Zusammenfassung der Ressource
Autonomic Drugs & ANS
- Cholinergics (Stimulate PANS-Ach): low HR, Inc. GI motility, miosis, dec. IOP (eye), inc. saliva bronchioconstriction
- Direct Acting
- Direct Acting on Nicontinic Receptors
- Nicotene, Nicorette, Varenicline, Champix (smoking cessation)
- Direct acting on muscarinic receptors
- Pilocarpine (glaucoma &xerostomia)
- Bethanechol (Tx incomplete emptying of bladder/urinary retention)
- Indirect (inhibit the enzyme that destroys ACH) Cholinesterase inhibitors
- Donepzil, Aricept, Galantamine, Reminly ER (Tx Alzheimers by inc. Ach in brian)
- Neostigmine (Tx myasthenia gravis)
- Physostigmine (glaucoma)
- Indirect & Irreversible: Organophosphates for pesticides & used in chemical warfare.
- ADR: large doses affect SLUD, neuromuscular paralysis, effects on CNS (confusion)
- Contraindications: athsma, hyperthyroidism, GI/UT obstructions, ulcers. Watch for orthostatic hypotension.
- Anticholinergics: Inhibit PANS/release of Ach, block both muscarinic & nicotinic receptors.
- ADR: xerostomia, blurred vision, photobpobia, high HR, constipation, dialates pupils.
- Contraindications: cardiac disease, myasthenia gravis (Ach not produced), ulcers, glaucoma
- Belladonna alkaloids: atropine, dialation of eyes
- Scopolamine: slow GI/motion sickness
- Ipratropium: bronchioconstriction
- Dicyclomine: GI relaxation
- Propantheline: dec stomach acid.
- Adrenergic Agonists: SANS, NE/EPI
- Alpha Agonists(NE has greater affinity than EPI)
- Alpha 1: contracts smooth muscle of BV, bladder, sweat, eyes, glands, Gi
- Eye decongestants, nasal mucosa(dec. secretions), vasoconstricts <3 muscle to inc BP, prolongs action of LA/dec bleeding (EPI)
- A2: Autoreceptors: FEEDBACK, inhibit NE, decrease BP, insulin & eye secretion
- Beta Agonists
- B1: stimulation on <3: inc HR & contractility
- B2: EPI most potent, NE doesnt really work here: relaxs lungs, bronchodialation, uterine contractions, vascular smooth muscle.
- Athsma (salbutamol, albuterol, terbutaline, metaproterenol
- non-selective B1&2: EPI (LA &Tx of anaphalaxis), isopropernol (athsma)
- Dopamine: receptors primarily in SANS, an inhibitory NT, balances Ach in vascular smooth muscle.
- Serotonin: produced in platelets, cells in GI & neurons. Controls sleep, pain & emotions.
- Adrenergic Antagonists: drugs usually to Tx urinary retention, migranes & glaucoma. Block SANS so PANS response more prevalent
- Direct
- A1: produces vasodialation to Dec. BP
- A2: keeps SANS turned on
- B2: cardioselective: betal blockers "olol" atenolol better than propranolol bc of less SE.
- Indirect
- doesnt act on adrenergic receptors but blocks NE so no SANS response, will Tx hypertension.