Pharm ANS

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Author:
nicstrain
ID:
12549
Filename:
Pharm ANS
Updated:
2010-04-05 22:40:48
Tags:
USMLE
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Description:
ANS Drugs
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  1. Epinephrine
    • Alpha 1 and 2
    • Beta 1 and 2
  2. Norepinephrine
    • Alpha 1 and 2
    • Beta 1 (no beta 2 activity)
  3. GABA
    Causes an inhibitory cell hyperpolarization
  4. Muscarinic-r
    • Uses DAG and IP3 as second messengers
    • Parasympathetic control
  5. Bethanechol
    • Cholinergic
    • Increase GI and bladder motility
    • Tx atonic bladder post-op
  6. Pilocarpine
    • Cholinergic
    • Papillary constriction = miosis. Ciliary contraction = accommodation
    • Tx acute glaucoma
  7. Isoflurophate
    • Organophosphate
    • Irreversible acetylcholinesterase (-)r
  8. Pralidoxime
    • "2 PAM"
    • Reverses organophosphate binding to acetylcholinesterase
  9. Neostigmine
    • Reversible acetylcholinesterase (-)r
    • Tx Myasthenia Gravis
  10. Myasthenia Gravis
    • Antibodies to Ach-r
    • Increased muscular weakness due to Ach's weak post-sympathetic effect at NMJ, Inactivates-r
  11. Tubocurium
    • Nondepol. Competitive cholinergic N-r (-)r
    • Prevents Ach binding but does not activate NMJ
    • increase Histamine release = decrease BP and increase bronchospasm
  12. Trimethaphan
    Non-selectively binds N-r of the PS- and SNS
  13. Pancurium
    More potent than tubocurium w/o histamine release
  14. Succinylcholine
    • Depol. Non competitive (-)r of muscle action
    • Opens Na Ch = fassciculations. Closes Na Ch = paralysis
    • Continuous infusion
  15. Alpha 1 & Eye
    • Mydriasis due to norepinephrine.
    • Prazosin (-)
  16. M-r & Eye
    • Miosis due to Ach
    • Atropine (-)
  17. Sympathetic
    Post ganglionic sympathetic fibers releases NE
  18. Parasympathetic
    Post ganglionic parasympathetic fibers release Ach
  19. M3-r & Eye
    • Contracts sphincter = miosis.
    • Contracts ciliary = accommodation
  20. M2-r & Heart
    • Negative chronotropy: decrease HR = vagal arrest
    • Negative inotropy: decrease contractility
  21. M3-r &Lung
    bronchospasm - increased secretions
  22. M3-r & GI
    Increased motility (cramps and diarrhea). Involuntary defecation
  23. Tacrine
    • Acetylcholine esterase (-)r
    • Tx Alzheimer's
  24. Atropine
    DOC w/ vagal arrest
  25. Glycoperrolate
    M-r(-), Antispasmodic. Tx peptic ulcer
  26. Pirenzepine
    M-r(-), Antispasmodic. Tx peptic ulcer
  27. Doxacurium
    Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No histamine release
  28. Beta Bungarotoxin
    Prevent the release of Ach from vessels at the pre-synaptic nerve ending
  29. Alpha Bungarotoxin
    Irreversible N-r (-) = decreased action poteintial
  30. alpha 1 & Eye
    Contracts radial muscle = mydriasis (pupil dilation)
  31. alpha 1 & arterioles
    Constriction: Increased TPR = Increased diastolic pressure = Increased afterload
  32. alpha 1 & Venules
    Constriction: increase venous return = increased preload
  33. Alpha 1 & Sex function
    Ejaculation
  34. Increase Diastolic
    Increase alpha 1 = Increased TPR
  35. Decreased diastolic
    Increased Beta 2; direct acting vasodilators; (+) Cholinergics
  36. Beta 1 & Heart
    • (+) chronotropism = increased HR
    • (+) inotropism = increased contractility, SV, CO, and O2 consumption
    • Increased conduction velocity
  37. Phenylephrine
    Alpha 1 (+) Nasal decongestant
  38. Beta 2 (+) Asthma Drugs
    Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol
  39. Ritodrine/Turbutaline
    Relaxes myometrium used in pre-mature labor pains
  40. Phentolamine
    • Epi reversal. Blocks alpha, vasodilation occurs. Pt goes from HyperTN to HypoTN
    • Tx pheochromocytoma = decreased BP
  41. Terazosin
    Tx BPH
  42. Yohimbine
    • Increase sympathetic outflow = alpha 2 (-)
    • Tx impotence
  43. Cardioselective NMJ
    Pancuronium = increased HR due to atropine-like anti muscarinic vagolytic effect and Gallamine (-)r
  44. Ecothiophate
    Irreversible cholinesterase (-)r
  45. Pyridostigmine
    • Cholinomimetic that increases M and N-r effects. (-) acetylcholinesterase and plasma cholinesterase
    • DOC for the oral tx of MG

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