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Autonomic Drugs
Pharm
37
Medical
Graduate
03/29/2013

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Cards

Term
Bethanechol
Cholinomimetic agents - direct agonists
Definition
Use - ileus and urinary retentaion
Action - activates bowel and bladder smooth muscle, resistant to AChE
"Bethany call me if you want to activate your bowels and bladder"
Term
Carbachol
Cholinomimetic agents - direct agonists
Definition
Use - glaucoma, pupillary contraction, relief of intraocular pressure
Action - carbon copy of acetylcholine
Term
Pilocarpine
Cholinomimetic agents - direct agonists
Definition
Use - potent stimulator of sweat, tears, saliva; open-angle and closed-angle glaucoma
Action - contract ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE
"You cry, drool and sweat on your 'pilow'"
Term
Methacholine
Cholinomimetic agents - direct agonists
Definition
Use - challenge test for diagnosis of asthma
Stimulates muscarinic receptors in airway when inhaled
Term
Neostigmine
Anticholinesterase (indirect cholinomimetic agonist)
Definition
Use - ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (postop)
Neo CNS = No CNS penetration
Term
Pyridostigmine
Anticholinesterase (indirect cholinomimetic agonist)
Definition
Use - myasthenia gravis (long acting); does not penetrate CNS
Action - inc strength
"Pyridostimine gets rid of myasthenia gravis"
Term
Endrophonium
Anticholinesterase (indirect cholinomimetic agonist)
Definition
Use - Dx myastenia gravis (extremely short acting)
Term
Physostigmine
Anticholinesterase (indirect cholinomimetic agonist)
Definition
Use - Anticholinergic toxicity (crosses BBB)
"Physostigmine 'phyxes' atropine overdose
Term
Donepezil
Anticholinesterase (indirect cholinomimetic agonist)
Definition
Use - Alzheimer's disease
Term
Atropine, homatropine, tropicamide
Muscarinic antagonists
Definition
System - eye
Use - produce mydriasis and cycloplegia
Term
Benztropine
Muscarinic antagonists
Definition
System - CNS
Use - Parkinson's disease
"Park my Benz"
Term
Scopolamine
Muscarinic antagonists
Definition
System - CNS
Use - Motion sickness
Term
Ipratropium, tiotropium
Definition
System - respiratory
Use - COPD, asthma
"I pray I can breathe soon!"
Term
Oxybutynin
Muscarinic antagonists
Definition
System - GU
Use - Reduce urgency in mild cystitis and reduce bladder spasms
Term
Glycopyrrolate
Muscarinic antagonists
Definition
System - GI, respiratory
Use - Parenteral: preop use to reduce airway secretions; Oral: drooling, peptic ulcer
Term
Atropine
Muscarinic antagonists
Definition
Eye - inc pupil dilation, cycloplegia
Airway - dec secretions
Stomach - dec acid secretions
Gut - dec motility
Bladder - dec urgency in cystitis
Toxicity - Hot, dry, red, blind, mad
Term
Epineprine
Sympathomimetics - direct
Definition
Receptors - alpha 1/2, beta 1/2
Use - anaphylaxis, glaucoma (open angle), asthma, hypotension
Term
Norepinephrin
Sympathomimetics - direct
Definition
Receptors - alpha 1/2, some beta 1
Use - hypotension (but dec renal perfusion)
Term
Isoproterenol
Sympathomimetics - direct
Definition
Receptors - beta 1/2
Use - Torsade de pointes (tachycardia decreases dec QT interval), bradyarrhythmias (but can worsen ischemia)
Term
Dopamine
Sympathomimetics - direct
Definition
Receptors - alpha 1/2 at high dose, beta 1/2 at medium dose, D1 at low dose
Use - shock (renal perfusion), HF; inotropic and chronotropic
Term
Dobutamine
Sympathomimetics - direct
Definition
Receptors - mainly beta 1, some beta 2 and alpha 1/2
use - HF, cardiac stress testing; inotropic and chronotropic
Term
Phenylephrine
Sympathomimetics - direct
Definition
Receptors - alpha 1/2
Use - Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
Term
Albuterol, salmeterol, terbutaline
Sympathomimetics - direct
Definition
Receptors - beta 2 > beta 1
Use - metaproterenol and albuteral for acute asthma; salmeterol for long-term asthma or COPD control; terbutaline to reduce premature uterine contractions
Term
Ritodrine
Sympathomimetics - direct
Definition
Receptors - beta 2
Use - reduces premature uterine contractions
Term
Amphetamine
Sympathomimetics - indirect
Definition
Action - releases stored catecholamines
Use - narcolepsy, obesity, ADD
Term
Ephedrine
Sympathomimetics - indirect
Definition
Action - releases stored catecholamines
Use - nasal decongestion, urinary incontinence, hypotension
Term
Cocaine
Sympathomimetics - indirect
Definition
Action - reuptake inhibitor
Use - causes vasoconstriction and local anesthesia; never give beta-blockers if cocaine intoxication is suspected (can lead to unopposed alpha-1 activation and extreme hypertension)
Term
Clonidine, alpha-methyldopa
Sympathoplegics
Definition
Action - centrally acting alpha2-agonists, dec central sympathetic outflow
Use - HTN, expecially with renal disease (no dec in blood flow to kidney)
Term
Phenoxybenzamine
Irreversible alpha-blocker - nonselective
Definition
Use - pheochromocytoma; use before removing tumor, since high levels of released catecholamines will not be able to overcome blockage
Toxicity - orthostatic hypotension, reflex tachycardia
Term
Phentolamine
Reversible alpha-blocker = nonselective
Definition
Use - give to pts on MAO-i who eat tyramine-containing foods
Term
Prazosin, terazosin, doxazosin, tamsulosin
alpha1 selective alpha-blocker
Definition
Use - HTN, urinary retension in BPH
Toxicity - 1st-dose orthostatic hypotension, dizziness, headache
Term
Mirtazapine
alpha2 selective alpha-blocker
Definition
Use - depression
Toxicity - sedation, inc serum cholesterol, inc appetite
Term
Acebutolol (partial agonist), betaxolol, esmolol (short acting), atenolol, metoprolol
Definition
Beta-1 selective antagonists
"A BEAM of beta1-blockers"
Advantages with comorbid pulmonary disease
Term
Propranolol, timolol, nadolol, pindolol
Definition
Nonselective beta antagonists
"Please Try Not Being Picky"
Term
Carvedilol, labetaolo
Definition
Nonselective (vasodilatory) alpha and beta-antagonists
Term
Pindolol, acebutolol
Definition
Partial beta-agonists
"PAPA"
Term
Beta-blockers
Definition
Angina pectoris - dec HR and contractility, resulting in dec O2 consumption
MI - dec mortality
SVT (metoprolol, esmolol) - dec AV conduction velocity (class II antiarrhytmic)
HTN - dec CO, dec renin secretion (due to beta1-receptor blockade on JGA cells)
CHF - slows progression of chronic failure
Glaucoma (timolol) - dec secretion of aqueous humor
Toxicity - impotence, worse asthma, bradycardia, AV block, CHF, seizures, sedation, sleep alterations; use with caution in diabetics
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