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