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Flashcards in Autonomic Agents Deck (37):
1

Bethanechol

Cholinomimetic - Activates bowel and bladder

2

Carbachol

Cholinomimetic
Treats glaucoma causes pupillary constriction

3

Pilocarpine

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

4

Methacholine

Stimulates muscarinic R in airway when inhaled
Asthma challenge test

5

Neostigmine

Blocks AChE
Activates bowel/bladder
MG
Reverse NMJ blockade

6

Physostigmine

Blocks AChE - Anticholinergic Toxicity (CNS)

7

Donepezil, rivastigmine, galantamine

Blocks AChE - Alzheimers

8

Edrophonium

Blocks AChE - Historically dx MG

9

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

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

10

What drug irreversibly inhibits AChE? What are the symptoms?

Organophosphates/Insecticides
Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating, salivation

11

How do you treat organophosphate poisoning?

Atropine and Pralidoxime (regenerate AChE)

12

Atropine, homatropine, tropicamide

Muscarinic Antagonist
Mydriasis and cycloplegia

13

Benztropine

Muscarinic Antagonist - CNS
Parkinsons

14

Scopolamine

Muscarinic Antagonist - CNS
Motion sickness

15

Ipratropium & tiotropium

Muscarinic Antagonist - Respiratory
COPD and asthma

16

Oxybutynin, darifenacin, slifenacin

Muscarinic Antagonist - GU
Reduce urgency in mild cystitis, reduce bladder spasms

17

Glycopyrrolate

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

18

What are signs of Atropine toxicity?

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

19

What 3 populations are you worried about atropine in?

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

20

Epinephrine

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

21

Norepinephrine

α1 > α2 > β1
Hypotension (dec. renal perfusion)

22

Isoproterenol

β1 = β2
Electrophysiologic evaluation of tachyarrhythmias - worsen ischemia

23

Dopamine

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

24

Dobutamine

β1 > β2, α
Heart failure, cardiac stress testing

25

Phenylephrine

α1 > α2
Hypotension
Ocular procedures - mydriatic
Rhinitis - decongestant

26

Albuterol, salmeterol, terbutaline

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

27

Amphetamine

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

28

Ephedrine

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

29

Cocaine

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

30

Clonidine

α2 agonist
HTN urgency, ADHD, severe pain

31

α-methyldopa

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

32

Phenoxybenzamine

Irr. α-blocker - Pheochromocytoma

33

Phentolamine

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

34

Prazosin, terazosin, tamsulosin

α1-blockers - Urinary symptoms of BPH, PTSD, HTN
1st dose orthostatic hypotension, dizziness, headache

35

Mirtazapine

α2-blocker
Sedations, inc. cholesterol, inc. appetite

36

What are the indications for β-blockers?

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

37

Pyridostigmine

AChE Inhibitor - MG - no CNS