Pharma control 1 drugs affecting PANS & ANAS

Adrenalin

Category: Drug affecting SANS.

Classification: Direct-acting nonselective adrenergic agonist; α1, α2, β1, β2 agonist.

Mechanism of Action: Activates α and β adrenoceptors, causing vasoconstriction, increased cardiac activity, and bronchodilation.

Therapeutic Use: Anaphylaxis, cardiac arrest, severe bronchospasm, and addition to local anesthetics.

Adverse Effects: Tachycardia, arrhythmias, hypertension, tremor, anxiety, headache, hyperglycemia.

Contraindications: No absolute contraindication in anaphylaxis or cardiac arrest; otherwise caution in severe hypertension, ischemic heart disease, and tachyarrhythmias.

Noradrenalin

Category: Drug affecting SANS.

Classification: Direct-acting adrenergic agonist; mainly α1, α2 and β1.

Mechanism of Action: Produces strong vasoconstriction through α receptors and increases cardiac contractility through β1 receptors.

Therapeutic Use: Septic shock and severe acute hypotension.

Adverse Effects: Hypertension, reflex bradycardia, arrhythmias, peripheral ischemia, tissue necrosis after extravasation.

Contraindications: Uncorrected hypovolemia; caution in peripheral or mesenteric vascular thrombosis.

Dopamine

Category: Drug affecting SANS.

Classification: Dose-dependent dopaminergic and adrenergic agonist.

Mechanism of Action: Low doses stimulate D1 receptors, moderate doses β1 receptors, and high doses α1 receptors.

Therapeutic Use: Selected shock states with low cardiac output and symptomatic bradycardia.

Adverse Effects: Tachycardia, arrhythmias, hypertension, myocardial ischemia, nausea, peripheral ischemia.

Contraindications: Pheochromocytoma and uncorrected tachyarrhythmias or ventricular fibrillation.

Dobutamine

Category: Drug affecting SANS.

Classification: Predominantly β1-adrenoceptor agonist.

Mechanism of Action: Stimulates cardiac β1 receptors, increasing myocardial contractility and cardiac output.

Therapeutic Use: Acute heart failure, cardiogenic shock, short-term inotropic support, cardiac stress testing.

Adverse Effects: Tachycardia, arrhythmias, angina, headache, hypertension or hypotension.

Contraindications: Hypertrophic obstructive cardiomyopathy and significant uncontrolled tachyarrhythmias.

Phenylephrine

Category: Drug affecting SANS.

Classification: Selective α1-adrenoceptor agonist.

Mechanism of Action: Activates α1 receptors causing vasoconstriction and increased peripheral vascular resistance.

Therapeutic Use: Hypotension, nasal congestion, and mydriasis.

Adverse Effects: Hypertension, reflex bradycardia, headache, ischemia, urinary retention.

Contraindications: Severe hypertension and significant ventricular tachycardia; caution in severe cardiovascular disease.

Clonidine

Category: Drug affecting SANS.

Classification: Centrally acting α2-adrenoceptor agonist.

Mechanism of Action: Activates central α2 receptors, decreasing sympathetic outflow and norepinephrine release.

Therapeutic Use: Hypertension, ADHD, withdrawal syndromes, and pain-management adjunct.

Adverse Effects: Sedation, dry mouth, bradycardia, hypotension, constipation, rebound hypertension after abrupt withdrawal.

Contraindications: Severe bradycardia or hypotension; should not be stopped abruptly.

Apraclonidine

Category: Drug affecting SANS.

Classification: Predominantly α2-adrenoceptor agonist with weak α1 activity.

Mechanism of Action: Decreases aqueous humor production and increases outflow; denervation hypersensitivity allows reversal of Horner-syndrome ptosis.

Therapeutic Use: Short-term reduction of intraocular pressure and diagnosis of Horner syndrome.

Adverse Effects: Dry mouth, allergic conjunctivitis, hypotension, bradycardia, fatigue.

Contraindications: MAO inhibitor therapy and hypersensitivity; caution in severe cardiovascular disease.

Pseudoephedrine

Category: Drug affecting SANS.

Classification: Indirect-acting sympathomimetic with some direct adrenergic activity.

Mechanism of Action: Promotes norepinephrine release and stimulates adrenergic receptors, producing vasoconstriction of nasal mucosa.

Therapeutic Use: Nasal and sinus decongestion.

Adverse Effects: Insomnia, nervousness, tremor, tachycardia, hypertension, urinary retention.

Contraindications: Severe hypertension, severe coronary artery disease, MAO inhibitor use within 14 days.

Albuterol (salbutamol, ventolin)

Category: Drug affecting SANS.

Classification: Short-acting selective β2-adrenoceptor agonist; SABA.

Mechanism of Action: Activates β2 receptors, increasing cAMP and relaxing bronchial smooth muscle.

Therapeutic Use: Rapid relief of bronchospasm in asthma and COPD; adjunct treatment of hyperkalemia.

Adverse Effects: Tremor, tachycardia, palpitations, hypokalemia, nervousness, hyperglycemia.

Contraindications: Hypersensitivity; caution with significant tachyarrhythmias and severe cardiovascular disease.

Amphetamine

Category: Drug affecting SANS.

Classification: Indirect-acting sympathomimetic and CNS stimulant.

Mechanism of Action: Increases release and decreases reuptake of dopamine and norepinephrine.

Therapeutic Use: ADHD and narcolepsy.

Adverse Effects: Insomnia, decreased appetite, weight loss, tachycardia, hypertension, anxiety, dependence, psychosis at high doses.

Contraindications: MAO inhibitor use within 14 days, severe hypertension, symptomatic cardiovascular disease, hyperthyroidism, glaucoma.

Phenoxybenzamine

Category: Drug affecting SANS.

Classification: Irreversible nonselective α1- and α2-adrenoceptor antagonist.

Mechanism of Action: Covalently blocks α receptors, producing prolonged vasodilation and preventing catecholamine-mediated vasoconstriction.

Therapeutic Use: Preoperative and chronic management of pheochromocytoma.

Adverse Effects: Orthostatic hypotension, reflex tachycardia, nasal congestion, miosis, sexual dysfunction.

Contraindications: Marked hypotension or shock; caution in coronary and cerebrovascular disease.

Tamsulosin

Category: Drug affecting SANS.

Classification: Selective α1A-adrenoceptor antagonist.

Mechanism of Action: Relaxes smooth muscle in the prostate and bladder neck.

Therapeutic Use: Benign prostatic hyperplasia and facilitation of ureteric stone passage.

Adverse Effects: Dizziness, orthostatic hypotension, headache, abnormal ejaculation, floppy iris syndrome.

Contraindications: Hypersensitivity; caution before cataract surgery and with other α-blockers.

Propranolol

Category: Drug affecting SANS.

Classification: Nonselective β1- and β2-adrenoceptor antagonist.

Mechanism of Action: Blocks β receptors, reducing heart rate, contractility, renin release, and sympathetic effects.

Therapeutic Use: Hypertension, angina, arrhythmias, post-MI therapy, essential tremor, migraine prevention, thyrotoxicosis.

Adverse Effects: Bradycardia, AV block, hypotension, fatigue, bronchospasm, masking of hypoglycemia.

Contraindications: Asthma, significant bronchospastic disease, severe bradycardia, advanced AV block, cardiogenic shock, decompensated heart failure.

Timolol

Category: Drug affecting SANS.

Classification: Nonselective β1- and β2-adrenoceptor antagonist.

Mechanism of Action: Blocks ocular β receptors and decreases aqueous humor production.

Therapeutic Use: Glaucoma and ocular hypertension.

Adverse Effects: Bradycardia, hypotension, bronchospasm, fatigue, ocular irritation.

Contraindications: Asthma, severe bronchospastic COPD, sinus bradycardia, advanced AV block, overt cardiac failure.

Pilocarpine

Category: Drug affecting PANS.

Classification: Direct-acting muscarinic cholinergic agonist.

Mechanism of Action: Stimulates muscarinic receptors, especially M3, increasing glandular secretion and contracting ciliary and pupillary sphincter muscles.

Therapeutic Use: Glaucoma and xerostomia.

Adverse Effects: Sweating, salivation, lacrimation, diarrhea, abdominal cramps, bronchospasm, bradycardia, miosis.

Contraindications: Uncontrolled asthma and acute iritis or conditions where miosis is undesirable.

Carbachol

Category: Drug affecting PANS.

Classification: Direct-acting muscarinic and nicotinic cholinergic agonist.

Mechanism of Action: Activates muscarinic and nicotinic acetylcholine receptors and resists acetylcholinesterase degradation.

Therapeutic Use: Ophthalmic induction of miosis and reduction of intraocular pressure.

Adverse Effects: Sweating, salivation, abdominal cramps, diarrhea, bradycardia, hypotension, bronchospasm.

Contraindications: Uncontrolled asthma, marked bradycardia or hypotension, gastrointestinal or urinary obstruction.

Physostigmine

Category: Drug affecting PANS.

Classification: Reversible acetylcholinesterase inhibitor; tertiary amine.

Mechanism of Action: Inhibits acetylcholinesterase, increasing acetylcholine at muscarinic and nicotinic receptors; crosses the blood-brain barrier.

Therapeutic Use: Severe central and peripheral antimuscarinic toxicity.

Adverse Effects: Bradycardia, excessive secretions, bronchospasm, diarrhea, seizures, cholinergic crisis.

Contraindications: Tricyclic antidepressant poisoning, major cardiac conduction defects, mechanical GI or urinary obstruction, severe asthma.

Neostigmine

Category: Drug affecting PANS.

Classification: Reversible acetylcholinesterase inhibitor; quaternary ammonium compound.

Mechanism of Action: Inhibits acetylcholinesterase, increasing acetylcholine at neuromuscular and muscarinic synapses; does not significantly cross the BBB.

Therapeutic Use: Myasthenia gravis, reversal of nondepolarizing neuromuscular blockade, postoperative ileus and urinary retention.

Adverse Effects: Bradycardia, salivation, diarrhea, cramps, bronchospasm, fasciculations, cholinergic crisis.

Contraindications: Mechanical gastrointestinal or urinary obstruction and peritonitis.

Pralidoxime

Category: Drug affecting PANS.

Classification: Acetylcholinesterase reactivator; oxime.

Mechanism of Action: Reactivates organophosphate-inhibited acetylcholinesterase before enzyme aging occurs.

Therapeutic Use: Organophosphate poisoning, normally together with atropine.

Adverse Effects: Hypertension, tachycardia, nausea, dizziness, diplopia, blurred vision, muscle weakness.

Contraindications: No major contraindication in life-threatening organophosphate poisoning; caution in renal impairment.

Atropine

Category: Drug affecting PANS.

Classification: Competitive nonselective muscarinic receptor antagonist.

Mechanism of Action: Blocks muscarinic acetylcholine receptors and inhibits parasympathetic activity.

Therapeutic Use: Symptomatic bradycardia, organophosphate poisoning, reduction of secretions, mydriasis.

Adverse Effects: Dry mouth, tachycardia, mydriasis, blurred vision, urinary retention, constipation, hyperthermia, confusion.

Contraindications: Narrow-angle glaucoma and obstructive GI or urinary disease; no absolute contraindication in life-threatening bradycardia or organophosphate poisoning.

Ipratropium

Category: Drug affecting PANS.

Classification: Short-acting muscarinic antagonist; SAMA.

Mechanism of Action: Blocks muscarinic receptors in bronchial smooth muscle, reducing vagally mediated bronchoconstriction and secretions.

Therapeutic Use: COPD and adjunct treatment of acute asthma exacerbations.

Adverse Effects: Dry mouth, cough, throat irritation, blurred vision, urinary retention, rare paradoxical bronchospasm.

Contraindications: Hypersensitivity to ipratropium or atropine derivatives; caution in narrow-angle glaucoma and prostatic hypertrophy.

Succinylcholine

Category: Drug affecting PANS.

Classification: Depolarizing neuromuscular blocker; nicotinic Nm receptor agonist.

Mechanism of Action: Persistently activates Nm receptors, causing initial fasciculations followed by depolarizing paralysis.

Therapeutic Use: Rapid-sequence intubation and short procedures requiring skeletal-muscle paralysis.

Adverse Effects: Hyperkalemia, malignant hyperthermia, bradycardia, fasciculations, myalgia, increased intraocular pressure, prolonged apnea.

Contraindications: Malignant-hyperthermia susceptibility, hyperkalemia, major burns or crush injury, denervation, neuromuscular disease, significant pseudocholinesterase deficiency.

Tubocurarine

Category: Drug affecting PANS.

Classification: Nondepolarizing competitive nicotinic Nm receptor antagonist.

Mechanism of Action: Competitively blocks acetylcholine at Nm receptors and prevents skeletal-muscle depolarization.

Therapeutic Use: Historically used for skeletal-muscle relaxation during surgery.

Adverse Effects: Respiratory paralysis, hypotension, bronchospasm, histamine release, prolonged muscle weakness.

Contraindications: Myasthenia gravis, severe neuromuscular weakness, severe hypotension, inability to provide mechanical ventilation.

Scopolamine

Category: Drug affecting PANS.

Classification: Competitive muscarinic receptor antagonist; tertiary amine.

Mechanism of Action: Blocks central and peripheral muscarinic receptors, particularly vestibular pathways involved in motion sickness.

Therapeutic Use: Prevention of motion sickness and postoperative nausea and vomiting.

Adverse Effects: Dry mouth, blurred vision, mydriasis, urinary retention, constipation, sedation, confusion.

Contraindications: Angle-closure glaucoma, significant urinary obstruction, gastrointestinal obstruction.

Botulin

Category: Drug affecting PANS.

Classification: Botulinum neurotoxin; inhibitor of acetylcholine release.

Mechanism of Action: Cleaves SNARE proteins in presynaptic cholinergic terminals, preventing acetylcholine release and causing flaccid paralysis.

Therapeutic Use: Dystonia, spasticity, chronic migraine, hyperhidrosis, overactive bladder, strabismus, cosmetic use.

Adverse Effects: Local muscle weakness, ptosis, dysphagia, dry mouth, rare systemic weakness or respiratory paralysis.

Contraindications: Infection at injection site and hypersensitivity; caution in neuromuscular-junction disorde