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