pharm 2 drugs

Epineph classrine

Non-selective (α+β

epinephrine primary use

Anaphylaxis, cardiac arrest, severe asthma (EpiPen

epinephrine key danger

Prototype rescue drug; monitor HR/BP closely

Norepinephrine class

non selsective a and b

norepinephrine primay use

Severe shock (vasopressor)

dopamine danger

(vasopressor)Vesicant — extravasation causes tissue necrosis

dopamine class

non selective- dose dependant

dopamine use

Shock, low cardiac output

doputamine class

B1

dobutamine uses

Cardiogenic shock, low CO

dobutamine warning

tachycardia

phenylephrine class

alpha 1 selective

what is phenylephrine used for

Nasal decongestion, shock, pupil dilation

what to watch for phenylephrine

reflex bradycardia; nasal spray max 3–5 days (rebound congestion

clondidine class

alpha 2 selective

clondidine use

Hypertension, ADHD, opioid withdrawal

Varenicicline mechanism

, nicotine receptor, partial agonist

Warning vareniciline

Watch closely for vivid dreams and severe neuropsychiatric event

Buproprion mechanism

Weekly inhibit neuronal reuptake of norepinephrine and dopamine

Buproprian warning

Contraindicated in pt with seizure

clondidine warning

🚨 NEVER stop abruptly — taper 2–4 days (rebound HTN crisis

Albuterol / Levalbuterol class

Beta-2 selective (SABA)

Albuterol / Levalbuterol use

Asthma rescue inhaler- immediate use

Salmeterol / Formoterol class

Beta-2 selective (LABA

Salmeterol / Formoterol use

Daily asthma maintenance NOT for acute attacks

Isoproterenol class

non selective beta

Isoproterenol use

Severe heart block, shock, cardiac arrest

isopreterenol warning

Needs continuous ECG; keep beta-blocker at bedside as antidote

Labetalol class

Non-selective (α+β)

labelatol use

HTN, hypertensive emergency, clonidine withdrawal

labelatol waning

Hepatic injury risk; no reflex tachycardia

Phentolamine class

Non-selective Alpha

Phentolamine use

IV extravasation rescue, pheochromocytoma dx

Phentolamine warning

Reflex tachycardia (blocks α2 brake); avoid in CAD/MI

Doxazosin class

Alpha-1 selective

doxazosin use

HTN + BPH

doxazosin warning

"First-dose phenomenon" — give first dose at BEDTIME- orthostatic hypotension

low dose dopamine (0.5-2) class

dopaminergic receptor

low dose dopamine (0.5-2) use

promote renal and mesenteric vasodilation

high dose doapmine (more than 10) class

alpha 1

high dose doapmine (more than 10) use

systemic vasoconstriction and spike BP

moderate dose doapmine (2-10) class

beta 1

moderate dose doapmine (2-10) use

increase myocardial contractility anf cardiac output

labelatol class

Non-selective (α+β)

labelatolol use

HTN, hypertensive emergency, clonidine withdrawal

labelatolol warning

Hepatic injury risk; no reflex tachycardia

Carvedilol class

non selective a + b

carvedilol use

Heart failure, post-MI

amiodarone class

nonselective a+b

amiodarone use

arrythmias, a-fib

Phentolamine class

nonselective alpha

phentolamine use

IV extravasation rescue, pheochromocytoma dx

phentolamine warning

Reflex tachycardia (blocks α2 brake); avoid in CAD/MI

Propranolol class

nonselective beta

propranolo use

HTN, angina, arrhythmias, migraines, anxiety, infantile hemangiom

propranolo warning

🚨 NEVER stop abruptly (rebound MI/arrhythmia); avoid in asthma/COPD

Atenolol class

beta 1 selective

atenolol use

Angina, HTN, acute MI

atenolol warning

Loses selectivity at HIGH doses → bronchospasm risk returns

Bethanechol class

Direct-acting muscarinic

bethanechol use

Binds bladder receptors

Urinary retention (non-obstructive), neurogenic bladder

Bethanechol warning

Not for kids under 8; watch for SLUDGE symptoms

Pilocarpine / Cevimeline class

direct acting muscarinic

Pilocarpine / Cevimeline use

Stimulates glands

Dry mouth (xerostomia), glaucoma

Pilocarpine / Cevimeline warning

sweating

gi upset

Acetylcholine chloride class

Direct-acting muscarinic

Acetylcholine chloride use

Miosis

Eye surgery

immediate onset

Pyridostigmine Neostigmine class

in/direct-acting (AChE inhibitor)

Pyridostigmine Neostigmine use

Blocks AChE

myasthenia gravis

Donepezil, Rivastigmine, Galantamine class

Indirect-acting (AChE inhibitor,

Donepezil, Rivastigmine, Galantamine use

slows progression, doesn't cure alzheimers

what to know Galantamine

Available as liquid — good for dysphagia

Atropine class

Prototype anticholinergic

atropine use

Pre-op secretion drying, symptomatic bradycardia, cholinergic crisis/mushroom poisoning antidote

atropine warning

IV peak 2–4 min; IM peak 30 min

Oxybutynin Tolterodine Solifenacin class

anticholernergic

Oxybutynin, tolterodine, and solifenacin use

overactive bladder/incontinence

Oxybutynin, tolterodine, and solifenacin warning

Avoid in BPH (can cause urinary obstruction

Ipratropium Tiotropium Umeclidinium class

anticholernergic

Ipratropium Tiotropium Umeclidinium use

COPD/asthma bronchodilation

Dicyclomine Hyoscyamine Scopolamine class

anticholernergic

Dicyclomine Hyoscyamine Scopolamine use

GI hypermotility/cramping

Dicyclomine warning

dont give children

Clonidine or Propranolol abrupt withdrawal andidote

Prevention only — never stop abruptly, must taper

Cholinergic Crisis (SLUDGE) or mushroom poisoning antidote

atropine

Isoproterenol-induced cardiac overdrive anditode

beta blcoker- bedside

Dopamine/Norepinephrine IV extravasation (tissue necrosis risk) antidote

Phentolamine