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Autonomic Nervous System

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Term
Definition
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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