Autonomic Drugs

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Author:
eefynan
ID:
76194
Filename:
Autonomic Drugs
Updated:
2011-03-30 11:38:35
Tags:
pharmacology
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Description:
First Aid 2010 Pages 234 - 238
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  1. Bethanechol
    • cholinomimetic agent (direct agonist)
    • application:
    • - postoperative and neurogenic ileus
    • - postoperative and neurogenic urinary retention
    • action:
    • - activates bowel and bladder smooth muscle
    • - resistant to achetylcholine esterase
  2. Carbachol
    • cholinomimetic agent (direct agonist)
    • application:
    • - glaucoma
    • - pupillary contraction
    • - release of intraocular pressure
  3. Pilocarpine
    • cholinomimetic agent (direct agonist)
    • application:
    • - potent stimulator of sweat, tears, and saliva
    • action:
    • - contracts ciliary muscle of eye (open angle)
    • - contracts pupillary sphincter (narrow angle)
    • - resistant to acetylcholine esterase
  4. Methacholine
    • cholinomimetic agent (direct agonist)
    • application:
    • - challenge test for diagnosis of asthma
    • action:
    • - stimulates muscarinic receptors in airway when inhaled
  5. Neostigmine
    • cholinomimetic agent (indirect agonist)
    • application:
    • - postoperative and neurogenic ileus
    • - postoperative and neurogenic urinary retention
    • - myasthenia gravis
    • - reversal of neuromuscular junction blockade (postoperative)
    • action:
    • - increases endogenous ACh by blocking AChE
    • - no CNS penetration
  6. Pyridostigmine
    • cholinomimetic agent (indirect agonist)
    • application:
    • - myasthenia gravis (long acting)
    • action:
    • - increase endogenous ACh by blocking AChE
    • - increases strength
    • - no CNS penetration
  7. Edrophonium
    • cholinomimetic agent (indirect agonist)
    • application:
    • - diagnosis of myasthenia gravis (very short acting)
    • action:
    • - increase endogenous ACh by blocking AChE
  8. Physostigmine
    • cholinomimetic agent (indirect agonist)
    • application:
    • - glaucoma (crosses BBB)
    • - atropine overdose
    • action:
    • - increase endogenous ACh by blocking AChE
  9. Echotiophate
    • cholinomimetic agent (indirect agonist)
    • application:
    • - glaucoma
    • action:
    • - increase endogenous ACh by blocking AChE
  10. Cholinesterase Inhibitor Poisoning
    • Diarrhea
    • Urination
    • Miosis
    • Bronchospasm
    • Bradycardia
    • Excitation of skeletal muscles and CNS
    • Lacrimation
    • Sweating
    • Salivation

    • - antidote - atropine (muscarinic antagonist) and pralidoxime (chemical antagonist to regenerate active cholinesterase)
    • - cause - parathion and organophosphates (irreversible inhibitors)
  11. Atropine
    • muscarinic antagonist
    • organ system: eye
    • application: produce mydriasis and cycloplegia
  12. Homatropine
    • muscarinic antagonist
    • organ system: eye
    • application: produce mydriasis and cycloplegia
  13. Tropicamide
    • muscarinic antagonist
    • organ system: eye
    • application: produce mydriasis and cycloplegia
  14. Benztropine
    • muscarinic antagonist
    • organ system: CNS
    • application: Parkinson's Disease
  15. Scopolamine
    • muscarinic antagonist
    • organ system: CNS
    • application: motion sickness
  16. Ipratropium
    • muscarinic antagonist
    • organ system: Respiratory
    • application: asthma and COPD
  17. Oxybutynin
    • muscarinic antagnoist
    • organ system: Genitourinary
    • application: reduce urgency in mild cystitis and reduce bladder spasms
  18. Glycopyrrolate
    • muscarinic antagnoist
    • organ system: Genitourinary
    • application: reduce urgency in mild cystitis and reduce bladder spasms
  19. Methscopolamine
    • muscarinic antagonist
    • organ system: gastrointestinal
    • application: peptic ulcer treatment
  20. Propantheline
    • muscarinic antagnoist
    • organ system: gastrointestinal
    • application: peptic ulcer treatment
  21. Atropine Toxicity
    • muscarinic antagonist
    • - increase pupil dilation, cycloplegia
    • - decrease secretions
    • - decrease acid secretion
    • - decrease motility
    • - decrease urgency in cystitis

    • Hot as a hare (increased body temperature)
    • Dry as a bone (decreased secretions, dry mouth)
    • Red as a beet (dry, flushed skin)
    • Blind as a bat (cycloplegia)
    • Mad as a hatter (disorientation)
    • Bloated as a toad (constipation)

    *can cause acute angle glaucoma in elderly, urinary retention in men with BPH, and hyperthermia in infants
  22. Hexamethonium
    • nictonic antagnoist
    • application: ganglionic blocker; used in experimental models to prevent vagal reflex responses to changes in blood pressure
    • use: help smokers to quit
    • toxicity: severe orthostatic hypertension, blurred vision, constipation, sexual dysfunction
  23. Anticholinergics for Urine Urgency
    • 1. oxybutynin
    • 2. tolteridine
    • 3. darfenacin
    • 4. solifenacin
    • 5. trospium
  24. Epinephrine
    • direct sympathomimetic
    • mechanism: α1, α2, β1, β2 (low doses β1 selective)
    • applications:
    • - anaphylaxis
    • - glaucoma (open angle)
    • - asthma
    • - hypotension
  25. Norepinephrine
    • direct sympathomimetic
    • mechanism: α1, α2 > β1
    • applications: hypotension (decreases renal perfusion)

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