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Boards > Autonomic Agents > Flashcards

Autonomic Agents Flashcards

1
Q

Bethanechol

A

Cholinomimetic - Activates bowel and bladder

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2
Q

Carbachol

A

Cholinomimetic

Treats glaucoma causes pupillary constriction

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3
Q

Pilocarpine

A

Cholinomimetic
Constricts ciliary muscle of eye - Glaucoma
Stim. sweat, tears, saliva

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4
Q

Methacholine

A

Stimulates muscarinic R in airway when inhaled

Asthma challenge test

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5
Q

Neostigmine

A

Blocks AChE
Activates bowel/bladder
MG
Reverse NMJ blockade

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6
Q

Physostigmine

A

Blocks AChE - Anticholinergic Toxicity (CNS)

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7
Q

Donepezil, rivastigmine, galantamine

A

Blocks AChE - Alzheimers

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8
Q

Edrophonium

A

Blocks AChE - Historically dx MG

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9
Q

What side effects do you have to watch for when using cholinomimetics?

A

Exacerbation of COPD, asthma, and peptic ulcers in susceptible patients

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10
Q

What drug irreversibly inhibits AChE? What are the symptoms?

A

Organophosphates/Insecticides

Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating, salivation

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11
Q

How do you treat organophosphate poisoning?

A

Atropine and Pralidoxime (regenerate AChE)

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12
Q

Atropine, homatropine, tropicamide

A

Muscarinic Antagonist

Mydriasis and cycloplegia

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13
Q

Benztropine

A

Muscarinic Antagonist - CNS

Parkinsons

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14
Q

Scopolamine

A

Muscarinic Antagonist - CNS

Motion sickness

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15
Q

Ipratropium & tiotropium

A

Muscarinic Antagonist - Respiratory

COPD and asthma

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16
Q

Oxybutynin, darifenacin, slifenacin

A

Muscarinic Antagonist - GU

Reduce urgency in mild cystitis, reduce bladder spasms

17
Q

Glycopyrrolate

A

Muscarinic Antagonist - GU/Resp
Parenteral: Preop to reduce airway secretions
Oral: drooling, peptic ulcer

18
Q

What are signs of Atropine toxicity?

A 
Inc. body temp, rapid pulse, dry mouth
Dry flushed skin
Cycloplegia
Constipation
Disorientation
19
Q

What 3 populations are you worried about atropine in?

A

Elderly - acute angle closure
Men w/ BPH - urinary retention
Infants - hyperthermia

20
Q

Epinephrine

A

β > α
Anaphylaxis, open angle glaucoma, asthma, hypotension
*high dose = α

21
Q

Norepinephrine

A

α1 > α2 > β1

Hypotension (dec. renal perfusion)

22
Q

Isoproterenol

A

β1 = β2

Electrophysiologic evaluation of tachyarrhythmias - worsen ischemia

23
Q

Dopamine

A

D1 = D2 > β > α
Unstable bradycardia, heart failure, shock
*high dose = α

24
Q

Dobutamine

A

β1 > β2, α

Heart failure, cardiac stress testing

25
Q

Phenylephrine

A

α1 > α2
Hypotension
Ocular procedures - mydriatic
Rhinitis - decongestant

26
Q

Albuterol, salmeterol, terbutaline

A

β2 > β1
Albuterol = acute asthma
Salmeterol = longterm asthma or COPD
Terbutaline = reduce premature uterine contractions

27
Q

Amphetamine

A

MDMA - indirect general sympathetic agonist, blocks reuptake, releases stored catecholamines

28
Q

Ephedrine

A

Indirect Sympathomimetic
Releases stored catecholamines
Nasal decongestion, urinary incontinence, hypotension

29
Q

Cocaine

A

Indirect sympathomimetic - Reuptake inhibitor
Vasoconstriction and local anesthesia
**Never give β-blockers -> extreme HTN

30
Q

Clonidine

A

α2 agonist

HTN urgency, ADHD, severe pain

31
Q

α-methyldopa

A

α2 agonist- Treat HTN in pregnancy
Toxicity = direct coombs + hemolytic anemia
SLE-like syndrome

32
Q

Phenoxybenzamine

A

Irr. α-blocker - Pheochromocytoma

33
Q

Phentolamine

A

Reversible α-blocker - Pts on MAOIs who eat tyramine-containing foods

34
Q

Prazosin, terazosin, tamsulosin

A

α1-blockers - Urinary symptoms of BPH, PTSD, HTN

1st dose orthostatic hypotension, dizziness, headache

35
Q

Mirtazapine

A

α2-blocker

Sedations, inc. cholesterol, inc. appetite

36
Q

What are the indications for β-blockers?

A 
Angina pectoris
MI
SVT - metoprolol, esmolol
HTN
CHF
Glaucoma - timolol
37
Q

Pyridostigmine

A

AChE Inhibitor - MG - no CNS

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