Autonomic Drugs III Flashcards
atropine MOA
muscarinic antagonist
used to tx bradycardia
and for ophthalmic applications
affects of atropine
eye - pupil dilation and cycloplegia (paralysis eye mm) airway - decreased secretion stomach - decreased acid secretion gut - decreased motility bladder - decreased urgency
atropine toxicity
hot as hare dry as bone red as beet blind as bat mad as hatter
increased body temp, rapid pulse, dry pulse, dry flushed skin, cycloplegia, constipation, disorientation
atropine toxicity
tetrodotoxin
binds fast voltage gated Na channels - cardiac and nerve tissues
prevents depolarization
nausea, dizziness, paresthesias, weakness, loss of reflexes
poorly prepared pufferfish
tetrodotoxin
binds fast voltage gated Na channels cardiac and nerve tisue
ciguatoxin
fish poisoning - consumption of reef fish - barracuda, snapper, moray eel
opens Na channels - depolarization
temp dysesthesia - cold feels hot, hot feels cold**
scombroid poisoning
acute onset - burning sensation of moth, flushing face, erythema, urticaria, pruritis, headache
consumption of dark meat fish - bonito, mackeral, mahi-mahi, tuna - stored at warm temp
bacterial histidine decarboxylase - converts histidine to histamine
albuterol
beta2 > beta1 agonist
acute asthma
salmeterol
beta2 > beta1 agonist
long term asthma
dobutamine
beta1 > beta2, a agonist
HF
cardiac stress testing
dopamine
D1 = D2 > B > a
agonist
inotropic and chronotropic - at high doses
epinephrine
B > a
agoinst
anaphylaxis
asthma
open angle glaucoma
a - at high doses
and stronger B2 effect
isoproterenol
non-selective B agonist
B1 = B2
norepinephrine
a1 > a2 > B1 agonist
tx hypotension
weak at B2
phenylephrine
a1 > a2 agonist
hypotension
amphetamine
sympathomimetic indirect
indirect general agonist - reuptake inhibitor
cocaine
agnonist sympathetic
reuptake inhibitor
CI with cocaine intox
beta-blocker
-unopposed a1 activation - extreme hypertension
ephedrine
general sympathetic agonist
release stored catecholamines
NE vs. isoproterenol
NE - a1 vasoconstriction
iso - B2 vasodilation
NE - increased MAP - reflex bradycardia
iso - decreased MAP - increased HR - reflex tachy
clonidine
a2 agonist
a-methyldopa
a2 agonist
tx HTN in pregnancy
phenoxybenzamine
irreversible a-blocker
tx of pheochromocytoma
-preop - prevent HTN crisis
phentolamine
reversible a-blocker
tx of tyramine MAO interaction
prazosin
a1 antagonist
terazosin
a1 antagonist
doxazosin
a1 antagonist
tamsulosin
a1 antagonist
tx PTSD
prazosin - a1 blocker
tx of BPH urinary sx
a1 blocker - prazosin
mirtazapine
a2 blocker
tx of depression
phenylephrine vs. epinephrine
E - a and B agoinst
P - only a-agonist
when give phentolamine - a block
- E - reversal of MAP - B effect
- P - suppression, not reversal of MAP - bc only a
tx of SVT
metoprolol and esmolol -class II antiarrhythmic
glaucoma tx
timolol - beta blocker - decreased aqueous humor production
B1 on kidney
increased renin secretion
beta-blocker - block this
beta1 selective antagonists
acebutolol, atenolol, betaxolol, esmolol, metoprolol
A > M
non-selective beta antagonists
nadolol, pindolol, timolol, propanolol
N > Z
cardevilol
a and B antagonist
labetalol
a and B antagonist
nebivolol
combine B1 block with B3 stimulation - activate nitric oxide synthase in vasculature
