autonomic nervous system Flashcards
atropine toxicity s/s
red as a beet, dry as a bone, blind as a bat, mad as a hatter
atropine toxicity treatment
physostigmine - anticholinesterase inhibitor
pralidoxime helps w muscle weakness
AE of catecholamines
increased myocardial O2 demand
myocardial ischemia
epinephrine vasopressor effects
vasopressor initially but may lead to vasodilation over time
isoproterenol MOA
nonselective B agonist
positive inotrope and chronotrope
rarely used
B2 selective agonists indication
bronchodilation in asthma/COPD
inhalation
SABA - albuterol
LABA - salmeterol
B3 receptor agonist name and indication
mirabegron
overactive bladder
midodrine MOA
alpha-1 selective agonist
alpha-1 selective agonists in CNS
modafinil, armodafinil
increases wakefulness QAM
narcolepsy, shift work disorder, OSA
alpha-2 receptor agonists in CNS
poorly understood mechanism to decrease BP
clonidine
methyldopa
others used for glaucoma & HTN & muscle relaxant
indications for indirect acting sympathomimetics
ADHD, narcolepsy, weight loss
should be used cautiously
schedule II - high abuse potential
non-selective alpha antagonists
phenoxybenzamine, phentolamine
limited by tachyphylaxis long term
short term use for HTN
very limited use
selective alpha-1 antagonist use
BPH (tamsulosin)
prazosin - nightmares in PTSD
when are nonselective B blockers bad?
COPD and asthma - block B2
B1 selective blockers indications
cardiac
MI HF angina HTN atrial arrhythmias - AF, SVT
nonselective B blockers indications
migraines, tremor, glaucoma, stage fright, anxiety, acute hyperthyroidism
B blockers AE
insomnia, sleep disturbance, hypoglc s/s, increased BG, bronchospasm, erectile dysfunction, bradycardia/heart block, worsen CHF at high doses
indication for indirect acting cholinesterase inhibitors
alzheimer’s,
also glaucoma, MG, neurogenic bladder
cholinergic effects
miosis (pupil contraction) slow CHV conduction broconstriction increase GI motility promote blatter utility increased salivation
indications for direct acting cholinomimetics
rarely seen
neurogenic bladder, glaucoma, xerostomia, induce miosis
example of anti-nicotinic agents
neuromuscular junction blockers
short acting B2 agonist
albuterol
long acting beta 2 selective agonists
salmetereol, formoterol, indacaterol, olodaterol, vilanterol
more selective for B2 than albuterol
beta blockers with alpha-blocking activity
labetalol and carvedilol
