Professional Documents
Culture Documents
SNS
1
Eye/HEENT
Blood vessel
Location
Blood vessel
Heart
SA node
Ectopic pacemakers
Contractility
Kidney
Aqueous humor production
skeletal muscle vessels
Metabolism
EYE/HEENT
Blood vessels
Bronchiolar smooth muscle
GU Smooth muscle
Metabolism
3
M
Fat Cells
Skin
Pregnant uterus
Liver (Gluconeogenesis)
Liver (Glycogenolysis)
Lipolysis
Eccrine
PSNS
M1
M2
Brain
Heart
M3
Eye
Blood vessels
Respiratory
GI
GU smooth muscle
Muscarinic
Nicotinic
Action
Antagonist
Contracts (dilation)
Vasoconstriction
contracts
pup
Decongestion
Contracts
contracts
Accelerates
Accelerates
Increases
Renin release
Increases
Relazes
Relaxes
Relaxes
Increases
Increases
Increases
Increases
cal activation
Deccelerates
Contracts
Contracts
Vasodilation
Contracts
Contracts
Relaxes
Increases
Contracts
Relaxes
Clinical use
Decongestion
M2
M3
2
2 2
1
1&2
1
ulsions, vomitting
cyclase, (-)cAMP
mor clearance
Class
Drug
Acetylcholine (Miochol)
Carbachol (Isopto Carbachol)
Methacholine (provocholine)
Bethanechol (urecholine)
Pilocarpine (Salagen/pilocar)
Cevimeline (Evoxac)
Nicotine
Varenicline (Chantix)
Quaternary amine
Neostigmine (Prostigmin)
Tertiary amine
Physostigmine (Eserine)
CNS
tacrine
Donepezil (Aricept)
Rivastigmine (Exalon)
Galantamine (Reminyl)
Quaternary ammonium
Edrophonium (Tensilon)
Irreversible
Echiothiophate (Phospholine)
Organophosphates (DFP, Soman, Sarin)
Pralidoximine (2-PAM/Protopam)
Muscarinic Antagonist
Atropine
Scopolamine
Methscopolamine (Pamine)
Glycopyrrolate (Robinul
Dicyclomine (Bentyl)
Homatropine
Tropicamide (Myadriacil)
Diphenoxylate-atropine (Lotmotil)
Benztropine (Cogentin)
Trihexyphenidyl (Artane)
Tolterodine (Detrol
Fesoterodine (toviaz)
Solifenacin (vesicare)
Darifenacin (enablex)
Oxyvutynin (Ditropan)
Trospium (sanctura)
Umeclidinium (incrus ellipta)
Ipratropium (Atrovent)
Tiotropium (Spiriva)
Class
Drug
D-tubocuarine
Skeletal muscle paralysis,
utilize two ACh molecules 10 Pancuronium
carbons apart
Rocuronium (Zemuron)
Vecuronium (Norcuron)
Succinycholine (Anectine)
Hexamethonium
Eppinephrine (adrenalin)
Inactivated by intestinal
mucosa, MAO, COMT
NE (Levophed)
Isoproterenol (Isuprel)
Pseudoephedrine (Sudafed)
Xylometazoline (Otrivin)
Tetrahydrazoline (Visine), Naphazoline
(Privine)
Oxymetazoline (Afrin),
Methoxamine (Vasoxyl)
Midodrine (ProAmatine)
Clonidine (Catapres)
Methylodopa (Aldomet)
Guanabenz (wytensin), Guanfacine
(Tenex)
Apraclonidine (Iopidine), Brimonidine
(Alphagan)
Dobutamine (Dobutrex)
Albuterol (Bentikub(
Sakneterik (Serevent)
Terbutaline (Brethine)
Ritrodine(Yutopar)
Mirabegron (Myrbetriq)
Ephedrine
Amphetamine/meth
Methylphenidate (Ritalin)
Cocaine
Tyramine
Dopamine (Intropin)
Fendolpam (Corlopam)
Mechanism
Cholin
Direct C
Stimulates Muscarinic And Nicotinic receptors
Stimulates Muscarinic And Nicotinic receptors
Stimulates Muscarinic And Nicotinic receptors
Mus
Stimulates (M) receptors
Tertiary amine alkaloid, well absorbed into the brain
M3 receptor selective
Nic
Stimulates (N) receptors
Stimulates (N) {42 in the brain] receptors Partial
Agonist,
Cholin
Reversibly binds
Cholin
Competitive antagonist of (M) receptors
Mechanism
Neurom
Non-de
Direct Blo
Depolarizin
Ga
non-depol competitve antagonists
Andre
Ca
All alpha, B1&B2 receptors
A1 selective agonist
A1 selective agonist
A1 selective agonist
A1&2
Al
Presynaptics A2 receptors -> (-) NT release
Dop
Effects
Pharmacokinetics
Cholinerginic Stimulants
Direct Cholinergic Agonists
See receptors
See receptors
See receptors
dopamine release
Cholinesterase Inhibitors
Reverse post-surgery neuromuscular
Poor oral abs
blockers
Good oral abs, crosses
BBB, longer half life
Enters BBB/CNS
Metabolized by
CYP2D6 & CYP3A4
Bronchiodilation
Effects
Pharmacokinetics
Neuromuscular Antagonists
Non-depolarizing Blockers
Long lasting
Ganglion Blockers
Andrenergic Stimulants
Catecholamines
Dosage depedant A1>Vasoconstriction-> intial (+)BP->
(-)disatolic due to B2 vasodilation of
muscle BV, Vasoconstriction prevails
w/ high doses
>=NE>>Isoproterenol
for Alpha
Eppi=NE for B1 must
be injected
Vasoconstriction
Vasoconstriction
Nasal spray
Vasoconstriciton
Eye drop
Vasoconstriction
Nasal spray
Alpha 2 Agonists
Platlet aggregation, (-) insulin
In brain, transdermal
secretion, BP, HR, (+) aqueous humor
patch
clearance
Beta 1 Agonists
(+) CO, AV conduction, & renin
secretion
Beta 2 Agonists
Slightly (+) CO, AV conduction, &
renin secretion
Relaxes resp,
uterine, GI, & skeletal muscle BV
smooth muscle. (+) K uptake into
muscle, glycogenolysis and
gluconeogenesis in liver Slight
increase in Systolic, drop in
diastolic BP
Beta 3 Agonists
(+) Liplysis in fat cells, relax detrusor
Others
Dopamine Agonists
Side Effects/Toxicity
mulants
Agonists
nists
Sweating (m1), salivation,
diarrhea, abdominal cramps.
Mushroom toxicity possible, t(x)
w/ atropine and eppi
ists
Nausea, vomiting, vivd
nightmares, psychosis, anxiety,
suicidal
hibitors
gonists
CNS stim->depression
Sedation->stimulation, euphoria
Side Effects/Toxicity
agonists
Blockers
Histamine release ->
Hypotension & bronchospasm
no hist. release
Histamine release & (+) toxicity
rsal Agents
ular Blocker
Genetic variances in metabolism,
Dibucain number diagnostic,
Hyperkalemia, muscle pain,
regurg w/ buff dudes or
esophageual dysfucntion/obesity,
+ inraocular pressure, maligant
hyperthermia w/ repeated doses
or halothane due to uncontrolled
SR Ca release
kers
ulants
es
ts
sts
sts
sts
sts
nists
Interactions
Interactions
Inactivated by Sugammadex
Clinical - Individual
Clincal - by
Group
resembles PSNS
activity, especially
in the Eye, GI,
Bladder, Salivary,
Urinary Retention
Narrow angle glaucoma w/ a cholinesterase
inhibitor, Sjogrens sydrome
Glaucoma, dry mouth
Reduce intraocular
pressure
Nicotine cravings
Myasthenia gravis
Myasthenia gravis DOC, Atropine poisoning,
glaucoma
Alzheimers
Alzheimers
Alzheimers
Myasthenia gravis Dx
Emergent, long term decrease in intraocular
pressure
Tx w/ 2-PAM
Organophosphate poisioning, maybe carabamte
cholinesterase tx
Cause mydriasis,
cycloplegia. Used in
Open angle
glaucoma, Tx for
cholinesterase
inhibitor poisoning
(no cure for (n)
receptors)
Clinical - Individual
Intubation
Clincal - by
Group
Surgery w/ gen
anesthetics,
ventilation,
orthopedics,
intubation,
convulsions
ventilation,
orthopedics,
intubation,
convulsions
Tacheotomy, intubation
Decongestant
Decongestnat
Tx for red eyes
Decongestant
Tx for HypoTN
Midodrine - tx for postural HypoTN & autonomic
insufficiencies
Pyridostigmine (Mestinon)
Ambenonium (mytelase)
Cevimeline
ne (Mestinon)
m (mytelase)