Autonomic Drugs & ANS

Cholinergics (Stimulate PANS-Ach): low HR, Inc. GI motility, miosis, dec. IOP (eye), inc. saliva bronchioconstriction
1. Direct Acting
  1. Direct Acting on Nicontinic Receptors
    1. Nicotene, Nicorette, Varenicline, Champix (smoking cessation)
  2. Direct acting on muscarinic receptors
    1. Pilocarpine (glaucoma &xerostomia)
    2. Bethanechol (Tx incomplete emptying of bladder/urinary retention)
2. Indirect (inhibit the enzyme that destroys ACH) Cholinesterase inhibitors
  1. Donepzil, Aricept, Galantamine, Reminly ER (Tx Alzheimers by inc. Ach in brian)
  2. Neostigmine (Tx myasthenia gravis)
  3. Physostigmine (glaucoma)
3. Indirect & Irreversible: Organophosphates for pesticides & used in chemical warfare.
4. ADR: large doses affect SLUD, neuromuscular paralysis, effects on CNS (confusion)
  1. Contraindications: athsma, hyperthyroidism, GI/UT obstructions, ulcers. Watch for orthostatic hypotension.
Anticholinergics: Inhibit PANS/release of Ach, block both muscarinic & nicotinic receptors.
1. ADR: xerostomia, blurred vision, photobpobia, high HR, constipation, dialates pupils.
  1. Contraindications: cardiac disease, myasthenia gravis (Ach not produced), ulcers, glaucoma
2. Belladonna alkaloids: atropine, dialation of eyes
3. Scopolamine: slow GI/motion sickness
4. Ipratropium: bronchioconstriction
5. Dicyclomine: GI relaxation
6. Propantheline: dec stomach acid.
Adrenergic Agonists: SANS, NE/EPI
1. Alpha Agonists(NE has greater affinity than EPI)
  1. Alpha 1: contracts smooth muscle of BV, bladder, sweat, eyes, glands, Gi
    1. Eye decongestants, nasal mucosa(dec. secretions), vasoconstricts <3 muscle to inc BP, prolongs action of LA/dec bleeding (EPI)
  2. A2: Autoreceptors: FEEDBACK, inhibit NE, decrease BP, insulin & eye secretion
2. Beta Agonists
  1. B1: stimulation on <3: inc HR & contractility
  2. B2: EPI most potent, NE doesnt really work here: relaxs lungs, bronchodialation, uterine contractions, vascular smooth muscle.
    1. Athsma (salbutamol, albuterol, terbutaline, metaproterenol
  3. non-selective B1&2: EPI (LA &Tx of anaphalaxis), isopropernol (athsma)
3. Dopamine: receptors primarily in SANS, an inhibitory NT, balances Ach in vascular smooth muscle.
4. 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
1. Direct
  1. A1: produces vasodialation to Dec. BP
  2. A2: keeps SANS turned on
  3. B2: cardioselective: betal blockers "olol" atenolol better than propranolol bc of less SE.
2. Indirect
  1. doesnt act on adrenergic receptors but blocks NE so no SANS response, will Tx hypertension.

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	Criado por fandrickb2 quase 11 anos atrás