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15 Cards in this Set

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botulinum toxin
Class: cholinergic nerve blocker
Action: blocks release of ACh
Tx.: spasms of larynx/eyelid, botox for cosmetics.
Side Effects:
Counterin.:
Notes:
echothiophate
Class: organophosphate AChE inhibitor
Action: inhibits AChE and PCE.
Tx.: Strabismus, wide-angle glaucoma
Side Effects:
Counterin.:
Notes:
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carbachol
Class: direct cholinomimetic
Action: a carbamic acid ester cholinomimetic; resistant to AChE. Causes iris circular mm contraction, ↑g alignment of trabeculae and thus outflow of aqueous humour through Canals of Schlemm.
Tx: wide-angle glaucoma, temp. management of narrow-angle glaucoma.
Side Effects:
Counterin.: small ant. chamber volume due to resulting convexity of lens
Notes: a quaternary amine applied locally; systemic nic effects are minimised.
bethanechol
Class:direct cholinomimetic
Action: a carbamic acid ester; naturally resistant to AChE. Specific for mus-R
Tx: Urinary Retention
Side Effects:
Counterin.: Unlike real ACh, bethanechol is minimally degraded by ACE.
Notes:
edrophonium
Class: AChE Inhibitor
Action: weakly interact with AChE subsites; readily reversible.
Tx.: Dx of Myasthenia Gravis
Side Effects:
Counterin.:
Notes:
neostigmine
Class: AChE Inhibitor
Action: carbamylates ACE; ACE decarbamylation occurs at medium rate. Thus longer acting than edrophonium.
Tx: Myasthenia Gravis, smooth mm atony of GI and urinary tract (ileus) following surgery.
Side Effects:
Counterin.:
Notes: quaternary amine, significant amt not absorbed.
physostigmine
Class: AChE Inhibitor
Action:
Tx: antimuscarinic toxicity, wide-angle glaucoma.
Side Effects:
Counterin.:
Notes: a 3° amine that gains access to CNS.
tubocurarine
Class: neuromuscular blockade
Action: a competitive inhibitor of the Nic NMJ R.
Tx: neuromscular blockade during surgery
Side Effects:
Counterin.:
Notes: reversed with AChE inhibitors; ↑'d ACh will out-compete tubocurarine at nic RR.
pyridostigmine
Class: AChE Inhibitor
Action:
Tx: Myasthenia Gravis
Side Effects:
Counterin.:
Notes: 4° amine, significant amt not absorbed.
pralidoxime
Class:
Action: quaternary N atom combines with anionic site and catalyses dephos'n of alkyl-phos'd AChE.
Tx: organophosphate toxicity
Side Effects:
Counterin.: non-organophosphate AChEI poisoning, due to some AChEI action.
Notes: Insignificant central effects; 4° amine, can't cross BBB easily. Very short half-life.
succinylcholine
Class: depolarising blockade
Action:
Tx.: neuromuscular blockade during surgery
Side Effects:
Counterin.:
Notes: Unlike tubocurarine, cannot be reversed by AChEIs
atropine
Class: Mus R antagonists
Action: competitive inhibitor of mus R.
Tx.: preop. med. to ↓ mus side effects; to reverse bradycardia in MI; anti-AChE poisoning; to induce mydriasis for eye exam.
Side Effects:
Counterin.:
Notes:
scopolamine
Class: Mus R antagonist
Action: competitive inhibitor of mus R
Tx.: motion sickness, preoperative med. to ↓ mus side effects, to reverse bradycardia in MI.
Side Effects:
Counterin.:
Notes: greater CNS action and longer half-life than atropine. Readily crosses the placenta.
ipratropium
Class: Mus antagonist
Action: for unclear reasons, ↓s both watery and mucous secretions.
Tx.: asthma
Side Effects:
Counterin.:
Notes: 4° amine; inhalant