Autonomic Rx Flashcards
Bethanchol
1) Activates Bowel and Bladder smooth m. Post-op and neurogenic ileus and urinary retention.
2) Direct Cholinomimetic.
4) Resistant to AchE.
Carbachol
1) Glaucoma, pupillary contraction, and relief of intraocular pressure.
2) Direct Cholinomimetic.
4) Carbon copy of Ach
Pilocarpine
1) Potent stim of sweat, tears, saliva. Contracts ciliary m of eye (open angle) and pupillary sphincter (narrow angle)
2) Direct Cholinomimetic
4) Resistant to AchE
Methacholine
1) Challenge test –> dx of asthma.
2) Direct Cholinomimetic, stim muscarinic r in airway
Neostigmine
1) Post-op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular jxn blockade (post-op).
2) Indirect Cholinomimetic; increases Ach.
4) No CNS penetration
Pyridostigmine
1) Myasthenia gravis (long acting)
2) Indirect Cholinomimetic; increases Ach, increases strength.
4) No CNS penetration
Edrophonium
1) Diagnosis of myasthenia gravis (short acting).
2) Indirect Cholinomimetic; increases endogenous Ach
Physostigmine
1) Anticholinergic toxicity
2) Indirect Cholinomimetic; increases Ach.
4) crosses BBB
Donepezil
1) Alzheimers
2) Indirect Cholinomimetic; increases Ach
ADE of all Cholinomimetics
Exacerbation of COPD, asthma, and peptic ulcers
Organophosphate poisoning (e.g. Parathion)
Irreversibly inhib AchE. (DUMBBELSS) Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal m and CNS, Lacrimation, Sweating, and Salivation
Rx for Organophosphate poisoning
Atropine + Pralidoxime = regenerate active AchE
Atropine Use/MOA
1) Blocks Organophosphate poisoning. Used to treat bradycardia and opthalmic applications
2) Muscarinic antagonist.
Atropine ADE
3) Increase body temp, rapid pulse, dry mouth, dry/flushed skin, cycloplegia, constipation. Can cause acute angle-glaucoma in elderly, urinary retention in men with BPH, hyperthermia in infants
Homatropine
1) Produce mydriasis and cycloplegia
2) Muscarinic antagonist
Tropicamide
1) Produce mydriasis and cycloplegia
2) Muscarinic antagonist
Benztropine
1) Rx for Parkinsons.
2) Muscarinic Antagonist
Scopolamine
1) Motion sickness.
2) Muscarinic antagonist
Tiotropium
1) Rx for COPD, Asthma.
2) Muscarinic antagonist
Ipratropium
1) Rx for COPD, Asthma.
2) Muscarinic antagonist
Oxybutynin
1) Reduce urgency in mild cystitis and reduce bladder spasms.
2) Muscarinic Antagonist
Glycopyrrolate
1) Parenteral: preop –> reduce airway secretions. PO: Rx for drooling, peptic ulcer
2) Muscarinic Antagonist