| 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 |
