Term
Bethanechol
Cholinomimetic agents - direct agonists |
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Definition
Use - ileus and urinary retentaion
Action - activates bowel and bladder smooth muscle, resistant to AChE
"Bethany call me if you want to activate your bowels and bladder" |
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Term
Carbachol
Cholinomimetic agents - direct agonists |
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Definition
Use - glaucoma, pupillary contraction, relief of intraocular pressure
Action - carbon copy of acetylcholine |
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Term
Pilocarpine
Cholinomimetic agents - direct agonists |
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Definition
Use - potent stimulator of sweat, tears, saliva; open-angle and closed-angle glaucoma
Action - contract ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE
"You cry, drool and sweat on your 'pilow'" |
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Term
Methacholine
Cholinomimetic agents - direct agonists |
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Definition
Use - challenge test for diagnosis of asthma
Stimulates muscarinic receptors in airway when inhaled |
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Term
Neostigmine
Anticholinesterase (indirect cholinomimetic agonist) |
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Definition
Use - ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (postop)
Neo CNS = No CNS penetration |
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Term
Pyridostigmine
Anticholinesterase (indirect cholinomimetic agonist) |
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Definition
Use - myasthenia gravis (long acting); does not penetrate CNS
Action - inc strength
"Pyridostimine gets rid of myasthenia gravis" |
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Term
Endrophonium
Anticholinesterase (indirect cholinomimetic agonist) |
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Definition
| Use - Dx myastenia gravis (extremely short acting) |
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Term
Physostigmine
Anticholinesterase (indirect cholinomimetic agonist) |
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Definition
Use - Anticholinergic toxicity (crosses BBB)
"Physostigmine 'phyxes' atropine overdose |
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Term
Donepezil
Anticholinesterase (indirect cholinomimetic agonist) |
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Definition
| Use - Alzheimer's disease |
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Term
Atropine, homatropine, tropicamide
Muscarinic antagonists |
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Definition
System - eye
Use - produce mydriasis and cycloplegia |
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Term
Benztropine
Muscarinic antagonists |
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Definition
System - CNS
Use - Parkinson's disease
"Park my Benz" |
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Term
Scopolamine
Muscarinic antagonists |
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Definition
System - CNS
Use - Motion sickness |
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Term
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Definition
System - respiratory
Use - COPD, asthma
"I pray I can breathe soon!" |
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Term
Oxybutynin
Muscarinic antagonists |
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Definition
System - GU
Use - Reduce urgency in mild cystitis and reduce bladder spasms |
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Term
Glycopyrrolate
Muscarinic antagonists |
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Definition
System - GI, respiratory
Use - Parenteral: preop use to reduce airway secretions; Oral: drooling, peptic ulcer |
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Term
Atropine
Muscarinic antagonists |
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Definition
Eye - inc pupil dilation, cycloplegia
Airway - dec secretions
Stomach - dec acid secretions
Gut - dec motility
Bladder - dec urgency in cystitis
Toxicity - Hot, dry, red, blind, mad |
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Term
Epineprine
Sympathomimetics - direct |
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Definition
Receptors - alpha 1/2, beta 1/2
Use - anaphylaxis, glaucoma (open angle), asthma, hypotension |
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Term
Norepinephrin
Sympathomimetics - direct |
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Definition
Receptors - alpha 1/2, some beta 1
Use - hypotension (but dec renal perfusion) |
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Term
Isoproterenol
Sympathomimetics - direct |
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Definition
Receptors - beta 1/2
Use - Torsade de pointes (tachycardia decreases dec QT interval), bradyarrhythmias (but can worsen ischemia) |
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Term
Dopamine
Sympathomimetics - direct |
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Definition
Receptors - alpha 1/2 at high dose, beta 1/2 at medium dose, D1 at low dose
Use - shock (renal perfusion), HF; inotropic and chronotropic |
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Term
Dobutamine
Sympathomimetics - direct |
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Definition
Receptors - mainly beta 1, some beta 2 and alpha 1/2
use - HF, cardiac stress testing; inotropic and chronotropic |
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Term
Phenylephrine
Sympathomimetics - direct |
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Definition
Receptors - alpha 1/2
Use - Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant) |
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Term
Albuterol, salmeterol, terbutaline
Sympathomimetics - direct |
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Definition
Receptors - beta 2 > beta 1
Use - metaproterenol and albuteral for acute asthma; salmeterol for long-term asthma or COPD control; terbutaline to reduce premature uterine contractions |
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Term
Ritodrine
Sympathomimetics - direct |
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Definition
Receptors - beta 2
Use - reduces premature uterine contractions |
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Term
Amphetamine
Sympathomimetics - indirect |
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Definition
Action - releases stored catecholamines
Use - narcolepsy, obesity, ADD |
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Term
Ephedrine
Sympathomimetics - indirect |
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Definition
Action - releases stored catecholamines
Use - nasal decongestion, urinary incontinence, hypotension |
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Term
Cocaine
Sympathomimetics - indirect |
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Definition
Action - reuptake inhibitor
Use - causes vasoconstriction and local anesthesia; never give beta-blockers if cocaine intoxication is suspected (can lead to unopposed alpha-1 activation and extreme hypertension) |
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Term
Clonidine, alpha-methyldopa
Sympathoplegics |
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Definition
Action - centrally acting alpha2-agonists, dec central sympathetic outflow
Use - HTN, expecially with renal disease (no dec in blood flow to kidney) |
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Term
Phenoxybenzamine
Irreversible alpha-blocker - nonselective |
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Definition
Use - pheochromocytoma; use before removing tumor, since high levels of released catecholamines will not be able to overcome blockage
Toxicity - orthostatic hypotension, reflex tachycardia |
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Term
Phentolamine
Reversible alpha-blocker = nonselective |
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Definition
| Use - give to pts on MAO-i who eat tyramine-containing foods |
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Term
Prazosin, terazosin, doxazosin, tamsulosin
alpha1 selective alpha-blocker |
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Definition
Use - HTN, urinary retension in BPH
Toxicity - 1st-dose orthostatic hypotension, dizziness, headache |
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Term
Mirtazapine
alpha2 selective alpha-blocker |
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Definition
Use - depression
Toxicity - sedation, inc serum cholesterol, inc appetite |
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Term
| Acebutolol (partial agonist), betaxolol, esmolol (short acting), atenolol, metoprolol |
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Definition
Beta-1 selective antagonists
"A BEAM of beta1-blockers"
Advantages with comorbid pulmonary disease |
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Term
| Propranolol, timolol, nadolol, pindolol |
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Definition
Nonselective beta antagonists
"Please Try Not Being Picky" |
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Term
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Definition
| Nonselective (vasodilatory) alpha and beta-antagonists |
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Term
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Definition
Partial beta-agonists
"PAPA" |
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Term
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Definition
Angina pectoris - dec HR and contractility, resulting in dec O2 consumption
MI - dec mortality
SVT (metoprolol, esmolol) - dec AV conduction velocity (class II antiarrhytmic)
HTN - dec CO, dec renin secretion (due to beta1-receptor blockade on JGA cells)
CHF - slows progression of chronic failure
Glaucoma (timolol) - dec secretion of aqueous humor
Toxicity - impotence, worse asthma, bradycardia, AV block, CHF, seizures, sedation, sleep alterations; use with caution in diabetics |
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