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Cholinergics

One Liners

QuestionAnswer
This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention Bethanechol
Only direct acting agent that is very lipid soluble and used in glaucoma Pilocarpine
This agent used to treat dry mouth in Sjögren's syndrome Cevimeline
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis Edrophonium
Carbamate with intermediate action, used for+A1170 postoperative and neurogenic ileus and urinary retention Neostigmine
Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions Physostigmine
Treatment of myasthenia gravis Pyridostigmine
Antiglaucoma organophosphate Echothiophate
Associated with an increased incidence of cataracts in patients treated for glaucoma Long acting cholinesterase inhibitors
Scabicide organophosphate Malathion
Organophosphate anthelmintic agent with long DOA Metrifonate
Toxicity of organophosphate: DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)
The most frequent cause of acute deaths in cholinesterase inhibitor toxicity Respiratory failure
The most toxic organophosphate Parathion
Treatment of choice for organophosphate overdose Atropine
This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure Pralidoxime
Prototypical drug is atropine Nonselective Muscarinic Antagonists
Treat manifestations of Parkinson's disease and EPS Benztropine, trihexyphenidyl
Treatment of motion sickness Scopolamine, meclizine
Produce mydriasis and cycloplegia Atropine, homatropine,C1208 tropicamide
Bronchodilation in asthma and COPD Ipratropium
Reduce transient hyper GI motility Dicyclomine, methscopolamine
Cystitis, postoperative bladder spasms, or incontinence Oxybutynin, dicyclomine
Toxicity of anticholinergics block SLUD (salivation, lacrimation, urination, defecation
Another pneumonic for anticholinergic toxicity "dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat"
Atropine fever is the most dangerous effect and can be lethal in this population group Infants
Contraindications to use of atropine Infants, closed angle glaucoma, prostatic hypertrophy
Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate Severe hypertension
Reversal of blockade by neuromuscular blockers Cholinesterase inhibitors
Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis Nondepolarizing Neuromuscular Blockers
Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use; has short duration of action Succinylcholine
Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred) Cholinesterase regenerators, pralidoxime
Used to treat patients exposed to insecticides such as parathion Pralidoxime, atropine
Pneumonic for beta receptors You have 1 heart (Beta 1) and 2 lungs (Beta 2)
This is the drug of choice for anaphylactic shock Epinephrine
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction Amphetamines
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia Phenylephrine
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to Reduce aqueous secretion
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis Albuterol
Longer acting Beta 2 agonist is recommended for prophylaxis of asthma Salmeterol
These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock Beta1 agonists
These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion Alpha1 agonists
Shock due to septicemia or myocardial infarction is made worse by Increasing afterload and tissue perfusion declines
Epinephrine is often mixed with a local anesthetic to Reduce the loss from area of injection
Chronic orthostatic hypotension can be treated with Midodrine
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus Terbutaline
Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses Epinephrine
Mast cells to reduce release of hisamine and inflammatory mediators Epinephrine
Agent used in shock because it dilates coronary arteries and increases renal blood flow Dopamine
Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance Dobutamine
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis Ephedrine
Alpha 1 agonist toxicity Hypertension
Beta 1 agonist toxicity Sinus tachycardia and serious arrhythmias
Beta 2 agonist toxicity Skeletal muscle tremor, tachycardia
The selective agents loose their selectivity at high doses
Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis Phenoxybenzamine
Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena Phentolamine
Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension Prazosin, terazosin, doxazosin
elective Alpha-1A blocker, used for BPH, but with little effect on HTN Tamsulosin
Selective Alpha 2 blocker used for impotence (controversial effectiveness) Yohimbine
SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma Acebutolol, atenolol, esmolol, metoprolol
Combined alpha and beta blocking agents that may have application in treatment of CHF Labetalol and carvedilol
eta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma Pindolol and acebutolol
This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma Timolol
This parenteral beta blocker is a short acting (minutes) Esmolol
This beta blocker is the longest acting Nadolol
These beta blockers are less lipid soluble Acebutolol and atenolol
This beta blocker is highly lipid soluble and may account for side effects such as nightmares Propranolol
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients Beta blockers
Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety) Beta blockers
Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction Pilocarpine, carbachol, physostigmine
Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins Epinephrine, dipivefrin
Selective alpha agonists that decreases aqueous secretion Apraclonidine, brimonidine
These Beta blockers decrease aqueous secretion Timolol (nonselective), betaxolol (selective)
This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis Acetazolamide
This agent cause increased aqueous outflow Prostaglandin PGF2a
Created by: tessah10