Autonomic Drugs Flashcards by Sarah Hogan

Bethanechol

Direct cholinomimetic

Act bowel and bladder smooth muscle

Uses: post-op or neurogenic ileus or urinary retention

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Carbachol

Direct cholinomimetic

Constricts pupil to relieve intraocular pressure

Uses: open angle glaucoma

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Methacholine

Direct cholinomimetic

Bronchospasm

Uses: meth challenge to diagnose asthma (inhaled)

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Pilocarpine

Direct cholinomimetic

Contracts ciliary muscle, contracts pupillary sphincter, induces tears, sweat and saliva

Uses: open angle glaucoma, closed angle glaucoma, Sjogrens

*crosses BBB

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Galantamine, donepizil, rivastigmine

Anticholinesterase

Uses: Alzheimers

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Edrophonium

Anticholinesterase

Uses: MG diagnosis (now use antibody detection more often)

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Neostigmine

Anticholinesterase

Quaternary (no CNS)

Uses: MG, post-op ileus or urinary retention, reverse NMJ blockade

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Physostigmine

Anticholinesterase

Tertiary (“phree to cross BBB” hydrophilic)

Uses: antidote for atropine OD

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Pyridostigmine

Anticholinesterase

Inc muscle strength, quaternary (no CNS)

Uses: MG (long acting)

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Atropine, homatropine, tropicamide

Muscarinic Antagonist

Dilation and cycloplegia (paralyze ciliary muscle) in eye

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Benztropine, trihexyphenidyl

Muscarinic Antagonist

CNS - Parkinsons and acute dystonia

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Glycopyrrolate

Muscarinic Antagonist

GI, respiratory

Uses: give PN to dec gut secretions pre-operatively or orally for peptic ulcers or drooling

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Hyoscyamine, Dicyclomine

Muscarinic Antagonist

Uses: anti-spasm for irritable bowel

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Ipratropium, tiotropium

Muscarinic Antagonist

Respiratory

Uses: COPD and asthma

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Oxybutynin, solifenacin, tolterodine

Muscarinic Antagonist

Uses: dec bladder spasm and urge incontinence (overactive bladder)

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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

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