epinephrine (Adrenalin)

albuterol (Proventil)

Beta-adrenergic blockers

- generally end in "olol"

- blocks beta 1 = decrease B/P and HR

- blocks beta 2 = bronchoconstricts

- propanolol (Inderal)

- atenolol (Tenormin)

Adrenergic neuron blockers

- block release of norepi.

- decrease B/P

- reserpine (Serpalan)

bethanechol (Urecholine)

 - improves ACh production, affects smooth muscle

- cardio: decrease B/P, HR

- GI: increase tone and motility

- GU: increase bladder contractions

- eye: constrict pupil, accomodation

- lungs: bronchoconstricts, increase secretions

- glands: increase secretions

- striated muscle: increase neuromuscular transmission, maintain strength and tone

Indirect-acting Cholinergic agonists

(for Myasthenia Gravis)

neostigmine (Prostigmin)

pyridostigmine (Mestinon)

edrophonium (Tensiolon)

• inhibit cholinesterase
• allow ACh to activate muscarinic (smooth musc.) & nicotinic (skeletal) receptors
• increased tone, strength of muscles
• increased GI/GU motility
• bradycardia
• miosis (pupil constriction)
• bronchoconstriction

atropine

trihexiphenidyl HCl (Artane)

tolterodine tartrate (Detrol)

antihistamines (anticholinergic effects)

• Cardio: large dose increases HR, low dose decreases
• Lungs: bronchodilation, decrease secretions
• GI: decrease tone, motility, secretions
• GU: increase sphincter constriction
• Eye: dilates pupils (mydriasis)
• Glands: decrease secretions
• CNS: decrease tremors and rigidity

Amphetamines

(used for ADHD & narcolepsy)

amphetamine (Adderall)

• stimulates release of norepi. & dop.
• increase wakefulness in narcolepsy
• increase attention span, cognition
• decrease hyperactivity, restlessness, impulsivity in ADHD

SEs/adv. reacs.

• tachycardia, palpitations, HTN, dysrhythmias
• insomnia, restlessness
• irritability
• anorexia, dry mouth, wt. loss, diarrhea, constipation
• impotence

methylphenidate (Ritalin)

• CNS stimulant for ADHD, fatigue, narcolepsy
• caffeine increases FX (tox risk)
• decreases FX of decongestants, antiHTNs, barbituates
• tachy, palps, dizzy, HTN
• insomnia, restlessness, anxiety, tremors, irritability
• possible increased hyperactivity
• anorexia, anticholinergic FX
• thrombocytopenia

Analeptics

(caffeine)

Caffeine (coffee, chocolate, cold meds), theophylline, NoDoz

• stimulate respirations in newbors
• restlessness, tremors, twitching
• palpitations, insomnia
• tinnitus, nausea, diarrhea
• psychologic dependence

Sedatives/hypnotics

(limit use 8-10 days)

Barbituates

• secobarbital (Seconal) - hypnotic
• severe resp. depression, laryngospasm, resp. distress

Benzodiazepenes

• alprazolam (Xanax) - sedative/hypnotic
• alcohol + benzos = lethal

Nonbenzodiazepines

• zopidem (Ambien) - hypnotic
• sleep driving, suicidal reaction

Anticonvulsants

Hydantoins

- phenytoin (Dilantin)

• decreases Na⁺ influx in neurons
• gingivitis, hyperplasia, nystagmus, teratogenic, alopecia,
• Thrombocytopenia, Stevens-Johnson syndrome
• harmless, pink or brown urine

Antiparkinsons

carbidopa-levodopa (Sinemet)

Action: converted to dopamine in the brain

      - increased mobility

Side FX:

• fatgiue, insomnia
• dry mouth
• blurred vision
• orthostatic hypotension, palpitations, dysrhythmias
• urinary retention, dark urine
• nausea, vomiting
• dyskinesia, psychosis, severe depression
• neuroleptic malignant syndrome

Acetylcholinesterase inhibitors (for Alzheimer's)

tacrin (Cognex)

• allows more ACh in neuron receptors
• increase cognitive function
• headache, dizziness
• depression
• GI distress
• dehydration, dry mouth, constipation
• blurred vision
• insomnia
• HTN, hypotension, dysrhthmias
• hepatotoxicity

Cholinesterase inhibitors (for Myasthenia Gravis)

pyridostigmine (Mestinon)

atropine is antidote

• transmission of neuromuscular impulses by preventing destruction of ACh
• Myasthenic crisis = underdose
• Cholinergic crisis = overdose
• similar symptoms
• musc. wkness, dyspnea
• dysphagia, abdominal cramps
• drooling, increased tears, sweating
• bradycardia

Skeletal muscle relaxants

carisprodol (Soma)

• acts on CNS to suppress muscle activity
• used for spasticity
• diplopia
• headache
• GI distress
• weakness, insomnia
• tachycardia, hypotension
• physical dependency

NSAID's

• aspirin (acetylsalicylic acid)(ASA)
• ibuprofen (Motrin, Advil)
• celecoxib (Celebrix)

SE's

• Tinnitus, hearing loss
• GI distress, peptic ulcer
• dizziness, confusion, drowsiness
• thrombocytopenia, leukopenia, agranulocytosis
• hepatotoxicity
• bleeding, edema
• nephrotoxicity

Antigout

• allopurinol (Zyloprim)

• decreases production of uric acid

Nonopioid analgesic

• acetminophen (Tylenol)

Opioid analgesic

• morphine

Opiate agonists-antagonists

• nalbuphine (Nubain)

Opioid antagonists

• naloxone (Narcan)
• antidote for narcotics