autonomic drugs Flashcards
neostigmine
class
MoA
clinical use
class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh
clinical use:ileus, urinary retention, myasthenia gravis
timolol
class
class:nonselective βantagonist
benztropine
class
organ affected
clinical use
class:muscarinic antagonist
organ affected:CNS
clinical use:Parkinson’s disease
albuterol, salmeterol, terbutaline
class
MoA
clinical use
class:direct sympathomimetic
clinical use:asthma, COPD, tocolytic (tertbutaline)
mechanism:α1(-), α2(-), β1(++), β2(++++), D1(-)
ipratropium, tiotropium
class clinical use
class:muscarinic antagonist
clinical use:COPD, asthma
edrophonium
class
MoA
clinical use
class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh
clinical use:diagnostic test for myasthenia gravis
epinephrine
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(+++), α2(+++), β1(++++), β2(++++), D1(-)
clinical use:anaphylaxis, open angle glaucoma, asthma, hypotension
dobutamine
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(+), α2(+), β1(++++), β2(+), D1(-)
clinical use:CHF, cardiac stress test (pharmacologic), increase heart rate and contractility
carbachol
class clinical use
class:direct cholinomimetic agonist
clinical use:glaucoma, reduce intraocular pressure
dopamine
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(+++) @ high dose, α2(+++) @ high dose, β1(+++) @ med dose, β2(++) @ med dose, D1(+++) @ low dose
clinical use:shock, CHF, increase heart rate and contractility
acebutolol
class
MoA
clinical use
class: β1 selective antagonist (partial)
class: partial nonselective β agonist
prazosin
class
toxicity
clinical use
class: α-1 selective blocker
toxicity: 1st-dose orthostatic hypotension
clinical use:BPH, HTN
cocaine
class
MoA
clinical use
class: indirect sympathomimetic
mechanism: reuptake inhibitor
clinical use:vasoconstriction, local anesthetic
propranolol
class
class:nonselective βantagonist
oxybutynin
class
clinical use
organ affected
class:muscarinic antagonist
clinical use:urge incontinence
organ affected:GU
atropine, homatropine, tropicamide
class
clinical use
organ affected
class:muscarinic antagonist
organ affected:eye
clinical use:mydriasis, cycloplegia
phenoxybenzamine
class
clinical use
toxicity
class: noncompetitive, nonselective α-blocker (irreversible)
toxicity: orthostatic hypotension, reflex tachycardia
clinical use:pheochromocytoma
phentolamine
class
clinical use
toxicity
class: nonselective α-blocker (reversible)
toxicity: orthostatic hypotension, reflex tachycardia
clinical use:
- patient w/ MAO inhibitors accidentally eats tyramine, give to avoid HTN
- patient w/ IV NE who demonstrates extravasation and resulting vasoconstriction (induration + pallor of tissues)
bethanechol
class
MoA
clinical use
class: direct cholinomimetic agonist
mechanism: activates smooth muscle in bowels and bladder
clinical use:ileus, urinary retention
glycopyrrolate
class
clinical use
organ affected
class:muscarinic antagonist
clinical use:pre-op to reduce airway secretions and drooling, peptic ulcers
organ affected:GI, respiratory
pindolol
class
class: nonselective β antagonist
class: partial nonselective β agonist
atenolol
class
class:β1 selective antagonist
organophosphates
class toxicity
class: irreversible cholinesterase inhibitor
toxicity: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation.
atropine
class
effects
clinical use
toxicity
class: muscarinic antagonist
effects: mydriasis, cycloplegia, reduced airway secretions, decreased GI motility, decreased urge incontinence, decreased acid secretion
clinical use: organophosphate poisioning
toxicity:hyperthermia, anhydrosis, flushed skin, cycloplegia, disorientation hot as a hare dry as a bone red as a beet blind as a bat mad as a hatter
pilocarpine
class
MoA
clinical use
class: direct cholinomimetic agonist
mechanism: contracts ciliary muscle, pupillary sphincter
clinical use:open and closed-angle glaucoma, stimulates sweating, lacrimation, salivation
labetolol
class
class:nonselective α and β antagonist
physostigmine
class
MoA
clinical use
class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh → crosses BBB to CNS
clinical use:anticholinergic overdose (e.g. atropine)
betaxalol
class
class:β1 selective antagonist
clonidine, α-methyldopa
class
MoA
clinical use
class: sympathoplegic
mechanism: central-acting α-2 agonist → decreases sympathetic outflow from CNS
clinical use:hypertension, (methyldopa safe in pregnancy)
esmolol
class
class:β1 selective antagonist (short-acting)
norepinephrine
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(++++), α2(++++), β1(++), β2(-), D1(-)
clinical use:hypotension
methacholine
class
MoA
clinical use
class: direct cholinomimetic agonist
mechanism: inhale → muscarinic receptors in airway → bronchodilation
clinical use:asthma diagnostic test
ephedrine
class
MoA
clinical use
class: indirect sympathomimetic
mechanism: releases stored catecholamines
clinical use:nasal decongestion, urinary incontinence, hypotension
amphetamine
class
MoA
clinical use
class: indirect sympathomimetic
mechanism: releases stored catecholamines
clinical use:narcolepsy, obesity, ADHD
isoproterenol
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(-), α2(-), β1(++++), β2(++++), D1(-)
clinical use:Torsade de pointes, bradyarrhythmia
donepezil
class
MoA
clinical use
class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh → crosses BBB to CNS
clinical use:Alzheimer’s disease
nadolol
class
class:nonselective β antagonist
phenylephrine
class
MoA
clinical use
class: direct sympathomimetic
mechanism: α1(+++), α2(++), β1(-), β2(-), D1(-)
clinical use:hypotension, ocular procedures, decongestion
carvedilol
class
class:nonselective α and β antagonist
scopolamine
class
organ affected
clinical use
class:muscarinic antagonist
organ affected:CNS
clinical use:motion sickness
pyridostigmine
class
MoA
clinical use
class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh
clinical use:myasthenia gravis
metoprolol
class
class:β1 selective antagonist
mirtazapine
class
clinical use
toxicity
class:α-2 selective blocker
clinical use:depression
toxicity:sedation, hypercholesterolemia, hyperphagia
