autonomic drugs Flashcards
bethanechol use
postoperative ileus, neurogenic ileus, urinary retention
bethanechol action
activates bladder and bowel smooth muscle
carbachol use
glaucoma, pupillary contraction, relief of intraocular pressure
pilocarpine
stimulates sweat, tears and saliva
pilocarpine action
contracts ciliary muscle and pupillary shpincter - resistant to AChE
methacholine use
challenge for dx of asthma
neostigmine use
postp[ and neurogenic ileus/urinary retention
MG
reversal of NMJ blockade in surgery
Neostigmine action
increases endogenous ACh (does not penetrate CNS)
pyridostigmine use
MG (does not penetrate CNS)
edrophonium use
dx of MG
edrophonium action
increases endogenous ACh
use of physiostigmine
anticholergenergic tox (crosses BBB) atropine OD
physiostigmine action
increases endogenous ACh
donepezil
alzheimer’s dx
donepezil action
increase endogenous ACh (crosses into CNS)
tox of cholinomimetic agents
worsens COPD, asthma, and PUD
antidote for cholinesterase inhibitor poisoning
atropine + pralidoxime
atropine, homatropine.tropacamide use
produceses mydrasis and cycloplegia (muscarinic antagonist)
benztropine use
parkinson’s (muscarinic antagonist)
scopolamine use
motion sickness (muscarinic antagonist)
ipratropium use
COPD, asthma (muscarinic antagonist)
oxybutin use
reduce bladder urgancy in mild cystitis and reduce bladder spasms (muscarinic antagonist)
glycoyrrolate use
preop to reduce airway secretions (muscarinic antagonist)
drooling, peptic ulcer
atropine actions
increases pupil dilation and cycloplegia,
lowers airway secretions,lowers stomach acid secretion, and gut motility, reduces cystitis urgency
atropine MOA
muscarine antagonist
atropine tox
increased body temp, rapid pulse and dry mouth, dry, flushed skin, cycloplegia, constipation, disorientation. urinary retention with prostatic hyperplasia, actute angle closure glaucoma in elderly
plant that can cause atropine tox
Jimson weed
epi effects on symapthatic receptors
big increases: a1, a2, b1, B2
NE effects on symapthatic receptors
big increase on a1, A1, some at B1
isoprotenerol effects on symapthatic receptors
big on B1, B2
isoprotenerol use
torsade de pointes abd bradyarrithmia
isoprotenerol tox
shrink QT interval, can worsen cardiac ischemia
dopamine effects on symapthatic receptors
big effects on all receptors
dopamine use (non CNS)
shock (RENAL PEFUSION!!) heart failure, inotropic and chronotropic
dobutamine effects on symapthatic receptors
slight on a1,a2, B2
large on B1
dobutamine use
HF, cardiac stress test, inotropic and chronotropic
phenylephrine effects on symapthatic receptors
big on a1, slight on a2
phenlyephrine use
hypoension and used in ocular procedures
decongestant
albuterol, salmeterol, terbutaline effects on symapthatic receptors
large on B2, some B1
metaproterenol and albuterol use
acute asthma
salmeterol use
long term asthma or COPD
terbutaline use
premature labor
ritodrine effects on symapthatic receptors
BIG on B2
ritodrine use
premature labor
NEVER give these to cocaine PD pts (why?)
beta blockers (can lead to unopposed a1 activation and extreme hypertension)
clonidine/a-methyldopa use
hypertenion with renal dx
clonidine/a-methyldopa action
central acting a2 agonist - lower sympathtic outflow
phenoxybenzamine use
pre pheo tumor surgery (will block the inevitable release of cathecolamines during surgery) - non selective irreversable alpha blocker
phenoxybenzamine tox
orthostatic hypotension, reflex tachycardia
phentolamine use
MAOi crisis (reversiable non-selective alpha blocker)
-osin (ex: prazosin) use
hypertension, urinary retention in BPH
prasozin tox
will cause orthostatic hypotension with first use (a1 blocker)
dizziness, headache
mirtazapine use
depression
mirtazapine tox
sedation, high cholesterol, increased appitite
uses of Beta blockers (olol)
angina (lowers HR and contractibility)
MI (lowers mortality)
SVT (lowers AV conduction velocity)
hypertension (reduces CO and renin section due to b1 receptor blockade on JGA cells)
CHF (slows progression)
glaucoma (lowers secretion of aqueous humor)
beta blockers for SVT
metoprolol, esmolol
beta blocker for glaucoma
timolol
beta blocker tox
impotence, asthma, CV adverse avents, seizures, sedation, sleep alterations, -caution in diabetics
B1 selective agents
ABEAM (acebutolol, betaxolol, esmolol, atenolol, metoprolol)
non selective Beta blockers
propanolol, timolol, nadalolol, pindolol
partial B agonists
pindolol, acebutolol