autonomic drugs Flashcards

1
Q

hemicholinium

effect on neuron

A

(-) choline uptake in neuron

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2
Q

vesamicol

effect on neuron

A

(-) ACh packaging into vesicle

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3
Q

botulinim

effect on neuron

A

(-) ACh vesicle release

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4
Q

metyrosine

effect on neuron

A

(-) tyrosine to DOPA

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5
Q

reserpine

effect on neuron

A

(-) dopamine to NE

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6
Q

bretylium
guanethidine
(effect on neuron)

A

(-) NE release

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7
Q

amphetamine
ephedrine
(effect on neuron)

A

(+) NE release

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8
Q

cocaine
TCA
amphetamine
(effect on neuron)

A

(-) NE reuptake

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9
Q

bethanechol

A

direct cholinergic agonist

ileus, urinary retention

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10
Q

carbachol

A

direct cholinergic agonist

constrict pupil
glaucoma

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11
Q

methacholine

A

direct cholinergic agonist

challenge test for dx of asthma

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12
Q

pilocarpine

A

direct cholinergic agonist

(+) sweat, tears, saliva
glaucoma

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13
Q

donezepil
galantamine
rivastigmine

A

indirect cholinergic agonist - anticholinesterase

alzheimer’s

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14
Q

echothiophate

A

indirect cholinergic agonist - anticholinesterase

glaucoma

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15
Q

edrophonium

A

indirect cholinergic agonist - anticholinesterase

dx MG

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16
Q

neostigmine

A

indirect cholinergic agonist - anticholinesterase

ileus, urinary retention
MG
reversal of NMJ blockade

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17
Q

physostigmine

A

indirect cholinergic agonist - anticholinesterase

anticholinergic toxicity (atropine)

crosses BBB

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18
Q

pyridostigmine

A

indirect cholinergic agonist - anticholinesterase

MG

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19
Q

cholinesterase inhibitor poisoning

A

organophosphate poisoning - “drooling farmer”

diarrhea 
urination 
miosis
bronchospasm 
bradycardia
excitation of CNS & sk m
lacrimation 
sweating 
salivation 

antidote: atropine + pralidoxime

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20
Q

pralidoxime

A

cholinesterase regenerator

organophosphate poisoning

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21
Q

atropine
homatropine
tropicamide

A

muscarinic antagonist

mydriasis
cycloplegia

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22
Q

benztropine

A

muscarinic antagonist

parkinson disease

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23
Q

glycopyrrolate

A

muscarinic antagonist

preop. to reduce airway secretions

24
Q

hyoscyamine

dicyclomine

A

muscarinic antagonist

antispasmotic for IBS

25
Q

ipratropium

tiotropium

A

muscarinic antagonist

COPD, asthma (decreases bronchoconstriction)

26
Q

oxybutynin
solifenacin
tolterodine

A

muscarinic antagonist

reduce bladder spasms & urge incontinence

27
Q

scopolamine

A

muscarinic antagonist

motion sickness
dec. oral secretions

28
Q

atropine

A

muscarinic antagonist

trx bradycardia, ophthalmic applications, organophosphate poisoning

AE: dryness, hyperpyrexia, flushing, cycloplegia, mydriasis, urinary retention, constipation, delirium

29
Q

drugs w/ antimuscarinic effects

A
atropine 
antidepressants 
H1 Rc antagonists 
neuroleptics 
anti-parkinson drugs
30
Q

albuterol

salmeterol

A

direct sympathomimetic

B2 > B1

acute asthma (albuterol)
long term asthma & COPD control (salmeterol)
31
Q

dobutamine

A

direct sympathomimetic

B1 > B2, a

HF
cardiac stress testing

32
Q

dopamine

A

direct sympathomimetic

D1, D2 = low dose, B = med dose, a = high dose

unstable bradycardia, HF
shock

33
Q

epinephrine

A

direct sympathomimetic

B1, B2, a1, a2

anaphylaxis
asthma
open-angle glaucoma

34
Q

isoproterenol

A

direct sympathomimetic

B1, B2

evaluation of tachyarrhythmias

AE: can worsen ischemia

35
Q

norepinephrine

A

direct sympathomimetic

a1 > a2 > B1

hypotension
septic shock, cardiogenic shock

AE: decreases renal perfusion

36
Q

phenylephrine

A

direct sympathomimetic

a1 > a2

hypotension (vasoconstrictor) 
ocular procedures (mydriatic)
rhinitis (decongestant)
37
Q

amphetamine

A

indirect sympathomimetic
general agonist - (+) NE release from presynaptic terminals

narcolepsy
obesity (dec. appetite)
ADHD

38
Q

cocaine

A

indirect sympathomimetic
general agonist - (-) NE reuptake

vasoconstriction 
local anesthesia 
nasal congestion (decongestant)

*never give B-blocker if cocaine use – unopposed a1 activation – extreme hypotension

39
Q

ephedrine

A

indirect sympathomimetic

general agonist - (+) NE release from presynaptic terminals

40
Q

clonidine

A

a2 agonist

hypertensive urgency (does not decrease renal blood flow)
ADHD
tourette syndrome

AE: CNS depression, bradycardia, hypotension, respiratory depression, miosis

41
Q

a-methydopa

A

a2 agonist

HTN in pregnancy

AE: direct coombs hemolysis, SLE-like syndrome

42
Q

phenoxybenzamine

A

nonselective a blocker, irreversible

pheochromocytoma - prevent catecholamine crisis during surgical removal

AE: orthostatic hypotsnsion, reflex tachycardia

43
Q

phentolamine

A

nonselective a blocker, reversible

pts on MAOI who eat tyramine containing foods

AE: orthostatic hypotension, reflex tachycardia

44
Q

prazosin
terazosin
dixazosin
tamulosin

A

a1 blocker

urinary sxs of BPH
PTSD
HTN (tamsulosin causes bladder sphincter relaxation but no effect on BP)

AE: 1st dose orthostatic hypotension, dizziness, HA, refle tachycardia

45
Q

mirtazapine

A

a2 blocker

depression

AE: sedation, inc cholesterol, inc appetite

46
Q

B-blocker application

A

angina –> dec HR & contractility = dec O2 consumption
MI –> dec mortality
SVT –> dec AV conduction velocity (class II antiarrhythmic)
HTN –> dec CO, dec renin
chronic HF –> dec mortality
glaucoma –> dec secretion aqueous humor

47
Q

acebutolol

A

B1 selective blocker

partial agonist

48
Q

atenolol

A

B1 selective blocker

49
Q

betaxolol

A

B1 selective blocker

50
Q

esmolol

A

B1 selective blocker

51
Q

metoprolol

A

B1 selective blocker

52
Q

nadolol

A

non-selective B-blocker

53
Q

pindolol

A

non-selective B-blocker

partial agonist

54
Q

propranolol

A

non-selective B-blocker

55
Q

timolol

A

non-selective B-blocker

56
Q

carvedilol

A

nonselective a- & B- blocker

57
Q

labetalol

A

nonselective a- & B- blocker