Autonomic meds Flashcards
Nicotine
nicotinic acetocholine receptor agonist
central action on cognitive function and reward pathways
found at neuromuscular junction, autonomic preganglionic terminals
brain
main metabolite is cotinine
muscarine
muscarinic acetocholine receptor agonist derived from certain mushrooms decrease cardio funciton increases secretion increase GI activity
varenicline
partial agonist of alpha4beta1 neuronal nicotinic receptor
help tx nicotine dependence
mivacurium, pancuronium, vecuronium
nicotinic receptor antagonst
non polarizing paralytic (neuromuscular blockers)
neostigmine
acetylcholinesterase inhibitor
tx reverse of non-depolarization neuromuscular blockers (vecuronium, pancuronium, mivacurium)
tx myasthenia gravis
pyridostigmine
tx myasthenia gravis
donepezil, galantamine, rivastigmine
AChE inhibitors
palliative tx of alzheimer’s
not effective for long term tx
parathion, malathion, chlorpyrifos
organophosphate AChE inhibitors
insecticides
sarin, tabun, VX
organophosphate AChE inhibitors
Nerve Gases
pralidoxime (2-pam)
prevents irreversible organophosphate binding
tx within 1-2 hours of exposures
AChE inhibitor symptoms
Diarrhea Urination Miosis (constricted pupils) Bronchoconstriction Excitation (of muscles and CNS) Lacrimation Salivation Sweating
Bethanechol, carbachol, pilocarpine
muscarinic agonist
tx urinary retention (bethanechol)
tx Glaucoma
Atrophine
Muscarinic antagonist tertiary amine (from deadly night shade) CNS penetrance tx AChE inhibitor poisoning tx severe bradycardia AE: decreased secretion (dry mouth), mydriasis (dilated pupils), cycloplegia (decreased accommodation), hyperthermia, tachycardia, sedation, brochodilation, urinary retention and constipation, behavioral excitation with hallucinations
scoplamine
muscarinic antagonist
tx motion sickness, sedative, amnesiac
AE: decreased secretion (dry mouth), mydriasis (dilated pupils), cycloplegia (decreased accommodation), hyperthermia, tachycardia, sedation, brochodilation, urinary retention and constipation, behavioral excitation with hallucinations
glycopyrrolate
muscarinic antagonist
tx to dry secretions (no CNS penetration)
benztropine
muscarinc antagonist tx parkinsonism (including drug induced)
tropicamide
muscarinic antagonist topical opthalmology (dilate pupils 4-8 hours)
Ipratropium
muscarinic antagonist
tx asthma and COPD
used with albuterol (combivent)
tiotropium
muscarinic antagonist
tx COPD
pierced capsule inhalation device (spiriva)