Term | Definition |
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 |