autonomic drugs

Question 1

neostigmine

class
MoA
clinical use

Answer 1

class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh

clinical use:ileus, urinary retention, myasthenia gravis

Question 2

timolol

class

Answer 2

class:nonselective βantagonist

Question 3

benztropine

class
organ affected
clinical use

Answer 3

class:muscarinic antagonist

organ affected:CNS

clinical use:Parkinson’s disease

Question 4

albuterol, salmeterol, terbutaline

class
MoA
clinical use

Answer 4

class:direct sympathomimetic

clinical use:asthma, COPD, tocolytic (tertbutaline)

mechanism:α1(-), α2(-), β1(++), β2(++++), D1(-)

Question 5

ipratropium, tiotropium

class
clinical use

Answer 5

class:muscarinic antagonist

clinical use:COPD, asthma

Question 6

edrophonium

class
MoA
clinical use

Answer 6

class: indirect cholinomimetic agonist (anticholinesterase)
mechanism: ↑endogenous ACh

clinical use:diagnostic test for myasthenia gravis

Question 7

epinephrine

class
MoA
clinical use

Answer 7

class: direct sympathomimetic
mechanism: α1(+++), α2(+++), β1(++++), β2(++++), D1(-)

clinical use:anaphylaxis, open angle glaucoma, asthma, hypotension

Question 8

dobutamine

class
MoA
clinical use

Answer 8

class: direct sympathomimetic
mechanism: α1(+), α2(+), β1(++++), β2(+), D1(-)

clinical use:CHF, cardiac stress test (pharmacologic), increase heart rate and contractility

Question 9

carbachol

class
clinical use

Answer 9

class:direct cholinomimetic agonist

clinical use:glaucoma, reduce intraocular pressure

Question 10

dopamine

class
MoA
clinical use

Answer 10

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

Question 11

acebutolol

class
MoA
clinical use

Answer 11

class: β1 selective antagonist (partial)
class: partial nonselective β agonist

Question 12

prazosin

class
toxicity
clinical use

Answer 12

class: α-1 selective blocker
toxicity: 1st-dose orthostatic hypotension

clinical use:BPH, HTN

Question 13

cocaine

class
MoA
clinical use

Answer 13

class: indirect sympathomimetic
mechanism: reuptake inhibitor

clinical use:vasoconstriction, local anesthetic

Question 14

propranolol

class

Answer 14

class:nonselective βantagonist

Question 15

oxybutynin

class
clinical use
organ affected

Answer 15

class:muscarinic antagonist

clinical use:urge incontinence

organ affected:GU

Question 16

atropine, homatropine, tropicamide

class
clinical use
organ affected

Answer 16

class:muscarinic antagonist

organ affected:eye

clinical use:mydriasis, cycloplegia

Question 17

phenoxybenzamine

class
clinical use
toxicity

Answer 17

class: noncompetitive, nonselective α-blocker (irreversible)
toxicity: orthostatic hypotension, reflex tachycardia

clinical use:pheochromocytoma

Question 18

phentolamine

class
clinical use
toxicity

Answer 18

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)

Question 19

bethanechol

class
MoA
clinical use

Answer 19

class: direct cholinomimetic agonist
mechanism: activates smooth muscle in bowels and bladder

clinical use:ileus, urinary retention

Question 20

glycopyrrolate

class
clinical use
organ affected

Answer 20

class:muscarinic antagonist

clinical use:pre-op to reduce airway secretions and drooling, peptic ulcers

organ affected:GI, respiratory

Question 21

pindolol

class

Answer 21

class: nonselective β antagonist
class: partial nonselective β agonist

Question 22

atenolol

class

Answer 22

class:β1 selective antagonist

Question 23

organophosphates

class
toxicity

Answer 23

class: irreversible cholinesterase inhibitor
toxicity: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation.

Question 24

atropine

class
effects
clinical use
toxicity

Answer 24

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

Question 25

pilocarpine class MoA clinical use

Answer 25

class:  direct cholinomimetic agonist mechanism:  contracts ciliary muscle, pupillary sphincter clinical use: open and closed-angle glaucoma, stimulates sweating, lacrimation, salivation 

Question 26

labetolol class

Answer 26

class: nonselective α and β antagonist 

Question 27

physostigmine class MoA clinical use

Answer 27

class:  indirect cholinomimetic agonist (anticholinesterase) mechanism:  ↑endogenous ACh → crosses BBB to CNS clinical use: anticholinergic overdose (e.g. atropine) 

Question 28

betaxalol class

Answer 28

class: β1 selective antagonist 

Question 29

clonidine, α-methyldopa class MoA clinical use

Answer 29

class:  sympathoplegic mechanism:  central-acting α-2 agonist → decreases sympathetic outflow from CNS clinical use: hypertension, (methyldopa safe in pregnancy) 

Question 30

esmolol class

Answer 30

class: β1 selective antagonist (short-acting) 

Question 31

norepinephrine class MoA clinical use

Answer 31

class:  direct sympathomimetic mechanism:  α1(++++), α2(++++), β1(++), β2(-), D1(-) clinical use: hypotension 

Question 32

methacholine class MoA clinical use

Answer 32

class:  direct cholinomimetic agonist mechanism:  inhale → muscarinic receptors in airway → bronchodilation clinical use: asthma diagnostic test 

Question 33

ephedrine class MoA clinical use

Answer 33

class:  indirect sympathomimetic mechanism:  releases stored catecholamines clinical use: nasal decongestion, urinary incontinence, hypotension 

Question 34

amphetamine class MoA clinical use

Answer 34

class:  indirect sympathomimetic mechanism:  releases stored catecholamines clinical use: narcolepsy, obesity, ADHD 

Question 35

isoproterenol class MoA clinical use

Answer 35

class:  direct sympathomimetic mechanism:  α1(-), α2(-), β1(++++), β2(++++), D1(-) clinical use: Torsade de pointes, bradyarrhythmia 

Question 36

donepezil class MoA clinical use

Answer 36

class:  indirect cholinomimetic agonist (anticholinesterase) mechanism:  ↑endogenous ACh → crosses BBB to CNS clinical use: Alzheimer's disease 

Question 37

nadolol class

Answer 37

class: nonselective β antagonist 

Question 38

phenylephrine class MoA clinical use

Answer 38

class:  direct sympathomimetic mechanism:  α1(+++), α2(++), β1(-), β2(-), D1(-) clinical use: hypotension, ocular procedures, decongestion 

Question 39

carvedilol class

Answer 39

class: nonselective α and β antagonist 

Question 40

scopolamine class organ affected clinical use

Answer 40

class: muscarinic antagonist organ affected: CNS clinical use: motion sickness 

Question 41

pyridostigmine class MoA clinical use

Answer 41

class:  indirect cholinomimetic agonist (anticholinesterase) mechanism:  ↑endogenous ACh clinical use: myasthenia gravis 

Question 42

metoprolol class

Answer 42

class: β1 selective antagonist 

Question 43

mirtazapine class clinical use toxicity

Answer 43

class: α-2 selective blocker clinical use: depression toxicity: sedation, hypercholesterolemia, hyperphagia