Autonomic Drugs

Front 1

Dobutamine

Back 1

direct acting beta 1 and some selectivity for beta 2

indicated for cardiogenic shock, acute heart failure, cardiac stimulation

ADR: Pro arrhythmic

Front 2

Adrenaline

Back 2

direct acting alpha 1, beta 1, beta 2
indicated for anaphylactic shock, reduce bleeding in surgery, cardiac arrest, VFib, prolongation of action of local anesthetics
ADR: arrhythmias, hypertension, vasoconstriction

Front 3

Isoproterenol/Isoprenaline

Back 3

direct acting beta 1 and beta 2
indicated for asthma due to bronchodilation, AV block, bradycardia

Front 4

Apraclonidone

Back 4

direct acting alpha 2, decreasing aqueous humour formation
indicated for short-term treatment of intraocular pressure in glaucoma
ADR: local irritation, dry mouth, taste disturbance

Front 5

clonidine

Back 5

direct acting partial agonist of alpha 2, decreasing sympathetic outflow from CNS
indicated for hypertension
CNS ADR (drowsiness, sedation, depression), hypotension, bradycardia

Front 6

Salbutamol and Salmeterol

Back 6

smooth muscle relaxation and bronchodilation by directly acting on beta 2 agonist. indicated in asthma and premature labour where breathing is assisted. ADR large doses or drug interactions can cause loss of selectivity and drug may act on beta 1 receptor, increasing heart rate, cardiac output and blood pressure. This may cause arrhythmias as well as tremors.

Front 7

Phenylephrine

Back 7

direct acting agonist for alpha 1 recptor, causing vasoconstriction and allowing opening of passageways. Also causes increased BP and mydriasis. Used for nasal decongestion, ocular decongestion and maintenance of BP. ADR hypertension. HR will decrease to compensate for increased BP and CO.
Highly metabolized by MAO in GIT, so oral dosage forms is not efficient

Front 8

Prazosin

Back 8

Competitive alpha 1 antagonist, causing vasodilation, decreasing PVR and BP as well as relaxing bladder, neck and prostate.
Therefore, used for hypertension and urinary retention due to benign prostatic hyperplasia. ADR include hypotension, tachycardia, nasal congestion and urinary urgency.

Front 9

Phentolamine

Back 9

Nonselective alpha 1 and alpha 2 antagonist. Effect is vasodilation, decreasing PVR and BP. Due to activity against alpha 2 receptors, it blocks NA reuptake and increases levels of NA.

Front 10

Amphetamine

Back 10

Indirect acting agonist by increasing noradrenaline release. Used as a CNS stimulant in narcolepsy, appetite suppresant. ADR hypertension, tachycardia and dependence

Front 11

Cocaine

Back 11

Indirect acting agonist by inhibiting reuptake of noradrenaline. Used as a local anaesthesia. ADR hypertension, tissue damage and enlargement causing cardiac damage and necrosis of nasal mucosa due to abuse

Front 12

Pseudoephedrine

Back 12

Mixed acting on alpha 1 receptors causing vasoconstriction. Thus used as in nasal decongestion in viral and allergic rhinitis. ADR include hypertension, tachycardia, insomnia and dependence. It is resistant to MAO and COMT (unlike phenylephrine), making it possible to be dosed as an oral form. Pseudoephedrine is more effective than phenylephrine as

However, due to being a precursor of methamphetamine, phenylephrine is the preferred decongestant.

Front 13

Atenolol

Back 13

Selective beta 1 blocker, causing a decrease in heart rate and contractility, lowering CO and BP. It is indicated for hypertension; disorders that require O2 demand such as angina pectoris; and arrhythmias. ADR include hypoglycemia, cardiac failure due to too much decrease in HR/contractility. Bronchoconstricton may occur when the drug has loss selectivity and antagonises the beta 2 receptors found in the lung

Front 14

Propanolol

Back 14

Nonselective beta 1 blocker (and beta 2), causing a decrease in heart rate and contractility, lowering CO and BP. It is indicated for hypertension; disorders that require O2 demand such as angina pectoris; and arrhythmias. ADR include hypoglycemia, cardiac failure due to too much decrease in HR/contractility. There is higher risk of causing bronchoconstriction with a nonselective beta blocker due to acting on the beta 2 receptors found in the lungs. This should not be used in asthmatic patients or in COPD.

Front 15

Carvedilol

Back 15

Antagonist for alpha 1, beta 1 and beta 2 receptors. This causes vasodilation due to alpha 1. There is decreased heart rate and BP in hypertensive patients whilst patients with heart failure result in an increase in cardiac output. ADR similar to beta blockers and renal failure

Front 16

Tyramine and MAO inhibitors

Back 16

Naturally occurring amine found in cheese. It is rapidly metabolised by MAO. MAO inhibitors increase tyramine levels and displace noradrenaline, causing sympathomimetic effects such as severe hypertension and tachycardia