)short
carbametes (30-8hrs) int (Ex. neo/physostigmine)
organophosphates (days to mos) long
Test tool in diagnosing MG
Edrophoonium (aka Tensilon Test)
Mgt of glaucoma
Physostigmin, Echothiopate, Demecarium
[glaucoma is in your PEDigree]
Carbachol, Pilocarpine
[Piloa ang Car kay daot kag mata]
Antidote to Curare-like poisoning
Neostigmine
[neo is rare]
Antidote to Atropine toxicity
Physostigmine
[tagpila ang atropine? physo ra]
Mgt of urinary retention
Betanechol
mgt of smoking addiction
lobeline
Cholinergic antagonist protype
Atropine
Treatment of organophosphate poisoning
atropine and pralidoxime
why is atropine given with anti-diarrheal drug like diphenoxylate
to decrease addiction/ dependence
nondepolarizing muscle relaxant use to provide rapid, intense short lasting muscular blockade
succinylcholine
most serious complication of succinylcholine
hyperkalemia (with resultant cardiac arrest)
Short acting nondepolarizing muscle relaxant
succinylcholine mivacurium rocuronium
[suc mi or]
intermediate acting nondepolarizing muscle relaxant
vecorunium atracurium
[atrac vecor( vicar means replacement)]
long acting nondepolarizing muscle relaxant
pancuronium, pipecoronium, doxacurium
[pan pipe do]
choline esters (3)
bethanichol methacholine carbachol
[Beth has Meth in the Car, hint chol]
MOA: blocks Nn receptors
Ganglionic blockers
Ganglionic blocker, alternative drug of hpn urgency
Trimetophan
MOA: nondepolarizing,reversible Nm blockers
neuromuscular blockers (curare derivatives)