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Drug Classes

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Bethanechol
cholinergic
contraction of smooth muscle in tx of urinary retention
Neostigmine
Cholinergic
(Reversible indirect action)Inhibits the breakdown of acetylcholine. Acetylcholine remains in the synapse.
Inhibits cholinesterase enxyme

Improves muscle strength in myasthenia gravis.
Prevents post operative urinary retention or ileus
Reverses nondepolarizing neuromuscular blockers.
Acts indirectly by binding to cholinesterase which breaks down acetylcholine.
Edrophonium
Cholinergic
(Tensilon) is similar and is used to diagnose Myasthenia gravis. (Tensilon test.)
Organophosphates
Cholinergic
Irreversible anti-cholinesterase agent.
Produces excessive stimulation of muscarinic and nicotinic cholinergic receptors.
Cholinesterase is inactivated and acetylcholine remains in the cholinergic synapses.
Atropine
two uses
Site of action
IV dose
Anticholinergic
1. treatment of bradycardia
2. Causes cycloplegia
Blocks parasympathetic vagal stimulation.
Affects the cardiac sinoatrial node.
Epinephrine
Adrenergic
Management of airway disease,
allergic reaction and
cardiac arrest.
Norepinephrine
Adrenergic
Increase BP, cardiac output in shock.
Causes contraction of arterial smooth muscle
Dopamine
Adrenergic
Dose dependant:
Produce renal vasodialtion
Cardiac stimulation (Inotropic, increasing force)
Renal vasoconstriction
Albuterol
Adrenergic
Beta 2 agonist
Bronchodilation
Clonidine
Adrenergic
Alpha 2 agonist
Centrally acting to decrease blood pressure.
Decreases the effect of the sympathetic nervous system
Doxazosin (Cardura)
Anti-adrenergic
Treatment of hypertension
Benign prostatic hyperplasia (BPH) Causes Vasodilation.
Blocks alpha 1 adrenergic receptors.
Propranolol
Antiadrenergic
Management of hypertension
Angina
Arrhythmias
Decreases heart rate and contractility.
Receptor type: Beta 1 and beta 2
Labetalol
Antiadrenergic
Antianginal,
anti-hypertension
Blocks stimulation of myocardial and pulmonary receptor sites.

Receptor type: Beta 1, Beta 2 and Alpha 1
Atenolol
Antiadrenergic
Management of hypertension
Heart rate.
Selective for Beta 1, (myocardial) receptors.
Oxybutynin (Ditropan)
Anticholinergic
Treatment of neurogenic bladder,frequency, urgency, nocturia,
incontinence.
Used for post prostate resection
Blocks acetylcholine in the bladder walls and sphincter so the bladder is less irritable.



urinary tract antispasmodic.
Hyoscyamine (Levsin)
Anticholinergic
Use: Control of GI, irritable bowel pain
Inhibits acetylcholine at muscarinic receptors.
Procainamide
To maintain NSR after conversion

Ventricular ectopic beats
Ventricular tachycardia
Slows conduction velocity. Prolongs refractory period.
Quinidine
Sodium channel blocker
To maintain NSR after conversion. Ventricular ectopic beats
Ventricular tachycardia
Slows conduction velocity. Prolongs refractory period.
Lidocaine
Sodium channel blocker
Supresses Ventricular arrhythmias Little or no effect on heart rate.
Propranolol (Inderal)
Antiadrenergic
Management of angina,
supraventricular tachycardia,
atrial fibrillation/flutter and
PSVT.
Blocks the sympathetic nervous system effect on the SA and AV nodes. increasing the refractory period.
Esmolol
Management of supraventricular tachycardia,
atrial fibrillation/flutter
Blocks the sympathetic nervous system effect on the SA and AV nodes
Amiodarone
Potassium channel blocker
IV use for Ventricular fibrillation/tachycardia.
PO use for recurrent ventricular tachycardia and to maintain NSR with atrial fibrillation/flutter.
Potassium cant get back into the cell, so slows repolarization.
Diltiazem (Cardizem)
Calcium channel blocker
IV for PSVT
Supraventrical tachycardia
Atrial fib/flutter (ACLS)
Angina

Slows conduction and prolongs refractory period
Verapamil
Calcium channel blocker
Angina
PO for chronic suppression of PSVT and atrial fibrillation/flutter.
Slows conduction and prolongs refractory period
Adenosine (Adenocard)
Antiarrhythmic
Use: Restore NSR after PSVT .
MOA: Reduces conduction of AV node.
Nitroglycerin
Antianginal, Nitrate
Use: Angina and episodic chest pain.
MOA: Dilates smooth muscle.
Decreases pre and afterload.
Converts to nitric oxide which activates enzyme for cGMP. Causes decrease of Ca in smooth muscle.
Isosorbide dinitrate (Isordil)
Antianginal, Nitrate
Tx of angina and chronic CHF
Vasodialation
Diltiazem
Calcium channel blocker
Used to treat angina by dilating coronary artery and reducing work load of the heart.
Used for A. fib/flutter
Hypertension to decrease peripheral vascular resistance.
Propofol (Diprivan)
General anesthetic
Balanced general anesthesia,
Conscious sedation
Deep sedation.
Halothane (Fluothane)
general anesthesia with rapid induction, rapid recovery.
No analgesic effect.
DoesnÂ’t irritate the mucosa.
Can only be used one time.
Isoflurane (Forane)
General anesthesia with rapid induction, rapid recovery.
No analgesic effect.
No cardiac dysrhythmias or hepatotoxicity.

DoesnÂ’t irritate the mucosa.
Nitrous Oxide
Use: Analgesic,
weak anesthetic,
Few adverse effects.
It cannot produce surgical anesthesia by itself.
Midazolam (Versed)
Benzodiazepine
Short acting
Reduces doses of opioid needed.
Used for preoperative sedation
induction and in general anesthesia. Maintenance of anesthesia in short procedures.
Rapid onset and short duration.
Alfentanil (Alfenta)
Opioid analgaesic
A fast acting opioid analgesic, anesthetic.
Succinylcholine (Anectine)
Neuromuscular blocking agent
Blocks the effect of acetylcholine at the neuromuscular junction.
Used to produce skeletal muscle paralysis.
Paralizes muscles of respiration,
Pancuronium (Pavulon)
Non-depolarizing neuromuscular blocker.
It is used for general anesthesia, intubation,compliance in mechanical ventilation.
Reversed by neostigmine
lasts about 60 minutes.
Blocks the effect of acetylcholine at the neuromuscular junction
Vecuronium (Norcuron)
Non-depolarizing neuromuscular blocker.
Used for intubation
facilitating compliance in mechanical ventilation. It is
reversed by neostigmine,
lasts about 15-30 minutes.
Blocks the effect of acetylcholine at the neuromuscular junction so there is no muscle contraction.
Bupivacaine (Marcaine)
Anesthetic used in epidural.
Inhibits sensory nerve impulse by altering influx of sodium and efflux of potassium. Slows or stops pain sensation.
Atropine
anticholinergic
Prevent vagal effects during anesthesia (bradycardia, hypotension) Dries secretions.
List the colinergic drugs
Bethanechol
Neostigmine
Edrophonium
List the anticholinergic drugs
Atropine
Hyoscyamine
Oxybutynin
List 4 nursing actions for anticholinergics
1. Observe for tachycardia
2. CNS stimulation followed by CNS depression
3. Constipation
4. Urinary retention
List nursing actions for cholinergic drugs
Observe for theraputic effects
Micturation
Increadsed muscle strenth in myasthenia gravis
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