ANS drugs tables only

Parasympathomimetics – direct = “-chol”, indirect = “-stigmine” or “stigmime”

Drug name Clinical use Specificity ACE hydrolysis
Carbachol Glaucoma M and N
Methacholine Dx bronchial airway M >> N YES
hyperactivity
Bethanechol Urinary retention M only
Neostigmine Reversal of non Targets AChE
depolarizing (nonDP)
muscle relaxants after resultant stimulation of M
surgery and N
Physostigime Reversal of CNS Targets AChE
anticholinergic syndrome
Pyridiostigmine Myasthenia gravis Targets AChE
Reversal of nonDP muscle
relaxants
Soman nerve gas preTx
Rivastigmine Dementia (Alzheimer’s Targets AChE
Disease or Parkinson’s
Disease)

Parasympatholytic – nicotinic antagonist “-curium” or “-curonium”

Drug name Clinical use
Atropine Anticholinesterase poisoning antidote
Symptomatic sinus bradycardia
Muscarinic antagonist Preop inhibit salivation/secretions
antimuscarinic Produce mydriasis – dilated pupils
cycloplegia – paralysis of ciliary muscle of eye
Scopolamine Prevention of nausea/vomiting
Hyoscine Preop for sedation
Decreased secretions
Muscarinic antagonist Smooth muscle spasms
Antimuscarinic Produces mydriasis / cycloplegia
Atracurium Intermediate action – 20 to 30 min
Adjunct to surgical anesthesia, NM blockade
Pancuronium Long – 60-100 min
Adjunct to surgical anesthesia, NM blockade
Tubocurarine Long acting
Adjunct to surgical anesthesia, NM blockade

ADRENERGIC RECEPTORS
α1 Blood vessels Gq
α2 β - cells of the pancreas Gi
Brain
β1 Heart Gs
β2 Lungs Gs
β3 Fat Gs
Indirect sympathomimetics
Ephedrine Releases stored catecholamines (NE, E, dopamine)
Cocaine Reuptake inhibitor
Amphetamines Reuptake inhibitors
Methylphenidate (Ritalin) ADHD
Fenfluramine – appetite suppressant (banned)
MDMA
Tricyclic Anti Depressants Reuptake inhibitor

Tyramine Releases catecholamine

Found in cheese and stuff

Sympathomimetics direct adrenergic agonists α1 or α nonspecific “-zoline” β2 “-erol”

Drug name Clinical use Affinity
Epinephrine Anaphylactic shock β and α
Hypotension / shock
Bronchospasm
Mydriasis during intraocular surgery
Norepinephrine Hypotension/shock α>β
Dopamine Adjunct in treatment of shock after fluid replacement D1 >> β > α

Midodrine α1 Orthostatic hypotension α1

Oxymetazoline Nasal congestion α1
Tetrahydrozoline Eye redness
Clonidine Hypertension α2
ADHD
Albuterol Acute bronchospasms β2
Short acting
Salmeterol Adjunctive to corticosteroids for asthma prophylaxis β2
Formoterol COPD

Sympatholytics adrenergic antagonists α1 blocker “-zosin” β blocker “-olol” or “-ilol”

Drug name Clinical use Affinity
Prazosin Hypertension α1
Doxazosin Urinary retention in BPH (benign prostate hyperplasia)
Acebutolol HTN β1 selective
Atenolol Mgmt. of ventricular arrhythmias
Metoprolol IOP
Acute MI
Angina
SVT
Afib
Intraop tachycardia
Heart failure
Carvedilol HTN β nonselective
Labetalol Heart failure α1
Presynaptic modulation parasympathetic and sympathetic
Drug name Effect
Hemicholinium Blocks import of choline into the cell
Vesamicol Blocks ChAT from packaging ACh into storage vesicles
Botulinum Prevents SNAP/SNARE from fusing vesicle for release of ACh
Metyrosine Prevents tyrosine hydroxylase from forming DOPA (from tyrosine)
Reserpine Blocks transport of dopamine into the vesicle
Therefore prevents dopamine from becoming norepinephrine
Guanethidine Prevents SNAP/SNARE from allowing fusion of storage vesicle to membrane, blocks NT
release
Cocaine Blocks reuptake of NE
Tricyclic antidepressants Cocaine also stimulates release of NE from presynaptic neuron

Summary of drug name endings

-olol β1 blocker
sympatholytic
-ilol/-alol β blocker, nonspecific
also α1 blocker
sympatholytic
-chol Direct muscarinic agonist
parasympathomimetic
-zosin α blocker
sympatholytic
-zoline α agonist
sympathomimetic
-curium Antinicotinic
-stigmine AChE inhibitor
-erol β2 agonist