Autonomic Drugs Flashcards
Bethanechol
- Direct cholinergic agonist
- Activates bowel and bladder smooth muscle
- Resistant to AChE
- “Bethany, call me to activate your Bowels and Bladder”
Carbachol
- Direct cholinergic agonist
- Consticts pupil and relieves intraocular pressure in glaucoma
“Carbon copy of acetylcholine”
Methacholine
- Direct cholinergic agonist
- Asthma challenge test
- Stimulates muscarinic receptors in airway (M3)
Pilocarpine
- Direct cholinergic agonist
- Contracts ciliary muscle eye (open-angle glaucoma)
- Contracts pupillary sphincter (closed-angle glaucoma)
- Resistant to AChE
- Potent stimulator of sweat, tears, saliva (“you cry, sweat, and drool on your PILow”)
Donepezil, galantamine, rivastigmine
- Anticholinesterase
- Alzheimer Disease
Edrophonium
- Anticholinesterase
- Used to be used for diagnosis of myasthenia gravis
Neostigmine
- Anticholinesterase
- Postop and neurogenic ileus/urinary retention
- Postop reversal of neuromuscular junction blockade
- Myasthenia gravis
- No CNS penetration
Physostigmine
- Anticholinesterase
- Atropine overdose/anticholinergic toxicity
- Penetrates CNS
- “PHYxes atropine overdose”
Pyridostigmine
- Anticholinesterase
- Myasthenia gravis
- No CNS penetration
- “PyRIDostiGMine gets RID of Myasthenia Gravis”
Atropine, homatropine, tropicamide
- Muscarinic antagonist
- Mydriasis
- Treat bradycardia
- For atropine: caution in elderly due to acute angle-closure glaucoma, hyperthermia in infants, urinary retention in men with big prostates
Benztropine
- Muscarinic antagonist
- Parkinson disease (CNS penetration)
- “Park my Benz”
Glycopyrrolate
- Muscarinic antagonist
- Oral: drooling, peptic ulcer
- IV: preop reduction in airway secretions
Hyosycamine, dicyclomine
- Muscarinic antagonist
- Antispasmodics for IBS
Ipratropium, tiotrupium
- Muscarinic antagonist
- COPD and asthma
Oxybutynin, solifenacin, tolterodine
- Muscarinic antagonist
- Reduce bladder spasms and urge urinary incontinence
Scopolamine
- Muscarinic antagonist
- CNS penetration: motion sickness
Albuterol
- β2 > β1 agonist
- Acute asthma
Salmeterol
- β2 > β1 agonist
- Long-term asthma or COPD control
Dobutamine
- β1 > β2, α agonist
- Heart failure (inotropic/chronotropic)
- Cardiac stress testing
Dopamine
- D1 = D2 > β > α agonist
- Unstable bradychardia, HF, shock
- Inotropic and chronotorpic α effects predominate at high doses
Epinephrine
- β > α agonist
- Anaphylaxis, asthma, open-angle glaucoma
- α effects predominate at high doses
- Way stronger at β2 receptor than norepinephrine
Isoproterenol
- β1 = β2 agonist
- Used for electrophysiologic evaluation of tachyarrhtmias
- Can worsen ischemia
- Can increase contraction and decrease vascular resistance simultaneously
Norepinephrine
- α1 > α2 > β1 agonist
- Treat hypotension (but will decrease renal perfusion)
- NO β2
Phenylephrine
- α1 > α2 agonist
- Treat hypotension, rhinitis, and use for ocular procedures
Clonidine
- α2 agonist
- Hypertensive urgency (does not decrease renal perfusion)
- ADHD, Tourette syndrome
α-methyldopa
- α2 agonist
- Hypertension in pregnancy
- Can cause Direct Coombs + hemolysis and SLE-like syndrome
Phenoxybenzamine
- α blocker, non selective, irreversible
- Pheochromocytoma preoperatively
Phentolamine
- α blocker, non selective, reversible
- Give to pt on MAOI who eats tryamine-containing food
Prazosin, terazosin, doxazosin, tamsulosin (-osin ending)
- α1 blocker, selective
- PBH, PTSD (Prazosin), hypertension (except tamsulosin)
Mirtazapine
- α2 blocker, selective
- Depression
