autonomic & neuromuscular
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Autonomic & Neuromuscular
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Atenolol Atropine Dobutamine Edrophonium Epinephrine Phenoxybenzamine Phentolamine Phenylephrine Pilocarpine
Pralidoxime Propranolol Pseudoephrine Pyridostigmine Rocuronium Sildenafil Succinylcholine Tamsulosin Terazosin
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Atenolol
Sympatholytic, antihypertensive
Β1 receptor antagonist
β1 receptor antagonist
Angina Post MI Hypertension
Bronchoconstriction w/ high doses b/c β1 blockade
Additive hypotension w/ nitrates
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Atropine
Anticholinergic Muscarinic receptor
antagonist
Muscarinic receptor blocker
Bradycardia IBS Anticholinesterase poisoning Antisecretory agent
Mydriasis & cycloplegia Warm, dry, flushed skin Tachycardia Delirium Hallucinations
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Dobutamine
Sympathomimetic, cardiac stimulant
β1 receptor agonist
Selective β1 receptor agonist β1 > β2 > α1
Cardiac contractility & output Acute heart failure Cardiogenic shock
Synergistic on cardiac output w/ nitroprusside
Tachycardia Arrhythmia
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Edrophonium
Diagnostic agent Cholinesterase
inhibitor
Reversible cholinesterase inhibitor
Dx myasthenia gravis
Muscarinic effects Miosis Salivation
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Epinephrine
Sympathomimetic, bronchodilator, vasopressor
Nonselective adrenergic agonist
Activates α & β receptors ↑ IP3 & cAMP
α1 – vasoconstrict & ↑ BP β1 – ↑ HR, conduction, &
contractility β2 – vasodilate, ↓ BP,
bronchodilate
Cardiac arrest, V fib Shock, asthma COPD
HTN Tachycardia Ischemia Hyperglycemia
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Phenoxybenzamine
Vasodilator Irreversible α receptor
antagonist
α receptor antagonist α1 > α2
Presurgical Tx of HTN d/t pheochromocytoma
Postural hypotension
Hypotension w/ β blockers & Ca channel blockers
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Phentolamine
Vasodilator α receptor antagonist
Blocks α1 & α2 receptors
Control BP during surgical removal of pheochromocytoma
IV admin only
Hypotension
Severe hypotension w/ Epi
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Phenylephrine
Vasocontrictor, decongestant Selective α1 receptor
agonist
Activates α1 receptor Increase IP3 causing
contraction of vascular smooth m.
Nasal & ocular decongestant Dilate pupil for opthalmoscopy Mydriasis w/o cycloplegia
Paralysis of accommodation
Rebound nasal congestion HTN
MAOI cause severe HTN
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Pilocarpine
Antiglaucoma, sialogogue Muscarinic receptor
agonist
Activates muscarinic receptors in ciliary m. & salivary gland
Sjogren’s syn Glaucoma
• Ciliary m. ↑ aqueous humor
Xerostomia• Salivary gland ↑ salivation
Miosis Blurred vision
Accommodative spasm
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Pralidoxime
Organophosphate antidote Cholinesterase reactivator
Binds phosphorous & breaks organophosphate bond w/ cholinesterase
Organophosphate toxicity Reverses muscle weakness
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Propranolol
Sympatholytic, antihypertensive Nonselective β receptor
antagonist
Blocks β1 & β2 receptors
Angina HTN Benign tremor Migraine prophylaxis thyrotoxicosis Post-MI
Highly lipophilic CNS effects
Bronchoconstriction Inhibits glycogenolysis Nightmares & depression
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Pseudoephedrine
Decongestant Indirect/direct-acting
adrenergic receptor agonist
↑ release NE directly activates adrenergic receptors causing vasoconstriction & cardiac stim.
Allergic & viral rhinitis
Tachycardia CNS stim. ↑ BP
MAOI cause severe HTN
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Pyridostigmine
Antimyasthenic Cholinesterase inhibitor,
cholinergic agonist
Reversibly inhibits cholinesterase
Tx myasthenia gravis Reverse nondepolarizing
NM blockers
Muscarinic effects Miosis Salivation
Prolongs effects of succinylcholine
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Rocuronium
Paralytic agent Nondepolarizing NM
blockade
Blocks nicotinic receptors in skeletal m.
Skeletal m. relaxation for intubation, surgery, ECT
Effects reversed by neostigmine & edrophonium
Respiratory m. paralysis Apnea
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Sildenafil
Vasodilator Phosphodiesterase
inhibitor
Inhibits type 5 phosphodiesterase & degradation of cGMP vasodilation in corpus
cavernosum d/t Ach release from sacral PNS neurons
Erectile dysfunction
HA Nasal congestion Back pain Visual disturbances
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Succinylcholine
Paralytic agent Depolarizing NM blockade
Binds nicotinic receptors causing prolonged depolarization of skeletal m. & paralysis
Skeletal m. relaxation for intubation & surgery
Transient m. fasciculations
Respiratory m. paralysis Apnea
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Tamsulosin
Urologic agent Uroselective α1
receptor antagonist
Blocks α1A receptors in prostate
Tx urinary outflow obstruction d/t prostatic hyperplasia
Dizziness HA Postural hypotension
Cimetidine increases blood levels & effects
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Terazosin
Antihypertensive, urologic agent
Selective α1 receptor antagonist
Blocks α1 receptors
HTN Outflow obstruction d/t
prostate hyperplasia
1st dose syncope