Autonomic Drugs Flashcards
Antidote for Atropine Overdose
Physostigmine
Symptoms of Muscarinic Agonist Overdose
DUMBBELS (or SLUDGE)
- Diarrhea
- Urination
- Miosis
- Bradycardia
- Brohchosecretions
- Emesis (vomiting/nausea)
- Lacrimation
- Salivation
Methacholine
“Marathon Challenge”
- Choline Ester
- Muscarinic Agonist
- Induces Bronchospasms for Asthma Challenge Test
M3 Receptor Locations
Smooth Muscle, Exocrine Glands, Vascular Endothelium
Verenicline
“1-800-Very-Clean”
- Partial Nicotinic Agonist
- Used to treat nicotine addiction
Carbachol
“Closed hoodie to protect from Carbon fumes from Nicotine smoker”
- Choline Ester
- Muscarinic and Nicotinic agonist
- Used to induce miosis (pupil constriction) during ocular surgery
Succinylcholine
- Depolarizing Muscle Relaxer
- Tightly binds to Nicotinic receptor at Neuromuscular Junction and causes deplolarization and depletion of all calcium
- Use to paralyze muscles in short surgeries
Botox
- Destroys Ach vesicles and prevents release at Neuromuscular Junction
- Causes flacid paralysis
Alpha-Latrotoxin
- Black widow venom
- Causes massive release of Ach
- Causes depolarizing paralysis
Diazinon
- Organophosphate that Irreversibly Binds Acetylcholinesterase
- Nerve gas
- Will kill you
Pilocarpine
“Pile-of-Carp-ine”
- Alkaloid
- Muscarinic Agonist
- Used to treat glaucoma and Sjorgeren’s Syndrome
Antidote for Acetylcholinesterase Inhibitor Overdose
Atropine
Pyridostigmine
- Carbamate Acytocholinesterase Inhibitor that does not penetrate CNS
- Treatment for Myasthenia Gravis
- Antidote to Curare Overdose
- Can treat glaucoma
Acytocholinesterase Inhibitor Overdose
DUMBBELS + Muscle Paralysis/Cramping/Fasiculations
Ipratropium
“Cat-ipra-tro-pillar”
- Synthetic Muscarinic Antagonist
- Quarternary - does not get into CNS
- Causes pupil dilation, increases HR, etc
Treatment for Organophosphate Poisioning
2-Pralidozime (2-PAM)
Atropine (for CNS)
Antidote for Tubocurarine Overdose
Neostigmine or Pyridostigmine (Acetocholinesterase Inhibitor)
Antidote to Malignant Hyperthermia
Dantrolene
Trimethaphan
- Blocks Ganglionic Nicotinic Receptor
- Used to rapidly decrease blood pressure by inhibiting sympathetics (you inhibit parasympathetics too, but VSM has sympathetic tone)
Antidote for Acetocholinesterase Inhibitor Overdose
Atropine
Scopolamine
“Walrus with Scope”
- Alkaloid Muscarinic Antagonist
- Treats motion sickness
- Causes pupil dilation
Potential problems with Succinylcholine
Hyperkalemia and Malignant Hyperthermia
Atropine
- Alkaloid - can get into CNS
- Muscarinic Antagonist
- Reduces vagal tone (increase HR)
- Can be used to stop heart block
- Treat diarrhea
- Dilates pupil
Effects of Stimulating Nicotinic Receptors
- Skeletal Muscle Contraction
- Epinephrine secretion from Adrenal Glands
- Action Potentials in Post-Synaptic Autonomic Ganglia
Pralidozime
Binds to organophosphate and removes it from Acetylcholinesterase
Antidote to Organophosphate poisioning
Explain Process of Nitric Oxide Mediated Vasodilation
M3 Receptors on Vascular Endothelium trigger Calcium influx, which stimulates NO-Synthase to produce Nitric Oxide from Arginine.
Nitric Oxide causes vasodilation in nearby smooth muscle by stimulating an increase in cGMP
cGMP is degraded by Phosphodiesterase
PDE5 is the main Phosphodiesterase in the penis, and it can be inhibited with Sildenafil to maintain erections
Symptoms of Muscarinic Antagonist Overdose
- “Dry as a Bone” - dry skin, eyes, mouth
- “Red as a Beet” - vasodilation in skin
- “Hot as a Hare” - no sweating
- “Blind as a Bat” - no accomidation, increased ocular pressure
- “Mad as a Hatter” - seizure, coma
M1 Receptor Locations
Brain, Enteric Nervous System (gut)
Neostigmine
- Carbamate Acytocholinesterase Inhibitor that does not penetrate CNS
- Treatment for Myasthenia Gravis
- Antidote to Curare Overdose
- Can treat glaucoma
Cevimeline
- Synthetic Muscarinic Agonist
- Used to treat Sjorgren’s Syndrome
M2 Receptor Locations
Heart (SA and AV Nodes, Atrium)
Cure for Succinylcholine Overdose
None; wait it out and put patient on ventilator
Edrophonium
“Phone booth testing for Myasthenia Gravis”
- Short-acting Acetylcholinesterase Inhibitor
- Used to diagnose Myasthenia Gravis
Tubocurarine
“Curare Crayons blocking the end-plate socket”
- Competitive blocker of the Neuromuscular Junction
- Quarternary compound
- Binds nicotinic receptors and leaves muscles in flacid state
- Long acting, used to paralyze muscles during surgery
Bethanechol
“Beth holding bladder firehose and colon cement mixer”
- Choline Ester
- Muscarinic Agonist
- Treatment for Urinary Retention or used to get GI tract moving again after surgery
Physostigmine
- Carbamate Acytocholinesterase Inhibitor that rapidly penetrates CNS
- Treatment for Atropine Poisioning
- Treats Alzheimer’s and Dementia
- Can treat glaucoma
