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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
Β1 receptor antagonist
β1 receptor antagonist
Angina Post MI Hypertension
Bronchoconstriction w/ high doses b/c β1 blockade
Additive hypotension w/ nitrates
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
β1 receptor agonist
Selective β1 receptor agonist β1 > β2 > α1
Cardiac contractility & output Acute heart failure Cardiogenic shock
Synergistic on cardiac output w/ nitroprusside
Tachycardia Arrhythmia
Edrophonium
Diagnostic agent Cholinesterase
inhibitor
Reversible cholinesterase inhibitor
Dx myasthenia gravis
Muscarinic effects Miosis Salivation
Epinephrine
Sympathomimetic, bronchodilator, vasopressor
Nonselective adrenergic agonist
Activates α & β receptors ↑ IP3 & cAMP
α1 – vasoconstrict & ↑ BP β1 – ↑ HR, conduction, &
contractility β2 – vasodilate, ↓ BP,
bronchodilate
Cardiac arrest, V fib Shock, asthma COPD
HTN Tachycardia Ischemia Hyperglycemia
Phenoxybenzamine
Vasodilator Irreversible α receptor
antagonist
α receptor antagonist α1 > α2
Presurgical Tx of HTN d/t pheochromocytoma
Postural hypotension
Hypotension w/ β blockers & Ca channel blockers
Phentolamine
Vasodilator α receptor antagonist
Blocks α1 & α2 receptors
Control BP during surgical removal of pheochromocytoma
IV admin only
Hypotension
Severe hypotension w/ Epi
Phenylephrine
Vasocontrictor, decongestant Selective α1 receptor
agonist
Activates α1 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
Sjogren’s syn Glaucoma
• Ciliary m. ↑ aqueous humor
Xerostomia• Salivary gland ↑ salivation
Miosis Blurred vision
Accommodative spasm
Pralidoxime
Organophosphate antidote Cholinesterase reactivator
Binds phosphorous & breaks organophosphate bond w/ cholinesterase
Organophosphate toxicity Reverses muscle weakness
Propranolol
Sympatholytic, antihypertensive Nonselective β receptor
antagonist
Blocks β1 & β2 receptors
Angina HTN Benign tremor Migraine prophylaxis thyrotoxicosis Post-MI
Highly lipophilic CNS effects
Bronchoconstriction Inhibits glycogenolysis Nightmares & depression
Pseudoephedrine
Decongestant Indirect/direct-acting
adrenergic receptor agonist
↑ release NE directly activates adrenergic receptors causing vasoconstriction & cardiac stim.
Allergic & viral rhinitis
Tachycardia CNS stim. ↑ BP
MAOI cause severe HTN
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 α1
receptor antagonist
Blocks α1A receptors in prostate
Tx urinary outflow obstruction d/t prostatic hyperplasia
Dizziness HA Postural hypotension
Cimetidine increases blood levels & effects
Terazosin
Antihypertensive, urologic agent
Selective α1 receptor antagonist
Blocks α1 receptors
HTN Outflow obstruction d/t
prostate hyperplasia
1st dose syncope