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