Drugs Of The Autonomic Nervous System

Front 1

activates bowel & bladder smooth muscle. resistant to AChE. Used in post-op & neurogenic ileus, and urinary retention. Direct cholinergic agonist.

Back 1

Bethanechol

Beth-Anne, Call me if you want to activate your Bowel & Bladder

Front 2

Used in glaucoma, pupillary contraction & release of IOP. Direct cholinergic agonist.

Back 2

Carbachol

Front 3

potent stimulator of sweat, tears & saliva. contracts ciliary muscle of eye (open angle), pupillary sphincter (narrow angle); resistant to AChE. Direct cholinergic agonist.

Back 3

Pilocarpine

PILE on the sweat & tears

Front 4

Challenge test for Dx of asthma. Stimulates muscarinic receptors in airway when inhaled. Direct cholinergic agonist.

Back 4

Methacholine

Front 5

Post-op/neurogenic ileus & urinary retention. Post-op reversal of NMJ blockade. Indirect cholinergic agonist: AChEI

Back 5

Neostigmine

NEO = NO CNS

Front 6

Tx: Myasthenia Gravis (long acting). No CNS penetration. Indirect cholinergic agonist: AChEI

Back 6

Pyridostigmine

Front 7

Dx of Myasthenia Gravis (extremely short-acting). Indirect cholinergic agonist: AChEI

Back 7

Edrophonium

Front 8

Tx glaucoma (crosses BBB) & atropine overdose. Indirect cholinergic agonist: AChEI

Back 8

Physostigmine.
"Phyxes" atropine overdose
PHYS is for EYES

Front 9

Tx: Glaucoma

Back 9

Echothiophate

Front 10

Symptoms of AChEI poisoning

Back 10

DUMBBELSS
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skel muscle/CNS, Lacrimation, Sweating, Salivation (& abd cramps)

Front 11

2 Antidotes of AChEI poisoning

Back 11

Atropine (muscarinic antagonist) helps with Sx's. Pralidoxime used to regenerate active AChE

Front 12

Produces mydriasis & cycloplegia, decreases respiratory secretions, decreases gastric acid secretion, decreases gut motility, decreased urgency in cystitis

Back 12

Atropine

Front 13

3 drugs that produce mydriasis & cycloplegia. Muscarinic antagonists

Back 13

Atropine, Homatropine, & tropicamide

Front 14

Muscarinic antagonist used in Parkinson's Dz

Back 14

Benztropine

PARK my BENZ

Front 15

Muscarinic antagonist used in motion sickness

Back 15

Scopolamine

Front 16

Muscarinic antagonist used in asthma & COPD

Back 16

Ipratropium

Front 17

2 Muscarinic antagonists that are used to reduce urgency in mild cystitis & reduce bladder spasms

Back 17

Oxybutynin & Glycopyrrolate

Front 18

2 Muscarinic antagonists that are used in the Tx of peptic ulcers

Back 18

Methscopolamine & propantheline

Front 19

Nicotinic antagonist blocks ACh @ ganglion.

Back 19

Hexamethonium

Front 20

Toxicity with Hexamenthonium

Back 20

Severe orthostatic hypotension, blurred vision, constipation, sexual dysfxn

Front 21

Side Effects of Atropine

Back 21

Hot as a hare (hyperthermia)
Dry as a bone (dry mouth, dry skin)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia, mydriasis)
Mad as a hatter (disorientation, delirium)
Bloated as a toad (constipation, urinary retention)

Front 22

Toxicity of Atropine

Back 22

Elderly: acute angle-closure glaucoma

Men w/BPH: urinary retention

Infants: hyperthermia

Front 23

Sympathomimetic used in anaphylaxis, hypotension, asthma, open-angle glaucoma

Back 23

Epinephrine

Front 24

What is EPI receptor selectivity?

Back 24

Low doses selective for B1 (BLOW)

High doses hits all - a1, a2, B1, B2

Front 25

Sympathomimetic used in hypotension that also results in decreased renal perfusion

Back 25

NE

Front 26

What is NE receptor selectivity?

Back 26

a1, a2 > B1

Front 27

Sympathomimetic rarely used in Tx of AV block

Back 27

Isoproterenol

Front 28

What is isoproterenol's receptor selectivity

Back 28

b1 = b2

Front 29

Sympathomimetic used in hypotension (with theoretical increase in renal perfusion) and heart . Inotropic & chronotropic function

Back 29

Dopamine

Front 30

What is dopamine's receptor selectivity?

Back 30

D1 = D2 > B > a

Front 31

Sympathomimetic used in cardiogenic shock, heart failure & stress testing. inotropic > chronotropic effects

Back 31

Dobutamine

Front 32

What is dobutamine's receptor selectivity?

Back 32

B1 > B2

Front 33

Sympathomimetic used in pupillary dilation, vasoconstriction, & nasal decongestion

Back 33

Phenylephrine

Front 34

What is phenylephrine's receptor selectivity?

Back 34

a1 > a2

Front 35

2 sympathomimetic drugs used in acute asthma

Back 35

Metaproterenol, albuterol

Front 36

Sympathomimetic used in long-term asthma Tx

Back 36

Salmeterol

Front 37

Sympathomimetic given IM for asthma, can reduce premature uterine contractions (tocolisis)

Back 37

Terbutaline

Front 38

What is the receptor selectivity for metaproterenol?

Back 38

B2 > B1

Front 39

What is the receptor selectivity for albuterol?

Back 39

B2 > B1

Front 40

What is the receptor selectivity for Salmeterol?

Back 40

B2 > B1

Front 41

What is the receptor selectivity for terbutaline?

Back 41

B2 > B1

Front 42

Sympathomimetic used to reduce premature uterine contractions (not terbutaline)

Back 42

Ritodrine

Front 43

What is ritodrine's receptor selectivity?

Back 43

B2

Front 44

Indirect sympathomimetic used in narcolepsy, obesity, ADD, & MDD

Back 44

Amphetamine

Front 45

What is the indirect sympathomimetic action of amphetamine?

Back 45

releases stored catecholamines

Front 46

Indirect sympathomimetic that causes vasoconstriction & local anesthesia

Back 46

Cocaine

Front 47

What is cocaine's indirect sympathomimetic action?

Back 47

Inhibits reuptake

Front 48

Sympathoplegic used to Tx hypertension, especially in renal dz (no decreased blood flow to kidneys)

Back 48

Clonidine

Front 49

What is the mechanism of action of clonidine?

Back 49

Centrally acting a2 agonist, decreases central adrenergic outflow

Front 50

What is a sympathoplegic commonly used as an anti-hypertensive in pregnancy?

Back 50

alpha-methyldopa

Front 51

Nonselective alpha blocker used in pheochromocytoma before removing tumor, irreversible blockade

Back 51

Phenoxybenzamine

Front 52

Nonselective alpha blocker used in pheochromocytoma, reversible blockade

Back 52

Phentolamine

Front 53

a1 selective alpha blocker used in Htn, & urinary retention in BPH

Back 53

Prazosin, terazosin, doxazosin

Front 54

What toxicities are associated with phenyoxybenzamine/phentolamine use?

Back 54

orthostatic hypotension, reflex tachycardia

Front 55

What toxicities are associated with a1 blockers?

Back 55

1st dose orthostatic hypotension, dizziness, headache

Front 56

a2 selective alpha blocker used in depression

Back 56

mirtazipine

Front 57

What toxicities are associated with mirtazipine?

Back 57

sedation, increased serum cholesterol, increased appetite

Front 58

B-blockers that decrease mortality post-MI

Back 58

metoprolol & carvedilol

Front 59

What caution should be give to diabetics taking a B-blocker?

Back 59

B-blocker can mask Sx of hypoglycemia (racing heart, etc)

Front 60

What kind of heart failure is benefited from B-blocker use?

Back 60

chronic

B-blockers contraindicated in acute heart failure

Front 61

What adverse effects are seen in B-blocker use?

Back 61

impotence, exacerbation of asthma (esp in nonselectives), bradycardia, AV block, CHF, sedation, sleep alteration

Front 62

What are the nonselective B-blockers?

Back 62

Nadolol, Pindolol, Propranolol, Timolol & Labetalol

Think last 1/2 of alphabet (N - Z)

Front 63

What are the B1 selective B-blockers?

Back 63

Acebutolol (partial agonist), Atenolol, Betaxolol, Esmolol, Metoprolol

Front 64

Which B-Blockers also block a-receptors

Back 64

Carvedilol & Labetalol

Front 65

What is the short-acting B-blocker?

Back 65

esmolol

Front 66

What should cocaine users never be put on B-blockers?

Back 66

Increase in BP, due to blocked B2 action of cocaine...unopposed alpha activation

Front 67

Why are B-blockers useful in a dissecting aortic aneurysm?

Back 67

Decrease the slope of the rise in blood pressure with each heartbeat