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Autonomic Pharmacology

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navyy's version from 2017-09-10 20:16

Section

Question Answer
CarbacholDirect Acting Cholinergic (MUSC) Agonist - Choline Ester, local application to produce miosis, LT therapy for Glaucoma
BethanecholDirect Acting Cholinergic (MUSC) Agonist - Choline Ester, stim contraction of bladder and bowel for GI and Urinary retention problems
PilocarpineDirect Acting Cholinergic (MUSC) Agonist - Alkaloid, Tx of Glaucoma
MuscarineDirect Acting Cholinergic (MUSC) Agonist - Alkaloid, TX: NONE
AtropineMUSC Antagonists - Tx for organophosphate poisoning, min CNS effects, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
ScopolomineMUSC Antagonists - Tx for motion sickness, anti-emetic, prominent CNS effects, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
IpratropiumMUSC Antagonists - Tx for asthma/COPD, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
CyclopentolateMUSC Antagonists - Used in opthamology for examination of the eye by produsing mydriasis, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
PirenzepineMUSC Antagonists - Tx for GI tract to dec secretions, reduce excessive salvation, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
TolterodineMUSC Antagonists - Tx for selective M2/M3 blocker, for urinary incontinence, Contraindicated in patients with Glacoma, BPH, Gastric Reflux
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Section

Question Answer
EdrophoniumIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Alcohol - REV), Used to test for Myasthenia Gravis patient dosing, SIDE EFFECTS = DUMBELSS
DonepezilIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Alcohol - REV), Used to Tx Early Alzheimers, crosses BBB, SIDE EFFECTS = DUMBELSS
PhysostigmineIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Carbamate Ester - REV), Used to Tx Glaucoma, SIDE EFFECTS = DUMBELSS
NeostigmineIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Carbamate Ester - REV), Used to Tx Myasthenia Gravis, Postop Ileus, SIDE EFFECTS = DUMBELSS
PyridostigmineIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Carbamate Ester - REV), Used to Tx Myasthenia Gravis, SIDE EFFECTS = DUMBELSS
AmbenoniumIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Carbamate Ester - REV), Used to Tx Myasthenia Gravis, SIDE EFFECTS = DUMBELSS
EchothiophateIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Organophosphate -IRR), Used as an insectaside, NOT LIPOPHILIC, SIDE EFFECTS = DUMBELSS
MalathionIndirect Acting Cholinergic Agonist AKA Anticholinesterase (Organophosphate -IRR), Used as an insecticide, SIDE EFFECTS = DUMBELSS
Soman, Sarin, DFP Indirect Acting Cholinergic Agonist AKA Anticholinesterase (Organophosphate -IRR), Used as chemical warfare agent in civilian attacks, SIDE EFFECTS = DUMBELSS
2 PAM AKA PralidoxmineCholinesterase Reactivator, Used with Atropine for Anticholinesterase poisoning AKA organophosphate poisoning
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Section

Question Answer
TubocurarineNMJ Blocker - COMP Blocker, interferes with transmission at motor end plate by blocking nAch rec, spastic paralysis
SuccinylcholineNMJ Blocker - DEPOL'G Blocker, interferes with transmission at motor end plate by producing depolariztion block, 2 phases: 1) depol + flaccid paralysis 2) repol but desensitzation to Ach
NicotineGanglion Stimulant - works at both nAch rec of sym and ps NS, TOXIC EFFECTS
HexamethoniumGanglion Blocker - works at both nAch rec of sym and ps NS, initial HTN ctrl in patients with dissecting aneurysm. Action predicted by knowing predom tone of tissues (ONLY BV, VENTRICULAR FOC AND SWEAT GLANDS HAVE PREDOM SYM TONE)
TrimethphanGanglion Blocker - works at both nAch rec of sym and ps NS, initial HTN ctrl in patients with dissecting aneurysm. Action predicted by knowing predom tone of tissues (ONLY BV, VENTRICULAR FOC AND SWEAT GLANDS HAVE PREDOM SYM TONE)
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Question Answer
MethoxamineAlpha 1 Agonist, Limited Use in Hypotension, Shock, no longer used for PAT
PhenylephrineAlpha 1 Agonist, Mydriatic, Nasal Decong, Used as diagnostic tool for Horners
ClonidineAlpha 2 Agonist, Tx for HTN (also for migrane, withdrawal, ADHD, Tourettes), 50% OF PATIENTS EXPERIENCE SEDATION, Abrupt Disuse can result in withdrawal
ApraclonidineAlpha 2 Agonist, Tx for Glaucoma (decs intraoccular pressure), 50% OF PATIENTS EXPERIENCE SEDATION, Abrupt Disuse can result in withdrawal
GuanfacineAlpha 2 Agonist, Tx for Tourettes, 50% OF PATIENTS EXPERIENCE SEDATION, Abrupt Disuse can result in withdrawal
MethyldopaAlpha 2 Agonist, Tx for HTN, 50% OF PATIENTS EXPERIENCE SEDATION, Abrupt Disuse can result in withdrawal
PhenoxybenzamineIRR Nonselective Alpha Blocker, Tx of Pheochromocytoma - Dec in BP in upright position only
PhentolamineREV Nonselective Alpha Blocker, Tx for ST ctrl of HTN in patients with Pheochromocytoma, Clonidine Withdrawal - Dec in BP in upright position only
TolazolineREV Nonselective Alpha Blocker, Tx for pulmonary HTN of the newborn - Dec in BP in upright position only
PrazosinAlpha 1 Antagonists, Tx of HTN, Refrac CHF, Urinary Obstruction due to BPH bc it relaxes SM increasing urine output, SIDE EFFECT: 1ST DOSE PHENOMENON
Yohimbine Alpha 2 Antagonists, Tx of male sexula dysfunction - Inc in sym outflow = Inc in NE (alpha 1 inc in BP)
Ergot AlkoloidsAlpha rec blocking properties, as well as 5 HT, DA rec effects, Tx of migrance, prevention of postpartum hemorrhage
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Section

Question Answer
AmphetamineIndirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, Tx for Obesity, Narcolepsy, Enuresis, ADHD
MethamphetamineIndirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, More prominent CNS then peripheral effects, Tx for Obesity, Narcolepsy, Enuresis, ADHD
MethylphenidateIndirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, more prominent effects on mental activites then motor activites, Tx for Obesity, Narcolepsy, Enuresis, ADHD
MDMA (Ecstacy)Indirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, Tx for Obesity, Narcolepsy, Enuresis, ADHD
AtomoxetiveIndirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, Tx for ADHD ( selective for NE reuptake)
CocaineIndirect Acting Sympathomimetic, Inc rel or inhibit uptake of CAs, Street Drug (selective for DA reuptake)
EphedrineIndirect Acting Sympathomimetic, Inc NE rel, Bronchodilation, Nasal Decong, Enhanced Perf, Weight Lose (no longer legal dietary supplement)
TyramineIndirect Acting Sympathomimetic, Taken up into presyn term and causes rel of CAs, found in certain foods, naturally broken down by MAO in liver, patients on MAO inhibitors should avoid these foods (wine, cheese, nuts) to avoid a HTN crisis
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Section

Question Answer
Epinephrine - BIG PUSHNONSELECTIVE Alpha and Beta Stimulant, Alpha 1 response predominates (A1 - Inc MAP, Muscarinic reflex dec in HR, A1 Inc and B2 Dec = Inc TPR, Beta 1 Inc HR, Used for 5 As (Asthma, Allergy, Anaphalactic Rxn, Anesthesia, Cardiac Arrest
Epinephrine - SLOW PUSHNONSELECTIVE Alpha and Beta Stimulant, Beta 2 response predominates (A1 - Inc MAP, B2 Dec TPR, B1 Inc HR w/ NO vagal reflex!), Used for 5 As (Asthma, Allergy, Anaphalactic Rxn, Anesthesia, Cardiac Arrest
NEAlpha 1 & 2, Beta 1 ONLY Stimulant, Dec HR, Inc in TPR, Limited Use in Shock
DopamineLow --> D1 , Med --> B1, High --> A1, Titrate dose used to Tx shock patients to prevent renal failure.
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Section

Question Answer
IsoproterenolNONSELECTIVE Beta Agonist - Limited Use as cardiac stim, Met'd by COMT
DobutamineBeta 1 agonist w/ some Alpha 1 activity - Tx of Acute MI, Cardiac decompensation
AlbuterolBeta 2 agonist, Tx of COPD, Acute Bronchospasm
MetaproteranolBeta 2 agonist, Tx of COPD, Acute Bronchospasm (A little less selective)
TerbutalineBeta 2 agonist, Tx of COPD, Acute Bronchospasm, also used to Tx Status Asmaticus
ProprandolNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks (Specifically used for Migrane and Stage Fright)
NadololNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks
TimololNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks (Specifically used for Glaucoma)
PinodololNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks - ISA ACTIVITY
LabetololNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks - ALSO BLOCKS Alpha 1 rec
SotalolNonselective Beta Blocker, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks (Specifically used for Arrythmia)
AtenololBeta 1 selective antagonist, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks
Metoprolol Beta 1 selective antagonist, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks - DO NOT USE IN PATIENTS WITH ACUTE MI
Esmolol Beta 1 selective antagonist, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks
Acebutolol Beta 1 selective antagonist, No effect to resting heart, Tx for HT, Angina, Ventri Arrythmia, Migrane, Glacoma, MI, Thyroid (Hyper), Panic Attacks - ISA ACTIVITY
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Section

Question Answer
Metyrosineinhibits tyrosine hydroxylase, Tx for pheochromocytoma
ReserpineBinds, disrupts integrity of storage vesicles, psychotic side effects
GuanethidineInhibits NE release, Tx for HTN
BretyliumBlocks Action potential therefore inhibits NE release, Tx for Arrythmias
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