Autonomic Drugs Flashcards
Bethanechol
Cholinergic Agonist that stimulates the smooth muscle in the GI tract and bladder.
Use: non obstructive urinary retention
Carbachol
Cholinergic Agonist that is used to decrease IOP, not used too much
Methacholine
Cholinergic Agonist
Use: Diagnostic test for pre-asthmatics
Pilocarpine/Cevimeline
Use: Sjogrens
Pilocarpine sometimes used to reduce IOP
Physostigmine
tertiary amine that reversibly inactivates Ach-ase
SE: can cause convulsions
Pyridostigmine/Neostigmine
quaternary amine that inactivates the enzyme Ach-ase
Use: myasthenia gravis
Use: reverses non-depolarizing relaxants
Overdose: treat with atropine and pralidoximine
Edrophonium
Use: diagnostic test for myasthenia gravis
Ambenonium
Use: alternative tx for myasthenia graves for those sensitive
Donepezil/Rivastigmine
Use: tx for mild-moderate Alzheimer’s (for the low cholinergic neurons)
Parathion/Malathion
Irreversible Ach-ase inhibitor that can cause toxicity in humans via insecticides
Tx for overdose: Pralidoxime
Atropine
Anticholinergic that acts as a competitive antagonist at receptor in both CNS and PNS
Tropicamide
Anticholinergic that dilates the eye and paralyzes accommodation
Much shorter half-life than atropine
Scopalamine
Anticholinergic used for motion sickness
Benztropine
Anticholinergic for Parkinson’s under the theory that dopamine is low and Ach is too high
Tolteridine/Oxybutynin
reduce urgency in cystitis to reduce bladder spasms
Amphetamine
Adrenergic that indirectly enhances catecholamine release from adrenergic nerve terminals with A1/B1 effects
Uses: narcolepsy, ADHD, weight loss
Tyramine
adrenergic found in red wine and cheese, enhances release of NE from adrenergic nerve terminals like amphetamines
Normally metabolized by MAO, so if pt is taking MAOI then can result in hypertensive crisis
Cocaine
adrenergic that blocks the reuptake of NE
Ephedrine
mixed-adrenergic that enhances effects of NE but also has A and B effects like Epi
Phenylephrine
A1 agonist that causes mydriasis WITHOUT paralysis of accommodation
Phenoxybenzamine
Irreversible (non-selective) anti adrenergic that causes alpha mediated response to sympathetic discharge
SHIFTS DOSE RESPONSE CURVE DOWN
Uses: pheochromocytoma
Phentolamine
Reversible (Non-Selective) anti-adrenergic
Uses: pheochromocytoma
Prazosin/Tamsulosin
Reversible A1 Selective
Uses: Zosin’s used for hypertension
Tamsulosin used for BPH to block A1a receptors in the urinary tract
A-M olol’s
B1 specific blockers = decrease in HR, SV, CO, Renin release
mask tachycardia associated with hypoglycemia in diabetics
N-Z olol’s
Non-specific adrenergic antagonists
Decrease in HR, renin release, bronchospasm, decrease in aqueous humor production, increase in LDLs, block glycogenolysis, gluconeogenesis, mask tachycardia associated with hypoglycemia in diabetics
Labetalol/Carvidilol
A1 and Beta Blockers
Use: CHF (carvidilol) and in hypertensive emergencies (labetalol)
Pindolol/Acebutolol
B1 and B1/B2 PARTIAL agonist respectively but competes with NE so acts as an antagonist
lowers risks of increased LDLs
