1

Drug classes
Drugs affecting the autonomic Neurons & Neuromuscular function

Cholinergic Agent Adrenergic Agonist Adrenergic Antagonist Neuromuscular Blockers

Cholinergic
Direct indirect Antagonist Direct Acting indirect Acting ALPHA BETA Competitive Depolarizing
Acting (Anti Nondepolarizing
esterase)
Acetyl choline Physostigmine Atropine E&NE (a1B) & Ephedrine Prazocin Propranolol D tubocurarine Succinylcholine
Ephedrine side effects:
Hyperthermia
Apnea
Pilocarpine Neostigmin Homatropine Isoproterenol (B) Amphetamine Terazosin Metoprolol Gallamine

Bethanechol pyridostigmin Benzotropine Phenylephrine (a1) Doxazocin Labetalol Pancuronium

Edrophonium Scopolamine Methoxamine (a1) Phenoxy Metocurine

Benzamine
Ipratropium (shake Clonidine (a2) Tyramine phentolamine Overcome by
before use) Neostigmine
physostigmine
Edrophonium
(choline
esterase
inhibitor)
Terbutaline
Dobutamine

Tel:+201222339340
 2

Adreno- Receptors

Alpha 1 Alpha 2 Beta 1 Beta 2

-Vasoconstriction
Increased peripheral resistance
Increased blood pressure
-Mydriasis
-Increased closure of internal
sphincter of the bladder
- Inhibition of norepinephrine
release (presynaptic)
-Inhibition of insulin release
-Tachycardia
- Increased myocardial
contractility
-Increased lipolysis
-increase release of rennin
-Vasodilation
Slightly decreased peripheral
resistance
-Broncho dilation
-Increased muscular and liver
glycogenolysis.
-Increased release of glucagon.
-Relaxed uterine smooth muscle

Tel:+201222339340
 3

Drugs affecting CVS

a)Antihypertensive B)antianginal C)CHF D)Antiarrhythmia

*Diuretics *org NO3- *vasodilators *Na channel blocker

+thiazides +isosorbide dinitrate +Hydralazine +quinine

+loop diuretic +nitroglycerin +isosorbide +procainamide

+K+ sparing diuretics +lidocaine

*vasodilators (direct) *B blockers *Duiretics *B blocker

+hydralazine +propranolol *amrinone and +propranolol

+minoxidil milrinone (inodilator) +metoprolol

+Na nitropruside inotropic and vasodilator

+diazoxide inh CAMP phosphodiesteraze enz

*ca channel blocker *ca channel blocker *inotropic agents *K+ channel blocker

+verapamil +verapamil +e.g. Digoxin +Amiodarone

+diltiazim +diltiazim & digitoxin +bretylium

+nifedipine +nifedipine +dobutamine

*ACE I *Ca+ channel blocker

Tel:+201222339340
 4

Effect of ACE I:
Angiotensinogen

(&2 globulin in blood) aliskiren decrease output of sympathetic

Rennin (-) (from kidney) nervous system

Angiotensin I ACE decrease angiotensin II increase vasodilation (+) decrease B.P

Inactive Of vascular smooth muscle

Decrease retention of Na+ & H2O

ACE inhibitors increase level of bradykinin

ACEI : *enalapril

*lisinopril *fosinopril (used in renal impairment) angiotensin II antagonist (ARBs):

*quinapril *trindolapril *valsartan *eprosartan

*captopril *moexipril *losartan *telmisartan

*benozepril *perindopril * irbesartan *olmesartan

*ramipril *candesartan

Tel:+201222339340