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ANS Drugs
B. Busey ANS Rx Study
| Name | MOA | SE | Uses |
|---|---|---|---|
| Acetyl Choline | M=N Receptor Cholinergic Agonist | W-SLUD (Wheeze Salivate, Urinate, Defecate) | Surgical Miosis (Pupil Constriction) |
| Carbachol | N>M Cholinergic Agonist | WSLUD | Glaucoma- Decrease IOP |
| Bethanecol | M>N Cholinergic Agonist | WSLUD Overdose Tx= ATROPINE + EPINEPHRINE | Urinary Retention, Post Op Ileus, Megacolon |
| Pilocarpine | M>>N Cholinergic Agonist | WSLUD | Glaucoma, Dry Mouth |
| Nicotine | N Cholinergic Agonist | Increased Cancer, CHF, Peptic Ulcer, NVD, HR, BP, Convulsion-Coma-Flaccid Paralysis | (blank) |
| Edrophonium | AChE Inhibitor- Irreversible | WSLUD | Myasthenia Gravis, Ileus, ARRYTHMIA |
| Echothiophate | Organophosphate Irreversible AChE Inhibitor | WSLUD | Glaucoma |
| Malathion | Organophosphate Irreversible AChE Inhibitor | WSLUD- Safer than Echothiophate | Glaucoma |
| Physostigmine | AChE Inhibitor- Reversible CNS Penetration Broken down by AChE | WSLUD Overdose Tx: ATROPINE + PRALIDOXIME | Glaucoma 4-6h |
| Neostigmine | AChE Inhibitor- Reversible Broken Down by Plasma Esterase Quarternary (no CNS Pentration) | WSLUD | Myasthenia Gravis (qid), Ileus, Megacolon, Urinary Retention |
| Tacrine | AChE Inhibitor- Reversible | WSLUD, High AChE affinity, Long CNS Duration, Liver Toxicity | Alzheimer's |
| Donepizil | AChE Inhibitor- Reversible | WSLUD, High AChE affinity, Long CNS Duration NO LIVER TOXICITY | Alzheimer's |
| Norepinephrine | alpha>beta Anerergic Vasoconstric>Increase BP/HR | Reflex Bradycardia, Pallor | Vasoconstriction, Hypotensive Patients |
| Epinephrine | beta>alpha Anerergic Increase HP/HP>Vasoconstrict | Pallor Overdose Tx=PROPANOLOL + PHENOLAMINE | Anaphylaxis and Glaucoma |
| Isoproterol | beta Anergic Increase BP/HR | Tremors and Sweats | Vasodilator, AV Block, Bronchial Asthma |
| Dopamine | D1- Renal Vasodilator, Higher Dose- alpha1 activator for Vasoconstriction and Increased BP | NA | Hypotensive, Cardiogenic/Septic Shock Patients, Acute Heart Failure |
| Fenodopam | D1- Renal Vasodilate | NA | SEVERE Hypertension |
| Dobutamine | Beta1>Beta2 Increase HR/Contraction>Smooth Muscles of the eye | NA | Increase BP, Cardiogenic and Septic Shock |
| Phenylpropanolamine | Nonselective alpha1 agonist | High Dose- CARDIOVASCULAR TOXICITY | Dilate Pupil, Nasal Decongestant |
| Phenylephrine | Direct Alpha 1 Agonist | NA | Mydriasis (pupil dilation) |
| Clonidine | Selective Alpha2 Agonist- Decreased HR, BP, CO More Potent than Methyldopa More Decrease in HR, CO Decreased NE Release | Sedation, Depression | Hypertension |
| Albuterol | Selective beta2- cardiac vessels, eye dilation, relax detrusor, relax GI | NA | Asthma, Delay Premature Labor |
| Ephedrine | Sympathetic Mimic Direct- Anerergic R Indirect- Increase NE Release | Euphoria, Abuse, Tachyphylaxis (decreased response to drug after first dose) | Epinephrine Substitute, Hypotension, Asthma |
| Amphetamine | Sympathetic Mimic Indirect Increase NE Release | Deferred Sleep, Euphoria, Increased Self Estem/Well-being, Restless, Confused, Anxious, AGGRESSIVE, VIOLENT, Increase in Libido | Appetite Suppressant, Dose Related increase in HR/BP |
| Dextroamphetamine | Sympathetic Mimic Same as Amphetamine MOST POTENT | Same as Amphetamine | ADHD, Narcolepsy |
| Methamphetamine | Sympathetic Mimic Same as Amphetamine- QUICKEST TO CNS | Same as Amphetamine | ADHD |
| Atropine | Cholinergic Antagonist M Blocker | OVERDOSE TX= Physostigmine Low dose- Decrease HR, High Dose- Increase AV conduction Decreases GI Secretions/Motility, Sweat, Salivation, Lacrimation=ANHYDROSIS | Diarrhea LOMOTIL(=Atropine+ Diphenoxylate) |
| Scopolamine | Cholinergic Antagonist M Blocker Transdermal or Oral | Overdose Tx: Physostigmine More Potent in CNS, Secretory, and Eye | Motion Sickness |
| Propatheline | M Block N Block quartenary | (blank) | Cholinergic Poisoning, Antispasmatic, Pupil Dilator, Decrease HR in Surgery |
| BENZTROPINE | M Block | (blank) | PARKINSON'S DZ |
| Ipratropium | M Block Aerosol | (blank) | COPD/Rhinitis |
| Darifenacin | M3 Block | Less Dry Mouth | Overactive Bladder |
| Glycopyrrolate | M Blocker quartenary | (blank) | Transient GI Hypermobility, Transient Cystitis, Post Op Bladder Spasm, INCONTINENCE |
| Phentolamine | Adrenergic Antagonist Direct Barorecptor actions, Alpha 2 actions | Decreased BP, Postural Hypotension, Reflex Tachycardia(alpha2 block- increase NE Release), Arrythmia, Angina, NVD, Worsen Peptic Ulcers | Frostbite, Impotence, Peripheral Vascular Dz. REVERSE EPINEPHRINE |
| Phenoxybenzamine | Irreversible Alpha2 antagonist | (blank) | NO EJACULATION |
| Terazosin | Alpha 1 antagonist, Decrease TPR, BP | No Reflex Tachycardia, Postural Hypotension | Benign Prostatic Hypertrophy |
| Tamsulosin | Alpha 1 Antagonist, Decrease TPR, BP | No Reflex Tachycardia, Postural Hypotension | BPH |
| Yohimbine | Alpha2 Antagonist | (blank) | Impotence |
| Propanolol | Beta Antagonist | Withdrawal, ASTHMA | Angina, Tremor, Migraine, Hyperthyroid |
| Nadolol | Beta Antagonist | No CNS, Lipid/Long Halflife | Angina |
| Timolol | Beta Antagonist | Extensive First Pass Metabolism | Prevent Recurrent MI, Glaucoma |
| Metoprolol | Beta1 Antagonist | First Pass, Avoid Beta1 Asthma Patient | COPD, HT w/ Asthma |
| Atenolol | Beta1 Antagonist, Partial ISA agonist | No CNS, Well Tolerated, Long Halflife | HT, CHF, Diabetics with HT |
| Esmolol | Beta1 Antagonist, RBC Esterase Breakdown | Short | Cardiac Arrythmia |
| Acebutolol/Pindolol | Beta1 Antagonist | Less Decrease in HR, CO, Less Metabolism (Lipid/CHO) | Cardiac Arrythmia, Bradycardia, CHF, HT Diabetics |
| Labetalol | Mixed alpha/beta Antagonist (Beta first, higher dose alpha effects) | (blank) | Decrease HR, BP, Increased Vasodilation |
| Carvediol | Mixed alpha/beta antagonist | (blank) | HT, CHF, Lacks Sympathetic Mimic Activity |
| Guanethidine | Adrenergic Neuron Block- Decrease NE release | Orhostatic Hypotension, Less Ejaculation | Chemical Sypathectomy, Severe HT |
| Reserpine | Adrenergic Neuron Block- Block vesicular uptake/Storage NE | CNS, Sedation, Depression, Decreased DOPA, 5-HT, NE | Mild HT |
| Methyldopa | Prodrug- False Adrenergic Transmitter in CNS- Alpha 2 R- Decrease Sympathetic Outflow | (blank) | Decreased CO, TPR, BP |
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bbusey
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