Copy of Autonomic Rx - Autonomic Flashcards
Bethanchol
1) Activates Bowel and Bladder smooth m. Post-op and neurogenic ileus and urinary retention.
2) Direct Cholinomimetic.
4) Resistant to AchE.
“Bethany call me if you want to move your bowel and bladder”
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. Use in Open-angle and Closed-angle Glaucoma. Contracts ciliary m of eye (open angle) and pupillary sphincter (narrow angle)
2) Direct Cholinomimetic
4) Resistant to AchE
“cry, drool, and sweat into your PILO”
Methacholine
1) Challenge test –> dx of asthma.
2) Direct Cholinomimetic, stim muscarinic r in airway –> bronchoconstriction
Neostigmine
1) Post-op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular jxn blockade (post-op).
2) Indirect Cholinomimetic; increases Ach (anticholinesterase)
4) No CNS penetration (“Neo CNS penetration”)
Pyridostigmine
1) Myasthenia gravis (long acting)
2) Indirect Cholinomimetic; increases endogenous Ach, increases strength. (Anticholinesterase)
4) No CNS penetration
“pyRIDostiGMine RIDs you of your MG”
Edrophonium
1) Diagnosis of myasthenia gravis (SHORT acting).
2) Indirect Cholinomimetic; increases endogenous Ach (Anticholinesterase)
Physostigmine
1) Anticholinergic toxicity
2) Indirect Cholinomimetic; increases Ach. (Anticholinesterase)
4) crosses BBB
“Physostigmine PHYxes Atropine overdose”
Donepezil
1) Alzheimers
2) Indirect Cholinomimetic; increases Ach (anticholinesterase)
ADE of all Cholinomimetics
Exacerbation of COPD, asthma, and peptic ulcers
Organophosphate poisoning (e.g. Parathion) *Farmers!
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
Hot as a hare Dry as a bone Red as a Beet Blind as a Bat Mad as a Hatter Bowel and Bladder lose their tone and the Heart runs alone
Homatropine
1) Produce mydriasis and cycloplegia (paralysis of ciliary m, loss of accomodation)
2) Muscarinic antagonist
Tropicamide
1) Produce mydriasis and cycloplegia (paralysis of ciliary m, loss of accomodation)
2) Muscarinic antagonist
Benztropine
1) Rx for Parkinsons**
2) Muscarinic Antagonist
“PARK my BENZ”
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
Put a BUUT in your FOXY Bladder
Glycopyrrolate
1) Parenteral: preop –> reduce airway secretions. PO: Rx for drooling, peptic ulcer
2) Muscarinic Antagonist
Sit by the PYRR and dry yourself up
Epinephrine
1) Anaphylaxis, glaucoma (open angle), asthma, hypotension
2) Sympathomimetics; A1, A2, B1, B2. LOW dose selective for B2**
NE
1) Hypotension (but low renal perfusion)
2) Sympathomimetics; A1, A2 > B1
