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Autonomic & Neuromuscular

Atenolol Atropine Dobutamine Edrophonium Epinephrine Phenoxybenzamine Phentolamine Phenylephrine Pilocarpine

Pralidoxime Propranolol Pseudoephrine Pyridostigmine Rocuronium Sildenafil Succinylcholine Tamsulosin Terazosin

Atenolol
Sympatholytic, antihypertensive 1 receptor antagonist
Bronchoconstriction w/ high doses b/c 1 blockade Additive hypotension w/ nitrates

1 receptor antagonist
Angina Post MI Hypertension

Atropine
Anticholinergic Muscarinic receptor antagonist Muscarinic receptor blocker
Bradycardia IBS Anticholinesterase poisoning Antisecretory agent Mydriasis & cycloplegia Warm, dry, flushed skin Tachycardia Delirium Hallucinations

Dobutamine
Sympathomimetic, cardiac stimulant 1 receptor agonist Selective 1 receptor agonist
1 > 2 > 1 Cardiac contractility & output Acute heart failure Cardiogenic shock Tachycardia Arrhythmia

Synergistic on cardiac output w/ nitroprusside

Edrophonium
Diagnostic agent Cholinesterase inhibitor
Muscarinic effects
Miosis Salivation

Reversible cholinesterase inhibitor


Dx myasthenia gravis

Epinephrine
Sympathomimetic, bronchodilator, vasopressor Nonselective adrenergic agonist Activates & receptors
IP3 & cAMP
1 vasoconstrict & BP 1 HR, conduction, & contractility 2 vasodilate, BP, bronchodilate

HTN Tachycardia Ischemia Hyperglycemia

Cardiac arrest, V fib Shock, asthma COPD

Phenoxybenzamine
Vasodilator Irreversible receptor antagonist
Postural hypotension Hypotension w/ blockers & Ca channel blockers

receptor antagonist
1 > 2
Presurgical Tx of HTN d/t pheochromocytoma

Phentolamine
Vasodilator receptor antagonist Blocks 1 & 2 receptors
Control BP during surgical removal of pheochromocytoma IV admin only
Hypotension Severe hypotension w/ Epi

Phenylephrine
Vasocontrictor, decongestant Selective 1 receptor agonist Activates 1 receptor
Increase IP3 causing contraction of vascular smooth m. Nasal & ocular decongestant Dilate pupil for opthalmoscopy Mydriasis w/o cycloplegia
Paralysis of accommodation

Rebound nasal congestion HTN MAOI cause severe HTN

Pilocarpine
Antiglaucoma, sialogogue Muscarinic receptor agonist Activates muscarinic receptors in ciliary m. & salivary gland
Sjogrens syn
Glaucoma
Ciliary m. aqueous humor

Miosis Blurred vision


Accommodative spasm

Xerostomia
Salivary gland salivation

Pralidoxime
Organophosphate antidote Cholinesterase reactivator Binds phosphorous & breaks organophosphate bond w/ cholinesterase
Organophosphate toxicity Reverses muscle weakness

Propranolol
Sympatholytic, antihypertensive Nonselective receptor antagonist Blocks 1 & 2 receptors
Angina HTN Benign tremor Migraine prophylaxis thyrotoxicosis Post-MI
Bronchoconstriction Inhibits glycogenolysis Nightmares & depression

Highly lipophilic CNS effects

Pseudoephedrine
Decongestant Indirect/direct-acting adrenergic receptor agonist
Tachycardia CNS stim. BP MAOI cause severe HTN

release NE directly activates adrenergic receptors causing vasoconstriction & cardiac stim.
Allergic & viral rhinitis

Pyridostigmine
Antimyasthenic Cholinesterase inhibitor, cholinergic agonist Reversibly inhibits cholinesterase
Tx myasthenia gravis Reverse nondepolarizing NM blockers Muscarinic effects
Miosis Salivation

Prolongs effects of succinylcholine

Rocuronium
Paralytic agent Nondepolarizing NM blockade Blocks nicotinic receptors in skeletal m.
Skeletal m. relaxation for intubation, surgery, ECT Effects reversed by neostigmine & edrophonium Respiratory m. paralysis Apnea

Sildenafil
Vasodilator Phosphodiesterase inhibitor Inhibits type 5 phosphodiesterase & degradation of cGMP
vasodilation in corpus cavernosum d/t Ach release from sacral PNS neurons Erectile dysfunction HA Nasal congestion Back pain Visual disturbances

Succinylcholine
Paralytic agent Depolarizing NM blockade Binds nicotinic receptors causing prolonged depolarization of skeletal m. & paralysis
Skeletal m. relaxation for intubation & surgery Transient m. fasciculations Respiratory m. paralysis Apnea

Tamsulosin
Urologic agent Uroselective 1 receptor antagonist
Dizziness HA Postural hypotension Cimetidine increases blood levels & effects

Blocks 1A receptors in prostate


Tx urinary outflow obstruction d/t prostatic hyperplasia

Terazosin
Antihypertensive, urologic agent Selective 1 receptor antagonist Blocks 1 receptors
HTN Outflow obstruction d/t prostate hyperplasia 1st dose syncope