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
Epinephrine
1) Anaphylaxis, glaucoma (open angle), asthma, hypotension
2) Sympathomimetics; A1, A2, B1, B2. LOW dose selective for B1
NE
1) Hypotension (but low renal perfusion)
2) Sympathomimetics; A1, A2 > B1
Isoproterenol
1) Torsade de pointes (tachycardia decr low QT interval), bradyarrhythmias (but can worsen ischemia)
2) Sympathomimetics; B1=B2
Dopamine
1) Shock (renal perfusion), heart failure
2) Sympathomimetic; D1 (low dose) >B (medium dose) >A (high dose), inotropic and chronotropic
Dobutamine
1) Heart failure, cardiac stress testing
2) Sympathomimetic; B1>B2, inotropic and chronotropic)
Phenylephrine
1) Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
2) Sympathomimetic; A1>A2
Albuterol
1) Acute asthma
2) Sympathomimetic; Selective B2-agonist (B2>B1)
Salmeterol
1) Long-term treatment of asthma or COPD control
2) Sympathomimetic; Selective B2-agonist (B2>B1)
Terbutaline
1) Reduce premature uterine contractions
2) Sympathomimetic; Selective B2-agonist (B2>B1)
Ritodrine
1) Reduces premature uterine contractions
2) Sympathomimetic; B2
Amphetamine
1) Narcolepsy, obesity, ADD
2) Indirect Sympathomimetic/general agonist, releases stored catecholamines
Ephedrine
1) Nasal decongestion, urinary incontinence, hypotension
2) Indirect sympathomimetic/general agonist, releases stored catecholamines
Cocaine
1) Causes vasoconstriction and local anesthesia
2) Indirect sympathomimetic/general agonist. Uptake inhibitor.
4) People use this to get high. Don’t give B-blockers if cocaine intoxication suspected.
Clonidine
1) HTN esp w renal disease (no decr in blood flow to kidney)
2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow
Alpha-methyldopa
1) HTN esp w renal disease (no decr in blood flow to kidney)
2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow
Phenoxybenzamine
1) Pheochromocytoma (b4 removing tumor)
2) Irreversible, Nonselective alpha blocker
3) Orthostatic hypotension, reflex tachycardia
Phentolamine
1) Give to pts on MAO-i who eat tyramine-containing foods
2) Reversible, Nonselective alpha blocker
Prazosin
1) HTN, urinary retention in BPH
2) A1 blocker
3) 1st dose orthostatic hypotension, dizziness, HA
Terazosin
1) HTN, urinary retention in BPH
2) A1 blocker
3) 1st dose orthostatic hypotension, dizziness, HA
Doxazoin
1) HTN, urinary retention in BPH
2) A1 blocker
3) 1st dose orthostatic hypotension, dizziness, HA
Tamsuolosin
1) HTN, urinary retention in BPH
2) A1 blocker
3) 1st dose orthostatic hypotension, dizziness, HA
Mirtazapine
1) Depression
2) A2 blocker
3) Sedation, incr serum cholesterol, incr appetite
Acebutolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Beta1-antagonist (partial Beta-agonist)
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Betaxolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Beta1-antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Esmolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Beta1-antagonist (short acting)
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Atenolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Beta1-antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Metoprolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Beta1-antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Propanolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Non-selective B-antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure sleep alteration). Use with caution in diabetics
Timolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Non-selective B-antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Pindolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Non-selective B-antagonist (partial B-agonist)
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Labetalol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma
2) Non-selective A and B antagonist
3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Carvedilol
Non-selective A and B antagonist
Nadolol
Non-selective B antagonist