Autonomic Drugs

Question 1

Bethanechol

Answer 1

Cholinergic Agonist that stimulates the smooth muscle in the GI tract and bladder.

Use: non obstructive urinary retention

Question 2

Carbachol

Answer 2

Cholinergic Agonist that is used to decrease IOP, not used too much

Question 3

Methacholine

Answer 3

Cholinergic Agonist

Use: Diagnostic test for pre-asthmatics

Question 4

Pilocarpine/Cevimeline

Answer 4

Use: Sjogrens

Pilocarpine sometimes used to reduce IOP

Question 5

Physostigmine

Answer 5

tertiary amine that reversibly inactivates Ach-ase

SE: can cause convulsions

Question 6

Pyridostigmine/Neostigmine

Answer 6

quaternary amine that inactivates the enzyme Ach-ase
Use: myasthenia gravis
Use: reverses non-depolarizing relaxants
Overdose: treat with atropine and pralidoximine

Question 7

Edrophonium

Answer 7

Use: diagnostic test for myasthenia gravis

Question 8

Ambenonium

Answer 8

Use: alternative tx for myasthenia graves for those sensitive

Question 9

Donepezil/Rivastigmine

Answer 9

Use: tx for mild-moderate Alzheimer’s (for the low cholinergic neurons)

Question 10

Parathion/Malathion

Answer 10

Irreversible Ach-ase inhibitor that can cause toxicity in humans via insecticides
Tx for overdose: Pralidoxime

Question 11

Atropine

Answer 11

Anticholinergic that acts as a competitive antagonist at receptor in both CNS and PNS

Question 12

Tropicamide

Answer 12

Anticholinergic that dilates the eye and paralyzes accommodation
Much shorter half-life than atropine

Question 13

Scopalamine

Answer 13

Anticholinergic used for motion sickness

Question 14

Benztropine

Answer 14

Anticholinergic for Parkinson’s under the theory that dopamine is low and Ach is too high

Question 15

Tolteridine/Oxybutynin

Answer 15

reduce urgency in cystitis to reduce bladder spasms

Question 16

Amphetamine

Answer 16

Adrenergic that indirectly enhances catecholamine release from adrenergic nerve terminals with A1/B1 effects
Uses: narcolepsy, ADHD, weight loss

Question 17

Tyramine

Answer 17

adrenergic found in red wine and cheese, enhances release of NE from adrenergic nerve terminals like amphetamines
Normally metabolized by MAO, so if pt is taking MAOI then can result in hypertensive crisis

Question 18

Cocaine

Answer 18

adrenergic that blocks the reuptake of NE

Question 19

Ephedrine

Answer 19

mixed-adrenergic that enhances effects of NE but also has A and B effects like Epi

Question 20

Phenylephrine

Answer 20

A1 agonist that causes mydriasis WITHOUT paralysis of accommodation

Question 21

Phenoxybenzamine

Answer 21

Irreversible (non-selective) anti adrenergic that causes alpha mediated response to sympathetic discharge
SHIFTS DOSE RESPONSE CURVE DOWN
Uses: pheochromocytoma

Question 22

Phentolamine

Answer 22

Reversible (Non-Selective) anti-adrenergic

Uses: pheochromocytoma

Question 23

Prazosin/Tamsulosin

Answer 23

Reversible A1 Selective
Uses: Zosin’s used for hypertension
Tamsulosin used for BPH to block A1a receptors in the urinary tract

Question 24

A-M olol’s

Answer 24

B1 specific blockers = decrease in HR, SV, CO, Renin release

mask tachycardia associated with hypoglycemia in diabetics

Question 25

N-Z olol’s

Answer 25

Non-specific adrenergic antagonists
Decrease in HR, renin release, bronchospasm, decrease in aqueous humor production, increase in LDLs, block glycogenolysis, gluconeogenesis, mask tachycardia associated with hypoglycemia in diabetics

Question 26

Labetalol/Carvidilol

Answer 26

A1 and Beta Blockers

Use: CHF (carvidilol) and in hypertensive emergencies (labetalol)

Question 27

Pindolol/Acebutolol

Answer 27

B1 and B1/B2 PARTIAL agonist respectively but competes with NE so acts as an antagonist
lowers risks of increased LDLs