-
parasymp control of eye
M3: lacrimation, miosis dec IOP
-
symp control of eye
a1: mydriasis, dec IOP / b: inc IOP
-
parasymp control of heart
M3: slows
-
symp control of heart
B1: inc HR and force
-
parasymp control of lung
M3: bronchostriction
-
symp control of lung
B2: bronchodilation
-
parasymp control of GI
M3: SLUD
-
symp control of GI
a1: bladder constrictions (holding your pee) so a1 antagonists good for BPH
-
symp control of blood vessels
a1: HTN
-
symp control of kidney
b1: inc renin, inc BP, D1 DA activation
-
a methyl groups on ACh
Nicotinic selective
-
b methyl groups on ACh
muscarinic selective
-
direct parasympathomimetics indications
glaucoma, miosis
-
direct parasympathomimetics contraindications
asthma COPD
-
direct parasympathomimetics SE
SLUD, confusion
-
Varenicline
special direct parasympathomimetic bc it acts on NICOTINIC receptors
-
use atropine for overdose of these indirect parasympathomimetics
stigmines, memantine
-
scopolamine
parasympatholytic for sea sickness
-
what to use as anti-GI spasms
quaternary amines (stays in gut, cant reach brain)
-
parasympatholytic SE
sedation, dry mouth, blurry eyes, coma, death, tachycardia (block M2 in heart)
-
ganglionic blocker structure
n= 5 or 6
-
neuromuscular blocker structure
n = 7 or greater
-
ganglionic nicotinic blocker indication
controlled surgical hypotension
-
neuromuscular nicotinic blockers
succinylcholine, Curiums, caution DEATH by resp paralysis
-
NET and DAT
uptake 1; presynaptic
-
uptake 2
cationic; postsynaptic
-
VMA
from MAO and COMT; too much in urine = pheochromacytoma
-
a1 receptors
vessels; inc BP, dec aq humor, mydriasis
-
a2 receptors
brain; presynaptic; dec BP and HR
-
b1 receptors
heart, kidney, inc HR and force and BP (renin)
-
b2 receptors
lungs, inc bronchodilation, inc aq humor
-
psychostimulant indications
ADHD, narcolepsy
-
droperidol
typical antispychotic for antiemesis
-
typical antipsychotics
D2 so EPS that may progress to TARDIVE DYS (permanent)
-
atypical antipsychotics
5HT2A, less EPS and TD but weight gain and diabetes; treat negative sx better
-
MAOIs
irreversible; cheese syndrome (inc tyramine = inc BP, HR)
-
miosis
circular muscle, M3
-
mydriasis
radial muscle, a1
-
-
varenicline
nicotinic; direct parasympathomimetic; smoking cessation
-
zolines
partial a1 agonists; TACHY; eye drops and nose sprays
-
phenylephrine
full a1 agonist; decongestant and glaucoma
-
-
-
zosin indications
HTN, BPH but causes reflex tachy
-
Phentolamine
A1 and a2 antagonist
-
Phenoxybenzamine
Irreversible a antagonist for pheochromacytoma
-
Clonidine
A2 agonist; HTN; alcohol withdrawal
-
Guanbenz
A2 agonist; HTN; alcohol withdrawal
-
Tizanidine
A2 agonist; HTN; alcohol withdrawal; muscle relaxer
-
Methyldopa
A2 agonist; HTN; alcohol withdrawal
-
A2 agonist SE
Causes WITHDRAWAL themselves
-
Yohimbine
Indole alkaloid; a2antagonist; inc BP and HR
-
Isoproterenol
Nonselective b agonist; asthma COPD, inc HR and BP
-
-
-
Metaproterenol
B2 agonist
-
-
Dobutamine
Mixed A1 b1; POSITIVE IONOTROPIC; no HR change; for cardiac failure
-
Propranolol
Nonselective b blocker
-
SE of all b antagonist
Bradycardia, bronchostriction, WITHDRAWAL (can be used for glaucoma)
-
-
-
Pindolol
B1 b2 ; partial agonist
-
Cardeolol
B1 b2 ; partial agonist
-
-
-
-
Esmolol
B1 agonist; short ester that�s CLEAVED. IV infusion to stop heart fast
-
Labetalol
Mixed a1 b; no HR effect; selectively treats BP
-
Carvedilol
Mixed a1 b; no HR effect; selective treats Bp
-
Reserpine
Indol alkaloid; blocks vesicular storage of DA, NE, 5ht; sympatholytic (dec BP and HR)
-
Reserpine SE
PD-like sx and depression
-
Cocaine
DAT/NET blocker; psychostimulant
-
Methylphenidate
DAT/NET blocker; psychostimulant
-
Modafinil
DAT/NET blocker; psychostimulant
-
Sibutramine
DAT/NET blocker; psychostimulant
-
Atomoxetine
NET selective; adhd ; psychostimulant
-
Psychostimulants
ADHD; narc; inc DA�abuse
-
Apomorphine
D1 d2 agonist; parkinsons
-
Bromocriptine
Ergolide; d2 agonist; PD
-
Pergolide
Ergolide; d2 agonist; PD
-
Ropirinole
D2 agonist, PD
-
Pramipexole
D2 agonist; PD
-
Dihydrexidine
D1; Nichols
-
Selegiline
Mao b inhib , may slow progression;neuroprotection
-
Rasalgine
Mao b inhib; may slow progression; neuroprotective
-
Psychadelics
5ht2a agonists; tachy, tolerance, but no abuse because no DA inc
-
Psilocibine
Tryptamine psychedelic
-
-
Mescaline
Phenethylamine psychedelic
-
Mdma
5ht release (serotonin syn, deaths from dehydration and hyperthermia), da releaser (abuse)
-
-
Haloperidol
Typical antipsychotic; d2, EPS
-
Chlorpromazine
Typical antipsychotic; d2, EPS
-
Thiothixene
Typical antipsychotic; d2, EPS
-
Droperidol
Typical antipsychotic; d2, EPS; ANTIEMESIS
-
Typical antispsychotics
D2, eps, tardive dysk
-
Clozapine
Atypical antipsychotic
-
Olanzapine
Atypical antipsychotic; clozapine bioisostere
-
Quetiapine
Atypical antipsychotic
-
Risperadone
Atypical antipsychotic
-
Aripiprazole
Atypical antipsychotic; partial d2 agonist; 5ht1a (anxiety); LOTS OF USES
-
Atypicals
5ht2a, less EPS and tardive but wt gain, diabetes. Treat negative sx better
-
Phenalzine
MAOI antidepressant; cheese syndrome
-
Selegiline
Maoi antidepressant; cheese syndrome
-
Triamcypramine
Maoi antidepressant; cheese syndrome
-
Moclebomide
Maoi antidepressant; reversible so no cheese syn
-
Cheese syndrome
Inc tyramine;; inc BP and HR; from IRREVERSIBLE MAOIs
-
-
Desipramine
TCA secondary
-
Amitryptiline
Tca tertiary (secondary is nortriptyline)
-
Nortryptiline
Secondary TCa
-
-
SSRIs
SERT blockers with no antimusc SE but causes ANXIETY, SEXUAL DYSFCT, insomnia, tremors (xetines)
-
-
-
-
-
-
TCA SE
Antimuscarinic, TACHY, antiSLUD
-
Venlafaxine
NET SERT (dual)
-
Desvenlafaxine
NET SERT dual
-
-
Dual inhibitors
NET SERT (no antimuscarinic SE) ; net blockade can be used for neuropathic pain
-
Reboxetine
NET selective antidepressant
-
Atomoxetine
NET selective antidepressant
-
Bupropion
DAT antidepressant; smoking cessation; gad
-
Trazodone, nefazodone, mirtazapine, maprotiline
Depression
-
Lithium
Dec IP turnover, small therapeutic index (toxic); mania
-
Mania/bipolar other txs
Anticonvulsants; antidepressant + antipsychotic; one drug with both
-
Antidepressant for mania
Fluoxetine
-
Antipsychotic for mania
Olanzapine
-
Antidepressant + antipsychotic for mania
Aripiprazole; partial
-
Caffeine
Adenosine antagonist
-
Fomepizole
ADH inhib; inc etOH; ethylene glycol and metOH poisoning
-
Disulfuram
Inc acetyl aldehyde ; bad etOH effects
-
MEOS
1st order; cyp2e1, on at higher conc
-
EtOH moa
Enhance cl influx (gabaA)and blocks glu recep (NMDA)
-
etOH withdrawal tx
bzds, pheny, naltrexone, ondansetron, disulfuram, acamprosate, baclofen, Chantix
-
ondansetron for etOH withdrawal
blocks NV via 5ht3
-
acamprosate for etOH withdrawal
glu blocker
-
baclofen for etoh withdrawal
GABAb; heterodimer
-
BZDs
Sedative hypnotics; GABAa PAM (inc GABA affinity, channel opening and cl influx)
-
Bbts
Sedative hypnotic; GABA A pam, PLUS channel stays open longer; small TI
-
Z hypnotics
A1 selective and controls sleeps
-
Midalozam
Short acting bzd
-
Z drugs
Zolpidem, zaleplone, esszopicline (long term)
-
flumazenil
bzd antagonist, neutrol allosteric modulator, used for BZD or z hypnotic overdose
-
GHD
gabaA PAM, gabaB agonist, no antidote, used for daytime sleepiness (GBL = prodrug)
-
ramelteon
melatonin agonist; MT1 and 2; modulate circadian rhythm; no dependence, abuse; used for JET LAG
-
anxiolytic for panic
BZDs only!!
-
Buspirone
5ht1a partial presynaptic ; anxiolytic
-
Other anxiolytics
Ssris, tcas, snris, propranolol (can penetrate brain;for acute)
-
Phenytoin
Na channel ; prolongs inactivation; autoinducer; nonlinear- titrate
-
Phenytoin se
Hirsutism, gingival hyperplasia
-
Fosphenytoin
Prodrug; phosphatases
-
Cbz
Anticonvulsant; na channel block; bipolar; neuralgia; autoinducer of 3a4
-
Phenobarb
gabaA; autoinducer
-
valproate;
na, ca block, inc gaba, ABSENCE; inhibits pheny and cbz metabolism (c/i)
-
ethosuximide
ca selective; absence
-
diazepam/any bzd for anticonvulsants
status epilepticus; quick
-
gabapentin; pregabalin
inc gaba; adjucnts
-
felbamate; topiramate
block glu; antipsychotic; nmda and ampa
-
diazepam spasmolydic
gaba a, spinal cord only
-
baclofen spasmolytic
gaba b; spinal cord only
-
tizanidine spasmolytic
a2 agonist; spinal cord only
-
cyclobenzaprine
brain; not good for neuralgias; spasmolytic
-
carisoprodol
brain, not good for neuralgias; spasmolytic
-
dantrolene
muscle ; spasmolytic; dec ca from sr; antidote for malig hypertherm
-
propofol
iv anesthetic; gaba a; etoh like; antiemetic
-
-
etomidate
gaba a iv anesthetic
-
midazolam, thiopental
adjunct anes; pre-op; amnesia
-
balanced anesthesia
anesthetic, analgesia (NSAID opiate) , antiemetic (propofol)/droperdiol, amnesia (midazolam, thiopental)
-
local anes
na blockers; work best unionized; caines; vasoconstriction at site
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