ANS Drugs

Question 1

Tropicamide

Answer 1

Anticholinergic / muscarinic antagonist

For causing mydriasis and cycloplegia

Question 1

Scopolamine

Answer 1

Anticholinergic / muscarinic antagonist

For motion sickness

Question 1

Pyridostigmine

Answer 1

Cholinomimetic, indirect agonist / AChE inhibitor

For long-acting myasthenia gravis treatment (doesn’t cross BBB)

Question 1

Homatropine

Answer 1

Anticholinergic / muscarinic antagonist

For causing mydriasis and cycloplegia

Question 1

Darifenacin, Solifenacin

Answer 1

Anticholinergic / muscarinic antagonist

For reducing bladder spasms and urgency in mild cystitis

Question 2

Amphetamine, Hydroxyamphetamine

Answer 2

Sympathomimetic, indirect: inhibits reuptake of and releases stored NE

For narcolepsy, ADHD, obesity

Question 3

Benztropine

Answer 3

Anticholinergic / muscarinic antagonist

For Parkinson’s tremors and rigidity

Question 3

Isoproterenol

Answer 3

Sympathomimetic, direct agonist: β1 = β2

For heart block and evaluation of tachyarrhythmias (β2 vasodilation can worsen ischemia, no longer commonly used)

Question 4

α-methyldopa

Answer 4

Sympatholytic / α2 agonist

For HTN in pregnancy

Question 5

Dopamine

Answer 5

Sympathomimetic, direct agonist: D1 = D2 > β1 > α1

For shock, heart failure, unstable bradycardia (α effects on contractility and HR predominate at high doses)

Question 5

Phentolamine

Answer 5

α-blocker, non-selective antagonist, reversible

For pheochromocytoma, hypertensive crisis from MAO-I + tyramine ingestion

Question 5

Pralidoxime

Answer 5

Regeneration of AChE after organophosphate (AChE inhibitor) poisoning

(Only works if given early enough)

Question 6

Epinephrine

Answer 6

Sympathomimetic, direct agonist: β > α at low doses, α > β at high doses

For anaphylaxis, asthma, hypotension, open angle glaucoma (vasoconstriction –> decreased aqueous production)

Question 8

Ephedrine

Answer 8

Sympathomimetic, indirect: releases stored NE

For hypotension, nasal congestion, urinary incontinence

Question 9

Physostigmine

Answer 9

Cholinomimetic, indirect agonist / AChE inhibitor

For atropine overdose (crosses BBB)

Question 9

Nadolol, Pindolol, Propranolol

Answer 9

β-blocker, nonselective antagonist: β1 = ​β2

Generally for HTN, angina, arrhythmias (class II antiarrhythmic), post-MI remodeling and survival

Question 10

Cocaine

Answer 10

Sympathomimetic, indirect: inhibits NE reuptake

For vasoconstriction, local anesthesia

Question 11

Betaxolol

Answer 11

β-blocker, selective antagonist: β1 > ​β2

For glaucoma, also generally for HTN, angina, arrhythmias (class II antiarrhythmic), post-MI remodeling and survival

Question 11

Norepinephrine

Answer 11

Sympathomimetic, direct agonist: α1 > α2 > β1

For hypotension (but decreases renal perfusion)

Question 13

Glycopyrrolate

Answer 13

Anticholinergic / muscarinic antagonist

1. For reducing airway secretions (given i.v., pre-op)
2. For drooling and peptic ulcers (given orally)

Question 13

Rivastigmine

Answer 13

Cholinomimetic, indirect agonist / AChE inhibitor

For Alzheimer’s

Question 15

Edrophonium

Answer 15

Cholinomimetic, indirect agonist / AChE inhibitor

For diagnosis of mysathenia gravis

Question 16

Tamsulosin

Answer 16

α-blocker, α1-selective antagonist

For BPH

Question 17

Nebivolol

Answer 17

β1-selective antagonist that also stimulates β3 receptors (which activates NO synthase in the vasculature)

Generally for HTN, angina, arrhythmias (class II antiarrhythmic), post-MI remodeling and survival

Question 18

Timolol

Answer 18

β-blocker, nonselective antagonist: β1 = ​β2 For glaucoma, also generally for HTN, angina, arrhythmias (class II antiarrhythmic), post-MI remodeling and survival

Question 19

Albuterol

Answer 19

Sympathomimetic, direct agonist: β2 \> β1 For acute asthma

Question 20

Terbutaline

Answer 20

Sympathomimetic, direct agonist: β2 \> β1 For uterine muscle relaxation

Question 21

Salmeterol, Formoterol

Answer 21

Sympathomimetic, direct agonist: β2 \> β1 For long-term asthma and COPD control

Question 23

Galantamine

Answer 23

Cholinomimetic, indirect agonist / AChE inhibitor For Alzheimer's

Question 24

Pilocarpine

Answer 24

Cholinomimetic, direct agonist For glaucoma, stimulation of sweat/tears/saliva (accommodation of ciliary muscle --\> helps open angle glaucoma, miosis of pupillary sphincter --\> helps closed angle glaucoma)

Question 25

Neostigmine

Answer 25

Cholinomimetic, indirect agonist / AChE inhibitor For ileus, urinary retention, myasthenia gravis, post-op reversal of NMB

Question 26

Tolterodine, Fesoterodine

Answer 26

Anticholinergic / muscarinic antagonist For reducing bladder spasms and urgency in mild cystitis

Question 27

Trospium

Answer 27

Anticholinergic / muscarinic antagonist For reducing bladder spasms and urgency in mild cystitis

Question 29

Methacholine

Answer 29

Cholinomimetic, direct agonist Challenge test for diagnosis of asthma

Question 31

Carbachol

Answer 31

Cholinomimetic, direct agonist For glaucoma, miosis, relief of intraocular pressure

Question 32

Prazosin

Answer 32

α-blocker, α1-selective antagonist For BPH, HTN, PTSD

Question 34

Donepezil

Answer 34

Cholinomimetic, indirect agonist / AChE inhibitor For Alzheimer's

Question 36

Atropine

Answer 36

Anticholinergic / muscarinic antagonist For causing mydriasis and cycloplegia, treatment of bradycardia, and symptomatic treatment of organophosphate poisoning (competitive inhibitor of ACh, to counter effects of the cholinesterase inhibitor) Also decreases airway secretions, gastric acid secretions, gut motility, and bladder urgency in cystitis

Question 37

Clonidine

Answer 37

Sympatholytic / α2 agonist For HTN (in limited situations), severe pain, ADHD

Question 39

Dobutamine

Answer 39

Sympathomimetic, direct agonist: β1 \> β2, α For heart failure (esp. increasing contractility in decompensated CHF patients), cardiac stress testing

Question 40

Phenoxybenzamine

Answer 40

α-blocker, non-selective antagonist, irreversible For pheochromocytoma, Raynaud's

Question 41

Terazosin, Doxazosin

Answer 41

α-blocker, α1-selective antagonist For BPH, HTN

Question 42

Mirtazapine

Answer 42

α-blocker, α2-selective antagonist Atypical antidepressant (also for anorexia)

Question 43

Carvedilol, Labetalol

Answer 43

α- and β-blocker, nonselective antagonist Generally for HTN, CHF, ICU use

Question 45

Acebutolol, Atenolol, Bisoprolol, Esmolol, Metoprolol

Answer 45

β-blocker, selective antagonist: β1 \> ​β2 Generally for HTN, angina, arrhythmias (class II antiarrhythmic), post-MI remodeling and survival

Question 46

Bethanechol

Answer 46

Cholinomimetic, direct agonist For ileus, urinary retention (bowel and bladder)

Question 47

Phenylephrine

Answer 47

Sympathomimetic, direct agonist: α1 \> α2 For hypotension, nasal congestion, and producing mydriasis

Question 48

Ipratropium, Tiotropium

Answer 48

Anticholinergic / muscarinic antagonist For asthma and COPD (tiotropium is better for long-term use)

Question 49

Oxybutynin

Answer 49

Anticholinergic / muscarinic antagonist For reducing bladder spasms and urgency in mild cystitis