Step 1 ANS drugs Flashcards
bethanechol uses
postoperative/neurogenic ileus, urinary retention
bethanechol mechanism
cholinomimetic
carbachol uses
glaucoma, pupillary contraction, IOP relief
carbachol mechanism
direct cholinomimetic
pilocarpine mechanism
direct cholinomimetic
pilocarpine uses
glaucoma (in emergencies, especially narrow angle), potent stimulator of sweat, tears, saliva
methacholine mechanism
direct cholinomimetic
methacholine use
challenge test for asthma
neostigime mechanism
cholinesterase inhibitor
neostigime uses
myasthenia gravis, postoperative blockade reversal, urinary retention
pyridostigime mechanism
cholinesterase inhibitor
pyridostigmine uses
myasthenia gravis (doesn’t penetrate CNS)
edrophonium mechanism
cholinesterase inhibitor
edrophonium use
short acting, diagnosis of MG
physostigime uses
glaucoma, atropine overdose
physostimine mechanism
cholinesterase inhibitor
echothiophate mechanism
cholinesterase inhibitor
echolthiophate use
glaucoma
cholinomimetic toxicity
brochospasm (exacerbate COPD, asthma), peptic ulcers
antidote to cholinesterase poisoning
atropine and pralidoxime
tropicamide use
eye dilation
muscarinic antagonists
atropine, homatropine, tropicamide, scopolamine, ipratropium, oxybutynin, glycopurrolate, methscopolamine, pirenzepine, propantheline
scopolamine use
motion sickness
ipratropium use
asthma, COPD
oyxbutinin use
reduce urgency in cystitis; reduce bladder spasms
methscopolamine, pirenzepine use
peptic ulcer treatment (reduces secretions)
atropine toxicity
dry as a bone, hot as hair, blind as a bat, red as a beet, mad as a hatter, can cause acute angle closure glaucoma, urinary retention in med with BPH, hyperthermia in infants (sympathetic and blocks sweat glands)
hexamethonium mechanism
nicotinic antagonist
hexamethonium use
experimental (ganglion blocker–prevents reflex bradycardia)
hexamethonium toxicity
severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
pancuronium, tubocurarine mechanism
nictotinic antagonists
epinephrine mechanism
sympathetomimetic (beta more than alpha)
epinephrine uses
cardiac arrest, anaphylasis, glaucoma (not narrow angle), hypotention
norepinephrine mechanism
sympathetomimetic. (alpha more than beta)
norepinephrine uses
hypotension (but decreases renal perfusion)
isoproterenol mechanism
sympathetomimetic (beta only)
isoproternol uses
rarely for AV block
dopamine mechanism
sympathomimetic (dopamine receptors most, then beta then alpha), at high levels, inotropic and chronotropic
dopamine uses
shock (increases renal perfusion), heart failure
dobutamine
sympathetomimetic (beta1 more than beta 2); inotropic but not chronotropic
dobutamine uses
heart failure, cardiac stress testing
phenylephrine mechanism
sympathetomimetic; alpha selective (alpha 1 more than alpha 2)
phenylephrine uses
pupillary dilation, vasoconstriction, nasal decongestion
metaproterenol mechanism
sympathetomimetic, selective beta 2
albuterol mechanism
selective beta 2 agonist
metaproterenol use
asthma (acute)
albuterol use
asthma (acute)
salmeterol mechanism
selective beta 2 agonist
salmeterol use
long term asthma treatment
terbutaline mechanism
selective beta 2 agonist
terbutaline use
reduce premature uterine contractions
ritodrine mechanism
beta 2 agonist
ritodrine use
reduce premature uterine contractions
amphetamine mechanism
indirect sympathetomimetic, releases stored catecholamines
amphetamine uses
narcolepsy, obesity, ADD
ephedrine mechanism
indirects sympathetomimetic, releases stored catecholamines
ephedrine use
nasal decongestio, urinary incontinence, hypotension
cocaine mechanism
NE reuptake inhibitor
cocaine use
vasoconstriction and local anesthesia
clonidine mechanism
alpha 2 agonist, decrease adrenergic outflow
clonidine uses
hypertension, especially in renal disease because doesn’t decrease flow to kidney
alpha methyldopa mechanism
central alpha 2 agonist, decreases adrenergic outflow
methyldopa use
hypertension, especially in pregnancy
phenoyxbenzamine mechanism
irreversible alpha blocker
phentolamine mechanism
reversible alpha blocker
phentolamine and phenoxybenzamine uses
pheochromocytoma before surgery
phenoxybenzamine, phentolamine toxicity
orthostatic hypotension, reflex tachycardia
prazosin, terazosin, doxazosin mechanism
alpha 1 selective blockers
zosin uses
hypertension, urinary retention in BPH
zosin toxicity
1st dose orthostatic hypertension. dizziness, headache
mirtazapine mechanism
selective alpha 2 blocker
mirtazapine use
depression
mirtazapine toxicity
increase appetite, serum cholesterol; sedation
non-selective beta blockers
propanolol, timolol, nadolol, pindolol
selective beta 1 blockers
acebutolol, betaxolol, esmolol, atenolol, metoprolol
nonselective alpha and beta blockers
carvedilol, labetalol
partial beta agonists
pindolol, acebutolol
beta blocker toxicity
impotence, asthma exacerbation, bradycardia, AV block, CHF, sedation, sleep alterations
propanolol additions effect
decreases peripheral conversion of T4 to T3