Autonomic Nervous System (Ans) Drugs

Front 1

Bethanecol

Back 1

Muscarinic agonist.

Postoperative and neurogenic ileus and urinary retention

Front 2

Carbachol

Back 2

Muscarinic AGONIST

Glaucoma (pupillary contraction and release of intraoccular press)

Front 3

Pilocarpine

Back 3

muscarinic agonist

Used for glaucoma. Potent stim of sweat, tears, saliva

Front 4

Methacholine

Back 4

muscarinic agonist

Challenge test for asthma

Front 5

Neostigmine

Back 5

Acetylcholinesterase inhibitor

Postop + neurogenic ileus and urinary retent, myasthenia gravis, reversal of non-depolarizing neuromuscular blockade post-op

Front 6

Pyridostigmine

Back 6

Acetylcholinesterase inhibitor

Myasthenia gravis (long acting), does not penetrate CNS

Front 7

Edrophonium

Back 7

Acetylcholinesterase inhibitor

Diagnosis of myasthenia gravis (extremely short acting)

Front 8

Physostigmine

Back 8

Acetylcholinesterase inhibitor.

DOES cross BBB.

Glaucoma and atropine toxicity.

Front 9

Echothiophate

Back 9

Acetycholinesterase inhibitor

Glaucoma

Front 10

Parathion

Back 10

Organophosphate - irreversible inhibitor of acetycholinesterase.

Front 11

Atropine, homatropine, topicamide

Back 11

Antimuscarinics. They DO cross BBB.

Produces mydriasis and cycloplegia. Also antidote for organophosphate

Front 12

Benztropine

Back 12

Muscarinic ANTAGONIST.

CAN cross BBB. Used in Parkinson's.

Front 13

Scopalamine

Back 13

muscarinic ANTAGONIST

CAN cross BBB. Motion sickness

Front 14

Ipratropium

Back 14

Antimuscarinic.

Non-selective, but cannot be absorbed systemically in significant amounts so it acts only locally on M3 receptors in bronchioles.

COPD, Asthma

Front 15

Methscopalamine

Back 15

Muscarinic antagonist

Reduces urgency in mild cystitis and reduces bladder spasm

Front 16

Pirenzepine

Back 16

Antimuscarinic

Peptic Ulcer treatment.

Front 17

Fxn of glaucoma drugs

Back 17

a1 stimulation -> decreased aqueous humor synthesis due to vasoconstriction
beta1 blocker -> direct inhibition of aqueous humor secretion by ciliary body
M3 stim -> miosis&ciliary muscle contraction. miosis leads to opening of canal of schlemm and trabecular meshwork (effective especially for EMERGENCY)
acetazolamide -> decreased aqueous humor synthesis due to decreased bicarb
prostaglandin (latanoprost) -> increased outflow of aqueous humor (permeability of trabecular mesh?)

Front 18

Epinephrine

Back 18

a1, a2, b1, b2. BUT b1 selective at low doses.

Anaphylaxis, glaucoma (open angle), asthma, hypotension

Wide pulse pressure because a1 agonist and b2 agonist. Tachycardia because b1 agoinst. b1 agonism also increase contractility.

Front 19

Norepinephrine

Back 19

Agonist: (a1, a2) > b1

Pulse pressure will remain the same (no beta2 agonism), average BP will increase (alpha1 agonism), reflex BRADYcardia (due to feedback inhibition from blood pressure)

Use: Hypotension (but decreases renal perfusion)

Front 20

Isoproterenol

Back 20

beta1 = beta2 AGONIST

AV block

Increase in heart rate (b1). Increase in pulse pressure (b2 lowering diastolic). Decrease in mean blood pressure (b2 lowering diastolic and vasodialation compensatory to increase in heart rate).

Front 21

Dopamine

Back 21

D1=D2 > beta > alpha

Shock (increases renal perfusion), heart failure

Front 22

Dobutamine

Back 22

beta1 > beta2 AGONIST

ionotrope but not chronotropic

Shock, heartfailure, cardiac stress test

Front 23

Phenylephrine

Back 23

AGONIST a1 > a2

Pupillary dialation, vasoconstriction, nasal decongestion

Front 24

Albuterol

Back 24

b2 agonist

Acute asthma

Front 25

Terbutaline

Back 25

beta 2 AGONIST

Reduces premature uterine contractions

Front 26

Ritodrine

Back 26

beta2 agonist

Reduces premature uterine contractions

Front 27

Amphetamine

Back 27

Indirect agonist. Induces release of catecholamines.

Narcolepsy, obesity, attention deficit disorder

Front 28

Ephedrine

Back 28

Indirect agonist. Promotes catecholamine release

Nasal decongestion, urinary incontinence, hypotension

Front 29

Cocaine

Back 29

NE re-uptake inhibitor

Vasoconstriction and local anesthesia

Front 30

Clonadine, alpha-methyldopa

Back 30

CENTRALLY ACTING alpha 2 AGONISTS

Hypertension, especially in renal disease (no decreased renal flow).

Alphamethyldopa is only antihypertensive (other than hydralazine) safe for pregnant women.

Front 31

Phenoxybenzamine

Back 31

ALPHA blocker. IRREVERSIBLE.

Pheochromocytoma, irreversible so high catecholamines can't overcome

Front 32

Phentolamine

Back 32

Reversible non-selective alpha antagonist

Front 33

Phenoxybenzamine (toxicity)

Back 33

Orthostatic hypotension, reflex tachycardia

Front 34

Prazosin, terazosin, doxazosin

Back 34

Alpha1 selective antagonists.

Hypertension, urinary retension in BPH

1st-dose orthostatic hypotension, dizziness

Front 35

Prazosin, terazosin, doxazosin (toxicity)

Back 35

1st dose orthostatic hypotension, dizziness, headache

Front 36

Mirtazapine

Back 36

Alpha2 blocker.

Used for depression (blocks feedback inhibition of NE and 5-HT)

Front 37

Mitrazapine (toxicity)

Back 37

Sedation(H1 blocking), increased serum cholesterol & appetite

Front 38

Beta blockers uses

Back 38

Hypertension, Angina, MI, SVT, CHF, Glaucoma

Front 39

Beta blockers for SVT

Back 39

Propranolol, esmolol

Front 40

Beta blocker for Glaucoma

Back 40

timolol

Front 41

Beta blocker (toxicity)

Back 41

Impotence, exacerbation of asthma, bradycardia, AV block, CHF, seadtion, sleep alterations.

Increased VLDL (chol & TGL). Decreased HDL.

Front 42

Atropine (eye)

Back 42

pupil dialation (mydriasis), cycloplegia

Front 43

Atropine (airway)

Back 43

decreased secretions. decreased contraction

Front 44

Atropine (Stomach)

Back 44

decreased acid

Front 45

Atropine (Gut)

Back 45

decreased motility

Front 46

Atropine (Bladder)

Back 46

decreased urgency in cystitis

Front 47

Atropine (toxicity)

Back 47

inc body temp, rapid pulse, dry mouth, flushed skin, cycloplegia, constipation, disorientation

Front 48

Hexamethonium

Back 48

Nicotinic antagonist. (Nn)

Ganglionic blocker. Prevents reflex tachycardia

Front 49

propranolol

Back 49

non-selective beta blocker (beta1 = beta2)

hypertension, aortic dissection, arrrhythmias

Front 50

acebutalol

Back 50

beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)

Intrinsic sympathomimetic activity (in other words, it is a partial beta agonist). Therefore, minimal bradycardia and minimal increase in VLDL.

Front 51

metoprolol

Back 51

beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)

Front 52

atenolol

Back 52

beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)

Front 53

pindolol

Back 53

non-selective beta blocker (beta1 = beta2)

Intrinsic sympathomimetic activity (in other words, it is a partial beta agonist). Therefore, minimal bradycardia and minimal increase in VLDL.

Front 54

carvedilol

Back 54

non-selective beta blocker (b1 = b2)

Also a vasodialator:
-a1 blockade
-Ca2+ channel blockade

Protective against detrimental remodeling post MI. Increased survival in CHF.

Front 55

labetalol

Back 55

non-selective beta blocker (b1 = b2)

Also a vasodialator:
-a1 blockade
-partial beta2 agonist

Beneficial in long-term CHF management (as is carvedilol).

Front 56

fenoldopam

Back 56

D1 receptor agonist leading to renal and splanchnic vasodialation. Some alpha2 stimulation (feedback inhibition of adrenergic release).

Lowers BP and increases renal perfusion.

Front 57

pralidoxime

Back 57

chemical antagonist used to regenerate active cholinesterase by REMOVING ORGANOPHOSPHATE. But cannot be used too long after poisoning because the organophosphate/Acetylcholinesterase bond becomes permanent.

Front 58

esmolol

Back 58

beta1 selective agonist

short acting

Front 59

betaxolol

Back 59

beta1 selective antagonist

Front 60

pancuronium

Back 60

non-depolarizing paralysis inducer (usually for surgery)

Nm receptor antagonist

Front 61

succinylcholine

Back 61

depolarizing paralysis inducer

cholinergic agonist (Nm mostly) that cannot be hydrolyzed by AChE