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Flashcards in Autonomic drugs Deck (52):
1

Bethanechol

Cholimimetic
activates bowel and bladder smooth muscle
resistant to AChE
used in post-operative ileum
neurogenic ileus and urinary retention

2

Carbachol

Cholimimetic
MoA sim to ACh
used for glaucoma / pupillary constriction / relief of intraocular pressure

3

Pilocarpine

Cholimimetic
contracts ciiary muscle of eye (open angle glaucoma)
const pupillary sphincter (closed angle glaucoma)
resistant to AChE
Potent stimulator of sweat, tears, and saliva ("You cry, drool, and sweat in your PILlow")

4

Methacholine

Cholimimetic
challenge test Dx for asthma
stimulates M3 receptors in airway when inhaled

5

Neostigmine

AChE inhibitor
inc endogenous ACh
postop and neurogenic ileus and urinary retention
myasthenia gravis
reversal of NMJ blockade
NO CNS penetration

6

Pyridostigmine

AChE inhibitor
inc endogenous ACh
inc strength in myasthenia gravis
NO CNS penetration

7

Physostigmine

AChE inhibitor
used to reverse Atropine toxicity
YES CNS penetration

8

Donepezil

AChE inhibitor
ind endogenous ACh
used in Alzheimers

9

Rivastigmine

AChE inhibitor
ind endogenous ACh
used in Alzheimers

10

Galantamine

AChE inhibitor
ind endogenous ACh
used in Alzheimers

11

Edrophonium

AChE inhibitor
historically used to Dx myasthenia gravis

12

Cholinomimetic warning

watch out for COPD / asthma / and peptic ulcer exacerbations in susceptible patients

13

AChE poisoning

Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle
Lacrimation
Sweating
Salivation

14

AChE poisoning antidote

atropine + pralidoxime

15

Atropine

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

16

Homatropine

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

17

Tropicamide

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

18

Benztropine

muscarinic antag
works in the CNS
used to treat Parkinson disease
also drug-induced extrapyramidal SE

19

Scopolamine

muscarinic antag
works in the CNS
used to treat motion sickness

20

Ipratropium

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

21

Tiotropium

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

22

Oxybutynin

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

23

Darifenacin

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

24

Solifenacin

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

25

Tolterodine
Fesoterodine
Trospium

reduce urgency in mild cystitis
reduce bladder spasms

26

Glycopyrrolate

muscarinic antag
works on GI and resp system
parenteral use: preoperative use to reduce airway secretions
oral use: drooling and peptic ulcers

27

Atropine toxicity

Hot as a hare = inc body temp
Dry as a bone = dry skin
Red as a beet = flushed skin
Blind as a bat = cycloplegia
Mad as a hatter = disorientation

28

Epinephrine

beta > alpha
used in anaphylaxis
open angle glaucoma (relaxation of ciliary muscle)
asthma
hypoTN
more alpha effects at high doses

29

Norepinephrine

alpha1 > alpha2 > beta1
used to Tx hypoTN --> decreases renal perfusion

30

Isoproterenol

beta1 = beta2
used to evaluate tachyarrhythmias
can worsen ischemia

31

Dopamine

D1 = D2 >Beta>alpha
used for unstable brady
heart failure
shock
high doses = inotropic and chronotropic alpha effects

32

Dobutamine

beta1 > beta2, alpha
used in heart failure (inotropic > chronotropic)
cardiac stress testing

33

Phenylephrine

alpha1 > alpha2
used to Tx hypoTN
prod mydriasis in ocular procedures
and decongestant in rhinitis

34

Albuterol

Beta2 > beta1
acute asthma

35

Salmeterol

beta2 > beta1
longer-term asthma or COPD control

36

Terbutaline

beta2 > beta1
reduce premature uterine contractions

37

Amphetamine

indirect sympathomimetic
indirect general agonist
reuptake inhibitor
also releases stored catecholamines
used in narcolepsy / obesity / ADD

38

Ephedrine

indirect sympathomimetic
indirect general agonist
releases stored catecholamines
used as a nasal decongestant / urinary incontinence / hypoTN

39

Cocaine

indirect sympathomimetic
indirect general agonist
reuptake inhibitor
causes vasoconstriction and local anesthesia
if intoxication is suspected, DO NOT GIVE BETA BLOCKERS (unopposed alpha1 stimulation)

40

Clonidine

alpha2 agonist
used for HTN urgency
does not increase renal blood flow
used also for ADHD / severe pain

41

Clonidine toxicity

CNS depression
bradycardia
hypoTN
respiratory depression
small pupil size

42

alpha-methyldopa

alpha2 agonist
used for HTN in prego (safe in pregnancy)
Toxicity: Direct Coombs + hemolytic anemia
SLE LIKE SYNDROME

43

Phenoxybenzamine

irreversible alpha blocker
used in pheochromocytoma (preoperatively) to reduce catecholamine crisis
Toxicity: orthostatic hypoTN / reflex brady

44

Phentolamine

reversible alpha blocker
give to pt on MAOIs who have eaten tyramine-containing foods

45

Prazosin

alpha1 blocker
used for urinary Sx of BPH / PTSD / HTN
Toxicity = first dose orthostatic hypoTN / dizziness / headache

46

Doxazosin

alpha1 blocker
used for urinary Sx of BPH and HTN
Toxicity = first dose orthostatic hypoTN / dizziness / headache

47

Tamsulosin

alpha1 blocker
used for urinary Sx of BPH
Toxicity = first dose orthostatic hypoTN / dizziness / headache

48

Mirtazapine

alpha2 blocker
used to Tx depression
Toxicity = sedation / inc serum cholesterol / in appetite

49

Beta1 selective blockers

Acebutolol (partial)
Atenolol
Betaxolol
Esmolol
Metoprolol
(A-M first half of alphabet)

50

Nonselective beta blockers

Nadolol
Pindolol (partial)
Propranolol
Timolol (glaucoma)
(N-Z second half of alphabet)

51

Nonselective alpha and beta blockers

Carvedilol
Labetalol
(modified -olol endings)

52

Nebivolol

Beta1 antag and beta3 stimulator
beta3 = activates NO synthase in vasculature