I - AUTONOMICS Flashcards
<p>rapidly hydrolyzed by AChE</p>
<p>Acetylcholine (TOPNOTCH)</p>
<p>resistant to AChE</p>
<p>Betanechol (TOPNOTCH)</p>
<p>for Bladder and bowel atony</p>
<p>Betanechol (first line), Neostigmine (TOPNOTCH)</p>
<p>Nonselective muscarinic and nicotinic agonist , used topically for glaucoma treatment</p>
<p>Carbachol (TOPNOTCH)</p>
<p>Partial muscarinic agonist; used for treatment of Glaucoma, Sjogren's syndrome and Sicca syndrome</p>
<p>Pilocarpine (TOPNOTCH)</p>
<p>Adverse Effects of Acetylcholine</p>
<p>CNS stimulation, miosis, cyclospasm, brochoconstriction, excessive GI and GU smooth muscle contraction, increased secretory activity of sweat gland, airways etc, vasodilation (TOPNOTCH)</p>
<p>activates autonomic post ganglionic neurons (both sympathetic and parasympathetic) and skeletal muscle neuromuscular end plants</p>
<p>Nicotine(TOPNOTCH)</p>
<p>used exclusively for smoking cessation</p>
<p>NICOTINE [C]VARENICLINE [C], LOBELINE</p>
<p>for Myasthenia gravis diagnosis (Tensilon test)</p>
<p>Edrophonium (TOPNOTCH)</p>
<p>for Myasthenia gravis treatment; reversal of nondepolarizing muscular blockade</p>
<p>Neostigmine (TOPNOTCH)</p>
<p>Long Acting Cholinesterase Inhibitors used as Scabicide and Insecticide</p>
<p>Malathion, Parathion (TOPNOTCH)</p>
<p>Competitively blocks all muscarinic receptors, antagonizes histamine and serotonin ; for motion sickness, dec. acid secretion in the GIT</p>
<p>Scopolamine (TOPNOTCH)</p>
<p>DOC for organophosphate poisoning</p>
<p>Atropine (TOPNOTCH)</p>
<p>for bradycardia, hypersalivation and to decrease airway secretion during general anesthesia</p>
<p>Atropine (TOPNOTCH)</p>
<p>Mydriatic, cycloplegic in eye examinations</p>
<p>ATROPINEHomatropine, Cyclopentolate, Tropicamide (TOPNOTCH)</p>
<p>Competitive nonselective antagonist at muscarinic receptors ; for BA and COPD, not as effective as SABAs but less tachycardia and arrhythmia</p>
<p>Ipratropium, Tiotropium (TOPNOTCH)</p>
<p>Nonselective muscarinic antagonist which reduces detrussor smooth muscle tone spasms</p>
<p>Oxybutinin (TOPNOTCH)</p>
<p>for decreasing urgency in mild cystitis and dec. bladder spasm after urologic surgery</p>
<p>Oxybutinin (TOPNOTCH)</p>
<p>Usual antidote for early stage (48h) cholinesterase inhibitor poisoning, Must be administered before 6-8 hours of organophosphate bond with cholinesterase occurs</p>
<p>Pralidoxime (TOPNOTCH)</p>
<p>Competitively blocks all Nn nicotinic Ach receptors ; for Hypertensive emergencies (obsolete)</p>
<p>Hexamethonium, Mecamylamine, Trimethaptan (TOPNOTCH)</p>
<p>DOC for Anaphylaxis</p>
<p>Epinephrine (TOPNOTCH)</p>
<p>used for Cardiac arrest, anaphylaxis, asthma, COPD, Hemostasis</p>
<p>Epinephrine (TOPNOTCH)</p>
<p>for cardiogenic Shock and heart failure</p>
<p>Norepinephrine (TOPNOTCH)</p>
<p>causes vasodilation in splanchnic and renal blood vessels ; for cardiogenic Shock and heart failure</p>
<p>Dopamine (TOPNOTCH)</p>
Beta nonselective sympathomimetic, for Asthma
Isoproterenol (TOPNOTCH)
SE: Rebound nasal congestion, hypertension, stroke, MI
Phenylephrine (TOPNOTCH)
A2 agonist, for Hypertension, Cancer pain, opioid withdrawal
Clonidine (TOPNOTCH)
Sedation, rebound hypertension, dry mouth
Clonidine (TOPNOTCH)
Sedation, positive Coomb's test (Hemolytic anemia)
Methyldopa (TOPNOTCH)
A2 agonist; reserved for ophthalmologic use in glaucoma for reduction of intraocular pressure
Apraclonidine, Brimonidine (TOPNOTCH)
B1 agonist, for cardiogenic shock and acute heart failure
Dobutamine (TOPNOTCH)
DOC as Asthma reliever, Rapid development of tolerance
Albuterol/Salbutamol (TOPNOTCH)
D1 agonist, for Hypertension
Fenoldopam (TOPNOTCH)
D2 agonist, restores dopamine actions in the CNS for Parkinson's disease, prolactinemia
Bromocriptine (TOPNOTCH)
Irreversibly blocks A1 and A2 receptors resulting to indirect baroreflex activation
Phenoxybenzamine (TOPNOTCH)
Reversible A1 and A2 receptor antagonist, for Pheochromocytoma and Rebound hypertension
Phentolamine (TOPNOTCH)
Blocks A1, for Benign Prostatic Hyperplasia, Hypertension
Prazosin, Doxazosin, Terazosin (TOPNOTCH)
Slightly selective A1a blockade causing relaxation of prostatic smooth muscles > vascular smooth muscle ; for BPH
Tamsulosin (TOPNOTCH)
Beta blockade > A1 blockade
Labetalol (TOPNOTCH)
Blocks B1 and B2 receptors
Propranolol, Nadolol, Timolol (TOPNOTCH)
B1 > B2 blockade
Metoprolol, Atenolol, Alprenolol, Betaxolol, Nebivolol (TOPNOTCH)
B1, B2 with intrinsic sympathomimetic (partial agonist) effect
Pindolol, Acebutolol, Carteolol, Bopindolol, Oxprenolol, Celiprolol, Penbutolol (TOPNOTCH)
Beta blockade > A1 blockade
Carvedilol, Medoxalol, Bucindolol, Labetalol (TOPNOTCH)
B1 > B2 blockade; for rapid control of BP and arrhythmias, thyrotoxicosis and myocardial ischemia intraoperatively ; for Supraventricular tachycardia
Esmolol (TOPNOTCH)
BB with direct vasodilating effect
Nebivolol (TOPNOTCH)
BB with local anesthetic effect
Propranolol (TOPNOTCH)
BB which is safe in pregnant patients
Labetalol (TOPNOTCH)
Mydriasis without cycloplegia
Phenylephrine (TOPNOTCH)
Cholinesterase Inhbitors with poor lipid solubility, oral, DOA: 30min-2h
Neostigmine (TOPNOTCH)
DOC for Alpha-1 agonist overdose
Phentolamine
drug used for the treatment of orthostatic hypertension
Midodrine
sympathomimetic avoided in CAD
Isoproterenol
* If given to patients with CAD, Isoproterenol won’t induce a compensatory baroreceptor mediated reflex slowing of the HR (because mean arterial pressure is not increased which is a trigger for reflex bradycardia to occur). Therefore, tachycardia in the setting of a CAD patient will worsen the existing coronary problem of the patient
DOC for rebound HTN brought about by Clonidine
Phentolamine
SE include Tachycardia, Arrhythmias, Tachyphylaxis, Hypertension, Eosinophilic myocarditis, Premature ventricular beats, Angina, Dyspnea, Fever, Headache, Nausea
Dobutamine
Drug used to induce ischemia in the myocardium
Dobutamine
has combined a and b blockade (may be used in pheochromocytoma)
Carvedilol and Labetalol
Lacks Local Anesthetic Activity making them useful in glaucoma
timolol and Betaxolol
Both beta and alpha antagonists
• Nebivolol
• Carvedilol
• Labetolol
