Shelf: Lippincot's Autonomics
Terms
undefined, object
copy deck
- ACh
-
direct acting cholinergic- M and N
not used therapeutically - bethanechol
-
direct acting cholinergic- M
stimulate atonic bladder - carbechol
-
direct acting cholinergic- M and N
used as miotic agent and to decrease intraocular pressure
also can cause release of epi from adrenal medulla by its nicotinic action - pilocarpine
-
direct acting cholinergic- M
rapid miosis and contraction of ciliary mm -> tx emergency narrow angle and wide angle glaucoma
can enter the brain and cause CNS disturbances; marked sweating and salivation - edrophonium
-
AChE inhibitor
alcohol- short acting
diagnosis of MG- leads to a rapid increase in muscle strength
if excess drug is taken -> cholinergic crisis -> atropine as antidote - neostigmine
-
AChE inhibitor
carbamate- int acting
tx MG, bladder and GI atony
does not enter CNS
tx tubocurarine overdose - physostigmine
-
AChE inhibitor
carbamate- int acting
tx bladder or intestinal atony
can treat glaucoma, can enter CNS
used to treat atropine, phenothiazine, and TCA overdoses - pyridostigmine
-
AChE inhibitor
carbamate- int acting
chronic management of MG - echothiophate
-
AChE inhibitor
organophosphate- very long acting
tx chronic open angle glaucoma - isoflurophate
-
AChE inhibitor
organophosphate- very long acting
tx chronic open angle glaucoma - pralidoxime
-
reactivation of AChE
can reverse effects of isoflurophate (except those in CNS) if given before aging occurs (loss of alkyl group) - hemicholinium
- inhibits transport of choline into nerve
- botulinum toxin
- inhibits release of ACh
- spider venom
- causes release of ACh
-
acetazolamide
epinephrine
timolol - chronic treatment of glaucoma
- atropine
-
antimuscarinic
when placed in eye, effects may last for days, instead of 4 hrs
mydriatic and cycloplegic -> measure refractive errors (in young people only!! don't want to induce glaucoma)
relax bladder and GI tract
antidote for cholinergics
block secretions in respiratory tract before surgery
Dry as a bone, red as a beet, hot as a hare, mad as a hatter - ipratropium
-
antimuscarinic
tx asthma and COPD - scopolamine
-
antimuscarinic
prevention of motion sickness and blocking short-term memory - mecamylamine
-
nicotinic ganglion blocker
tx moderately severe or severe HTN - nicotine
- nicotinic ganglion blocker
- trimethaphan
-
nicotinic ganglion blocker
IV given for emergency hypertension from pulmonary edema or dissecting aortic aneurysms - atracurium
-
NM blocker- non-depolarizing
good for mechanical ventilation of critcally ill patients and for short surgical procedures
spontaneously degrades in plasma!! -> dose does not need to be altered in patients with renal failure - doxacurium
-
NM blocker- non-depolarizing
(all NM blockers:
first eyes then fingers, limbs, nec, trunk, intercostals, and diaphragm;
all given IV) - metocurine
- NM blocker- non-depolarizing
- mivacurium
-
NM blocker- non-depolarizing
great for short surgical procedures - pancuronium
-
NM blocker- non-depolarizing
vagolytics -> inc HR - pipercuronium
- NM blocker- non-depolarizing
- rocuronium
-
NM blocker- non-depolarizing
rapid onset of action -> good for tracheal intubation in patients w/ gastric contents
clearance prolonged w/ hepatic disease - vecuronium
-
NM blocker- non-depolarizing
clearance prolonged w/ hepatic disease - tubocurarine
-
NM blocker- non-depolarizing
may induce histamine release and promote ganglionic blockade; can also lower BP - succinyl choline
-
NM blocker- depolarizing
fasciculations (Phase 1) then paralysis (Phase 2)
rapid endotracheal intubation required during anesthesia
used in ECT - halothane
-
enhances NM blockade by stabilizing action at NMJ
causes malignant hyperthermia w/ succinyl choline (tx w/ dantrolene) - aminoglycosides
-
inhibit ACh release by competing w/ Ca ions
synergize -> enhancing blockade - Ca channel blockers
- increase NM block
- albuterol
-
direct adrenergic agonist
b2
tx of bronchospasm and premature labor - clondine
-
direct adrenergic agonist
a2
tx HTN - dobutamine
-
direct adrenergic agonist
b1
*a catecholamine*
tx of CHF - dopamine
-
direct adrenergic agonist
dopaminergic and b1
*a catecholamine*
tx of shock and CHF - epinephrine
-
direct adrenergic agonist
a1 a2 (high doses)
b1 b2 (low doses)
* a catecholamine*
acute asthma
tx open angle glaucoma
anaphylactic shock
local anesthetics to inc duration of action
can cause hyperglycemia
cardiac arrhythmias w/ digitalis
must be reduced w/ hyperthyroid pt's - isoproterenol
-
direct adrenergic agonist
b1 and b2
* a catecholamine*
asthma
cardiac stimulant - metaproterenol
-
direct adrenergic agonist
b2 > b1
tx bronchospasm - methoxamine
-
direct adrenergic agonist
a1
tx of supraventricular tachycardia
not likely to trigger arrhythmias in anesthetized pt!! - norepinephrine
-
direct adrenergic agonist
a1 a2 b1
*a catecholamine*
tx of shock - phenylephrine
-
direct adrenergic agonist
a1
nasal decongestant
tx of supraventricular tachycardia
can cause hypertensive headache - ritodrine
-
direct adrenergic agonist
b2
tx of bronchospasm and premature labor - terbutaline
-
direct-acting adrenergic
b2
tx bronchospasm and premature labor - amphetamine
-
indirect acting adrenergic- taken into presynaptic neuron and cause release of NE from vesicles
a, b, CNS
tx ADD - tyramine
- indirect acting adrenergic- taken into presynaptic neuron and cause release of NE from vesicles
- ephedrine
-
mixed action adrenergic
a, b, CNS
tx asthma prophylactically
nasal decongestant
helps w/ MG - metaraminol
-
mixed action adrenergic
tx shock and acute hypotension - reserpine
- inhibits DA uptake into vesicle
-
guanethidine
bretylium - blocks NE release
-
cocaine
TCAs - block NE reuptake
- doxazosin
-
a1-blocker (lowers BP -> reflex tachycardia; epinephrine reversal)
tx hypertension
benign prostatic hypertrophy
excreted in feces, instead of urine
longest acting
may cause first dose hypotension - phenoxybenzamine
-
a1 and a2 blocker
tx pheochromocytoma
Raynaud's
autonomic hyperreflexia - phentolamine
-
a1 and a2 blocker
shorter acting
diagnose pheochromocytoma
contraindicated in patients w/ decreased coronary perfusion - prazosin
-
a1-blocker
tx hypertension
benign prostatic hypertrophy
may cause first dose hypotension
give w/ diuretic - terazosin
-
a1-blocker
tx hypertension and benign prostatic hypertrophy
may cause first dose hypotension - acebutolol
-
cardioselective beta-1-blocker
w/ partial agonist activity
tx hypertensive patients w/ impaired pulmonary function and w/ diabetes - atenolol
-
cardioselective beta-1-blocker
tx hypertension - labetalol
-
alpha and beta blocker
tx hypertensive patients in whom increased peripheral vascular resistance is undersirable- black patients and pregnant patients - metaprolol
- beta-1 blocker
- nadolol
-
nonselective beta blocker
tx hypertension
very long acting - pindolol
-
beta blocker w/ partial agonist activity
HTN patients w/ moderate bradycardia, esp w/ diabetics - propranolol
-
non-selective beta blocker
lowers BP by dec CO
tx glaucoma
tx migraine
blunt hyperthyroidism
tx stable angina
prophylactic for MI - timolol
-
non-selective beta blocker
tx open angle glaucoma