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autonomic pharm

First Aid autonomic pharm

alpha-1 Gq; increaes vasculr smooth muscle contraction
alpha-2 Gi; decrease sym outflow; decrease insuline release
beta-1 Gs; heart- increase HR, contractility; increase renin release, increase lipolysis, maintains aqueous humor formation
beta-2 Gs; lungs- vasodilation, bronchodilation; heart- increase HR, contractility; increase lipolysis, increase glucagon release
M1 Gq; in brain; CNS, enteric nervous system
M2 Gi; decrease HR, contractility
M3 Gq; increase exocrinie gland secretions, increase gut peristalsis, increase bladder contraction
D1 Gs; relaxes renal vascular smooth muscle
D2 Gi; modulates transmitter release, especially in brain
H1 Gq; increase nasal and bronchial mucus production, contraction of bronchioles, pruritis, pain
H2 Gs; increase gastric acid secretion
V1 Gq; increase vascular smooth muscle contraction
V2 Gs; increase water permeability and reabsorption in the collecting tubles of kidney
Gq receptors H1, alpha-1, V1, M1, M3 (HAVe 1 M&M)
Gs receptors B1, B2, D1, H2, V2
Gi receptors M2, alpha-2, D2 (MAD 2's)
Gq protein MOA PLC --> PIP2 --> IP3 and DAG --> increase Ca++ in and PKC
Gs protein MOA adenylyl cyclase --> cAMP --> PKA
Gi protein MOA inhib adenylate cyclase -->decreased cAMP --> inhib PKA
bethanechol direct ACh agonist; activates bowel and bladder
carbachol direct ACh agonist; used in glaucoma, pupillary contraction, release of intraocular pressure
pilocarpine direct ACh agonist; stimulates sweat, tears, saliva
methacholine direct ACh agonist; challenge test for asthma diagnosis
neostigmine AChE inhibitor; reversal of neuromuscular jxn blockade, MG; NO CNS penetration
pyridostigmine AChE inhibitor; MG (long-acting)
edorphonium AChE inhibitor; tensilon test to diagnose MG
physostigmine AChE inhibitor; glaucoma
used in glaucoma; crosses BBB; used to treat atropine OD physostigmine
AChE inhibitor poisoning excess ACh; DUMBBELSS- diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, salivation
AChE inhibitor OD antidote atropine (anti-muscarinic), parlidoxime (regenerates active AChE)
AChE inhibitor for Alzheimer's donepezil, galantamine, rivastigmine
muscarinic antag; produces mydriasis and cycloplegia atropine
muscarinic antag; use in Parkinson's benztropine
muscarinic antag; use for motion sickness scopolamine
muscarinic antag; used in asthma, COPD ipratropium
muscarinic antag; use to reduce urgency in mild cystitis and reduce bladder spasms oxybutynin
muscarinic antag; use for peptic ulcer treatment propantheline, methoscopolamine, glycopyrrolate
glaucoma drugs alpha-agonists (epi, brimonidine), beta-blockers (timolol), cholinergics (pilocarpine), diuretics (acetazolamide, mannitol), PG (latanoprost)
1st line for glaucoma latanoprost (PG)
glaucoma drug that increases outflow of aqueous humor pilocarpine
atropine contraindications glaucoma, BPH, GI obstruction, dementia, infants with fever
atropine muscarinic antag; (blocks ACh effects); used to treat cholinesterase inhibitor poisoning (insecticides)
parathion AChE inhibitor in insecticides --> HIGH amounts of ACh; get DUMBBELS
effects of atropine muscarinic antag --> decreased ACh effects; increased temp, decrease secretions, peripheral vasodilation, mydriasis, agitation, urinary retention, constipation
hexamethonium nicotinic antag; blocks both sym and parasym; prevents reflex bradycardia caused by NE
epi alpha-1, alpha-2, beta-1, beta-2 sympathomimetic
NE alpha-1, alpha-2 > beta-1 sympathomimetic
isoproterenol beta-1 = beta-2 sympathomimetic
dopamine D1 = D2 > B > alpha sympathomimetic
dobutamine beta-1 > beta-2 sympathomimetic
phenylephrine alpha-1 > alpha-2 sympathomimetic
albuterol beta-2 > beta-1 sympathomimetic
terbutaline beta-2 > beta-1 sympathomimetic
ritodrine beta-2 sympathomimetic
amphetamine indirect general agonist; releases stored catecholamines
ephedrine indirect general agonist; release stored catecholamines
cocaine indirect general agonist; uptake inhibitor
clonidine central alpha-2 agonist
methyldopa central alpha-2 agonist
treatment for anaphylaxis, open angle glaucoma epi
treatment for septic shock NE
treatment for shock, heart failure dopamine
treatment for cardiogenic shock dobutamine
treatement for acute asthma albuterol
treatement for reducing premature uterine contractions terbutaline, ritodrine
treatement for narcolepsy, obesity, ADD, MDD amphetamine
treatment for nasal congestion, urinary incontinence, hypoTN ephedrine
causes vasoconstriction and local anesthesia cocaine
treatment for HTN, especially in patients with renal disease clonidine, methyldopa
phenoxybenamine irreversible alpha blocker
phentolamine reversible alpha blocker
used to treat pheochromocytoma phenoxybenzamine (irreversible alpha block), phentolamine (reversible alpha block)
SE: 1st dose orthostatic hypoTN prazosin (alpha-1 blocker)
prazosin, terzosin, doxzosin alpha-1 blocker
use to treat HTN, urinary retention in BPH prazosin (alpha-1 blocker)
mirtazapine alpha-2 blocker
use for thin, elderly patient with depression mirtazapine (anti-depressant, alpha-2 blocker)
Created by: anpham26



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