Autonomic Drugs Flashcards
Bethanechol
Direct cholinomimetic
Act bowel and bladder smooth muscle
Uses: post-op or neurogenic ileus or urinary retention
Carbachol
Direct cholinomimetic
Constricts pupil to relieve intraocular pressure
Uses: open angle glaucoma
Methacholine
Direct cholinomimetic
Bronchospasm
Uses: meth challenge to diagnose asthma (inhaled)
Pilocarpine
Direct cholinomimetic
Contracts ciliary muscle, contracts pupillary sphincter, induces tears, sweat and saliva
Uses: open angle glaucoma, closed angle glaucoma, Sjogrens
*crosses BBB
Galantamine, donepizil, rivastigmine
Anticholinesterase
Uses: Alzheimers
Edrophonium
Anticholinesterase
Uses: MG diagnosis (now use antibody detection more often)
Neostigmine
Anticholinesterase
Quaternary (no CNS)
Uses: MG, post-op ileus or urinary retention, reverse NMJ blockade
Physostigmine
Anticholinesterase
Tertiary (“phree to cross BBB” hydrophilic)
Uses: antidote for atropine OD
Pyridostigmine
Anticholinesterase
Inc muscle strength, quaternary (no CNS)
Uses: MG (long acting)
Atropine, homatropine, tropicamide
Muscarinic Antagonist
Dilation and cycloplegia (paralyze ciliary muscle) in eye
Benztropine, trihexyphenidyl
Muscarinic Antagonist
CNS - Parkinsons and acute dystonia
Glycopyrrolate
Muscarinic Antagonist
GI, respiratory
Uses: give PN to dec gut secretions pre-operatively or orally for peptic ulcers or drooling
Hyoscyamine, Dicyclomine
Muscarinic Antagonist
GI
Uses: anti-spasm for irritable bowel
Ipratropium, tiotropium
Muscarinic Antagonist
Respiratory
Uses: COPD and asthma
Oxybutynin, solifenacin, tolterodine
Muscarinic Antagonist
GU
Uses: dec bladder spasm and urge incontinence (overactive bladder)
Scopalamine
Muscarinic Antagonist
CNS
Uses: motion sickness
Atropine
Muscarinic Antagonist
Eye - pupil dilation and cycloplegia
Airway - dec secretions
Stomach - dec acid secretion
GI - dec motility
Bladder - dec urgency in cystitis
Albuterol, salmeterol
Sympathomimetics
B2 > B1
Uses: asthma and COPD (albuterol acute and salm longer)
Dobutamine
Sympathomimetic
Beta 1 > Beta 2 > alpha
Uses: HF and stress test (inc contractility more than HR)
Dopamine
Sympathomimetic
D1 = D2 > beta > alpha
Beta effects - brady, HF, shock
Alpha - (HIGH DOSE) vasoconstriction
Epi
Sympathomimetic
Beta > alpha
Uses: anaphlyaxis and asthma (open airway and alpha vasoconstriction to counteract histamine vasodilation), inc HR and contractility to also overcome hypotension (beta)
Overall inc in MAP, PP and CO but mostly due to inc CO from beta 1 effects
Fenoldopam
Sympathomimetic
D1
Uses: post-op HTN or hypertensive crisis (inc coronary, renal, splanchnic and peripheral pressures)
Isoproterenol
Sympathomimetic
Beta 1 = Beta 2
Uses: electrical eval of tachy
Since all beta, causes dec MAP and large pulse pressure from vasodilation BUT also huge inc CO b/c beta 1 effects and reflexive tachy from the dec pressure
Midodrine
Sympathomimetic
Alpha 1
Uses: autonomic insufficiency and orthostatic hypotension
Mirabegron
Sympathomimetic
Beta 3
Uses: overactive bladder or urge incontinence
Norepinephrine
Sympathomimetics
Alpha 1 > alpha 2 > beta 1
Uses: hypotension and septic shock
Overall causes huge inc in MAP and PP but just from the alpha 1 effects; no inc CO from beta and actually reflex bradycardia so dec HR
Phenylephrine
Sympathomimetic
Alpha 1 > alpha 2
Uses: Hypotension, dilation of eye for procedures, rhinitis (decongestant by dec blood flow)
Amphetamine
Indirect Sympathomimetic
Reuptake inhibitor and gets into pre-synapse via NET –> displace NE from vesicles –> inc NE conc in cytoplasm –> reverses NET –> NE released into synapse in bulk
Uses: narcolepsy, obesity, ADHD
Cocaine
Indirect Sympathomimetic
Reuptake inhibitor
Uses: vasoconstriction and local anesthesia
Ephedrine
Indirect Sympathomimetic
Also releases stored NE
Uses: nasal congestions, urinary incontinence, hypotension
Clonidine, guanfacine
Alpha 2 agonist (sympatholytic)
Uses: hypertensive urgency, ADHD, Tourettes
Alpha - methyldopa
Alpha 2 agonist (sympatholytic)
Uses: HTN in preg
Non- selective alpha blockers
Phenoxybenzamine - irreversible; for pheo and HTN crisis
Phentolamine - reversible; if on MAO and eat tyrosine
Alpha 1 Blockers
-osins
Prazosin, terazosin, doxazosin, tamsulosin
Uses: urinary prob w/ BPH, PTSD (prazosin), HTN (not tam)
Mirtazapine
Alpha 2 selective blocker
Depression
Beta 1 Antagonists
MET a BABE who’s an ACE (or think early alpha A - M)
Metoprolol, acebutolol, bisoprolol, atenolol, betaxolol, esmolol
Uses: dec mortality in HF/MI, dec CO and renin for HTN, dec contractility and HR to dec O2 demand if angina, dec AV conduction for arrhythmias
Non-selective Beta Blockers
Late Alpha (N - Z)
nadolol, propranolol, pindolol, timolol
Uses: also beta 2 so dec aqueous humor for glaucoma, dec portal HTN if esophageal varices
Beta Blockers that are also Alpha Blockers
DIFF SUFFIX
carvedilol, labetalol
