Autonomics Flashcards
Hemicholinium
Blocks transport of choline into neurons. No acetylcholine synthesis
Vesimacol
Prevents loading of Ach into vesicles
Botulinum
Blocks release of Ach vesicles
Metyrosine
Blocks conversion of tyrosine to dopa
Reserpine
Blocks packaging of dopamine into vesicles
Bethanecol
Muscarinic agonist that moves bowel and bladder. Used for postop ileus and urinary retention
Carbachol
Used for glaucoma and relief of intraocular pressure.
Pilocarpine
Used for glaucoma. Stimulates sweat, tears, soliva
Methacholine
Used to bronchoconstrict for asthma tests
Neostigmine
ACHe inhibitor used to reverse neuromuscular blockade. Also used in myesthenia gravis. NO CNS penetration
Physostigmine
Penetrates CNS, used in atropine poisoning.
Pyridostigmune
used for myesthenia gravis
Donepezil, rivastigmine, galantamine
Ache inhibitors used to increase cognitive ability
Edrophonium
Short lasting ache inhibitor used to diagnose MG
Cholinesterase inhibitor poisoning
Organophosphates irreversibly inhibit ACHE. Causes bradycardia, bronchoconstriction, diarrhea, lacrimation, unination, miosis, salivation.
Treat with atropine and pralidoxime.
Poisoning usually seen in farmers.
Atropine
Muscarinic antagonist used for the eye. Causes mydriasis and cycloplegia
Benztropine
Antimuscarinic used for PD
Scopolamine
Antimuscarinic used for motion sickness
Ipratropium/tiotropium
Used for asthma/COPD
Oxybutynin/darifenacin/solifenacin
Used to reduce urgency in cystitis
Glycopyrollate
Preoperative use to reduce airway secretions. Also used in peptic ulcers
Epinephrine
Beta>alpha.
Norepinephrine
a1>a2>b
Isoproterenol
B1=b2 agonist
Dopamine
D1=D2>b>a.
Dobutamine
B1>b2=a. Used for heart failure. Has inotropic effects.
Phenylephrine
A1>a2
Albuterol
B2>b1
Treat cocaine intoxication with beta blockers?
NO WAY! unopposed alpha effects can lead to extreme hypertension
A2 agonists
Clonidine = used for hypertensive urgency, also ADHD and severe pain
Methyldopa - used to treat hypertension in pregnancy
Methyldopa side effects
Coombs positive hemolytic anemia, SLE like syndrome
Nonselective Alpha blockers
Phenoxybenzamine (irreversible)- used to treat pheochromocytoma
Phentolamine (reversible) - used in tyramine crisis
A1 selective alpha blockers
Prazosin, tamulosin, doxazosin. Used to treat the urinary symptoms of bph (relax bladder). Prazosin also used to treat PTSD.
Can cause first dose hypertension, dizziness, headache
A2 blocker
Mirtazepine used for depression
Sedation, increased serum cholesterol, increased appetite
B1 selective antagonists
Acebutolol, betaxolol, carvedilol, esmolol, atenolol
Non selective beta antagonists
Nadolol, pindolol, propanolol, timolol
Nonselective alpha and beta antagonists
Carvedilol, labetalol
Toxicity of beta blockers
Impotence, sedation, depression, dyslipidemia (metoprolol). CAN use in diabetics regardless of theoretical risks.