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Cardiovascular 1

Autonomic Nervous System

TermDefinition
Cholinergic receptors Acetylcholine Muscarinic Nicotinic
Muscarinic located on parasympathetic postganglionic synapses and the sympathetic postganglionic synapses in sweat glands
nicotinic located on presynaptic ganglia of the sympathetic and parasympathetic nervous system
Adrenergic receptors Alpha Beta Dopamine
Direct Acting Cholinergic Carbachol and Pilocarpine Bethanecol Nictoine a lot of side effects
Carbachol (Isopto Carbachol) Nicotinic and mucarinic Opthalmic agent, resistant to cholinesterase treats glaucoma- reduce intraocular pressure by pupillary constriction and ciliary muscle activation
Bethanecol (Urecholine) mostly muscarinic increases GI and urinary tract tone relaxes sphincters. atonic pts orally or subcutaneously can be given systemically and longer lasting
Nicotine (Nicorette) replacement for smoking cessation drug of abuse
Cholinesterase Inhibitors Neostigmine Pyridostigmine Edrophonium Physostigmine Donepezil Galantamine rivastigmine
Neostigmine (Prostigmin) nicotinic and muscarinic partial neuromuscular nicotinic receptor agonist* anesthesiology
Pyridostigmine (Mestinon) muscarinic and nicotinic reversal of neuromuscular blockade after general anesthesia
Edrophonium (Tensilon) muscarinic and nicotinic reversal of neuromuscular blockade after general anesthesia
Physostigmine muscarinic and nicotinic reversal of anticholinergic induced toxicity
Donepezil (Aricept) Help decrease the the symptoms of Alzheimers and delay memory loss
Galantamine (Reminyl) Help decrease the the symptoms of Alzheimers and delay memory loss
Rivastigmine (Exelon) Help decrease the the symptoms of Alzheimers and delay memory loss
Anticholinergic Agents- Muscarinic Blockers Benztropine Scopolamine Atropine Dicyclomine Glycopyrrolate Oxybutinin Tolterodine Ipratropium
Benztropine (Cogentin) reduce tremor, muscle rigidity, used in treating psychosis
Scopolamine motion sickness, vertigo
Atropine** inhibits accommodation and causes pupillary dilation- glaucoma Resuscitation for symptomatic bradycardia
Dicyclomine (Bentyl) slows peristalsis, decrease hypermotility treating IBS
Glycopyrrolate (Robinul) reduce secretions and decrease salivation
Oxybutinin (Ditropan) GU- decreases bladder tonicity, urge incontinence, bladder spasm
Tolterodine (Detrol) GU- decreases bladder tonicity, urge incontinence, bladder spasm
Ipratropium (Atrovent) reverse bronchospasm in asthmatics
Anticholinergic agents- Nicotinic blockers Succinylcholine Tubocurarine Vecuronium
Succinylcholine (Anectine) depolarizing agents- bind and activate but dont dissociate. no muscle contraction, paralysis
Tubocurarine non-depolarizing agents- block the receptor without activating it. flaccid paralysis
Vecuronium (Norcuron) most commonly used for flaccid paralysis. takes a few minutes
Alpha 1 agonists phenylephrine oxymetazoline found on vascular and smooth muscle Midodrine
Phenylephrine (Neo-synephrine) nasal decongestant, systemic vasoconstrictor
Oxymetazoline (Afrin) nasal decongestant
Midodrine (ProAmatine) systemic vasoconstrictor used to treat orthostatic hypotension
Alpha 2 Agonists Clonidine Methyldopa Tizanidine Brimonidine on presynaptic terminal
Clonidine (Catapres) antihypertensive- decrease release of neurotransmitter
Methyldopa (Aldomet) antihypertensive- decrease release of neurotransmitter
Tizanidine (Zanaflex) decrease muscle tone to treat spasticity
Brimonidine (Alphagan) decreases intraocular pressure by decreasing vitreous production for glaucoma
Alpha Blockers (Alpha 1) Doxazosin Phentolamine Terazosin Tamsulosin
Doxazosin (Cardura) mild anti hypertensive. vasodilate
Phentolamine (Regitine) potent alpha blocker used prior to surgery of pheochomocytoma. vasodilator. IV
Terazosin (Hytrin) ureteral dilation for prostate. BPH and Kidney stone
Tamsulosin (Flomax) ureteral dilation. BPH and Kidney stone
Nonspecific Adrenergic agonists Epinephrine Norepinephrine Amphetamine
Epinephrine (Adrenaline) stimulates all receptors vasoconstrictive for anaphylaxis (alpha) Bronchodilatory (beta 2) Cardiostmulatory (beta 1) vasoconstriction and cardiac stim for cardiac arrest added to local anesthetics for decreased bleeding and prolonged effect
Norepinephrine (Levophed) used in treating shock* stimulates alpha1 and 2 Mostly Beta 1
Amphetamine indirect sympathomimetic amplifys norepinephrine* penetreates CNS better than catecholamines causes euphoria, insomnia, and increased alertness- effects at NE and dopamine synapses
Beta 1 agonists dopamine dobutamine
Dopamine (Intropin) treat shock or to increase cardiac output IV inotropic agents
Dobutamine (Dobutrex) treat shock or to increase cardiac output IV inotropic agents
Beta 2 Agonists Albuterol Salmeterol Terbutaline
Albuterol (Proventil) bronchodilation inhaled but available oral or parenteral
Salmeterol (Serevent) bronchodilation inhaled but available oral or parenteral
Terbutaline (Brethine) prevents premature labor- uterine relaxations adverse effects of cardiovascular stim
Beta 1 selective Blockers Metoprolol Atenolol
Metoprolol (Lopressor) used for cardiac disease, HTN, CHF in pts with underlying asthma or COPD
Atenolol (Tenormin) used for cardiac disease, HTN, CHF in pts with underlying asthma or COPD
Nonselective Blockers Propranolol Nadolol
Propranolol (Inderal) more lipid soluble, penetrate CNS better than selective agents adverse: depression
Nadolol (Corgard) more lipid soluble, penetrate CNS better than selective agents adverse: depression
Alpha and Beta Blockers Labetalol Carvedilol
Labetalol (Normodyne) useful in CHF
Carvedilol (Coreg) useful in CHF
Created by: Kbailey1