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Peripheral Nervous System Pharmacological Agents

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Updated 2008-05-05 15:33

PNS Agents

ClassDrugsUses
muscarinic receptor agonistsacetylcholine, carbamylcholine, bethanecol, pilocarpineresearch; OA glaucoma; gastrointestinal stasis, stimulate urination; OA glaucoma, emergency treatment of CA glaucoma, stimulate salvation, treatment of muscarinic antagonist overdose
muscarinic receptor antagonistsatropine, scopolamine, quaternary amines (methylatropine)GENERAL antispasmadics(in intestine and colon); mydriasis; motion sickness(CNS effects); urge incontinence and antispasmatics
ganglionic stimulants/nicotinic receptor agonistsnicotineinsectisides, smoking cessation, experimental for ulcerative colitis and certain neuralogic disorders
ganglionic blockers/nicotinic antagonistshexamethonium, mecamylamineessential hypertension, hypertensive crisis, test for pheochromocytoma
non-depolarizing neuromuscular blockersd-tubocurarineproduction of skeletal muscle relacation during surgery, for controlled ventilation during surgery, facilitate orthopedic procedures (bone setting), electroconvulsive shock(prevent injury), to permit forced ventilation in ventilatory failure
depolarizing neuromuscular bockerssuccinylcholinefacilitate tracheal intubation
cholinesterase inhibitors(anticholinesterases)endrophonium, neostigmine and pyridostigmine, physostigmine, donepezil, echothiophate(ir)diagnosis of myasthenia gravis; treatment of mysathenia gravis, reverse nondepol. NM blockade; OA glaucoma, Alzheimer's, antimuscarinic poisoning; Alzheimer's; OA glaucoma
cholinesterase reactivatorpralidoxime(2-PAM)for organophosphate anticholinesterase intoxication
Drugs/toxins inhibiting Neuromuscular Transmission or Muscle ContractionDantrolene, Botulinum toxins(7)malignant hyperthermia, neuroleptic malignant syndrome, spasticity; local injection into muscles to cause weakness or reduce spasm
Nonselective adrenergic receptor agonists(alpha and beta)Norepinephrine and Epinephrinelocal vasoconstriction, nose, throat and larynx surgery, slow abs. or local anesthetics, open angle glaucoma, cardiovascular shock (NE), cardiac arrest(EP), bronchial asthma(OTC), anaphylactic shock (EP)
alpha1 receptor selective agonistsphenylepherine, axymetazoline, tetrahydrozolinemydriatic agent, cardiovascular shock, slow abs. of local anesthetics, nasal and ocular decongestion; nasal and ocular decongestion
alpha2 receptor selective agonistsclonidine, methyldopahypertension, in select drugs reduce anxiety symptoms, analgesia, sedative/hypnotic effect, anesthesia(vet)
nonselective beta receptor agonistsisoproterenolemergency cardiostimulant, brochodilator in asthma
beta2 receptor selective agonistsalbuterol, terbutaline, salmeterol; ritodrineasthma; uterine relaxation in premature labor
indirectly acting sympathomimetic amines/ those with mixed indirect and direct actionsTyramine, Ephedrine, Pseudoephedrine, Amphetamine, methamphetamine"cheese effect" causes inc. NE when taking MAOI; bronchodilation in asthma, nasal decongestion; nasal decong.; appetite suppression, ADHD, narcolepsy; rec drug
non-selective alpha receptor antagonistsphenoxybenzamine(haloalkylamine), phentolamine(imidazoline)epinephrine reversal, pheochromocytoma, benign prostatic hypertrophy, periphereal vascular disease; acute control of hypertension in pheochromocytoma, acute control of hypertensive emergencies, prevention of dermal necrosis, treatment of impotence via injection
alpha receptor selective antagonistsprozasin, tamsulosin(alpha 1A)essential hypertension, CHF, peripheral vascular disease, hemorrhagic shock, benign prostatic hypertrophy; benign prostatic hypertrophy
non-selective beta receptor antagonistspropranololhypertension, prevention of cardiac dysrhythmias, CHF, cardioprotection following MI, angina pectoris, hyperthyroidism, OA glaucoma, prevention of migraines, treatment of anxiety symptoms, essential tremor and drug-induced tremor
beta1 receptor selective antagonistsatenololsimilar to non-selective beta antagonists but preferred for patients w/ diabetes, peripheral vascular disease, bronchospasm
beta receptor selective antagonists/agents with intrinsic sympathomimetic activity (ISA)pindololclinical significance controversial
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