coast midterm 1

direct acting cholinomimetics

choline esters: bethanechol for ileus, urinary retention

alkaloids: pilocarpine for glaucoma, dry mouth (xerostomia)/eyes

indirect acting cholinomimetics

noncovalent: donepezil for alzheimer’s

carbamoylating (-stigmine): physostigmine (BBB) for glaucoma, machr tox and pyridostigmine for MG

phosphorylating

echothiophate: topical glaucoma

parathione: insecticide

treat tox with pralidoxime and atropine unless aged (no tx)

botox

anticholinergic; degrades snps and vamps; use topically

anti-nicotinic

ganglion blockers: trimethaphan used to be used for HTN

Nm blockers: vecuronium for surgery paralysis

Nm agonists: succinylcholine for surgery paralysis

anti-muscarinic

atropine: anti-che tox, bradycardia, AV block

scopolamine: motion sickness

tolterodine/oxybutynin: overactive bladder

ipatropium: copd, rhinorhhea

CI gi obst, glaucoma

atropine tox

treat with physostigmine

red as a beet

hot as a stone

dry as a bone

mad as a hatter

blind as a bat

machr tox

diarhhea

urination

muscle paralysis

bradycardia

bronchoconstriction

excess bronchial secretion

lousy for vision

lacrimations

sweating

treat with atropine/pralidoxime

amphetamine-like indirect sympathomimetics

ephedrine: hypotension

pseudoephedrine: nasal congestion

cns effects

endogenous catecholamines

NE: severe hypotension and shock

Epi: anaphylaxis, maintaining bp during cardiac arrest

non-selective alpha agonists (zolines)

oxymetazoline: nasal congestion, ocular irritation

selective alpha 1 agonists

phenylephrine: nasal congestion, mydriasis, hypotension

non-selective beta agonists used for beta 1

isoproterenol: av block (inc. av conduction), bradycardia

selective beta 1 agonists

dobutamine: acute heart failure, cardiogenic shock

selective beta 2 agonists “terols”

albuterol: asthma/copd

non-selective alpha antagonists

phentolamine: pheochromocytoma (tumor causes excess EPI/NE prod)

selective alpha antagonists “osins”

prazosin: BPH and HTN

alpha 2 agonists

clonidine: HTN

methyldopa: preg HTN

beta antagonists

nonselective and selective beta antagonists

cv disease: HTN, angina pectoris, arrhythmias, HF, MI

other: migraine, performance anxiety

1st gen nonselective “olol”: N-Z

2nd gen beta 1 selective “olol: A-M

3rd gen: additional vasodilation efefcts “alol/ilol”

methyltyrosine

competitively inhibits tyrosine hydroxylase

reserpine

inhibits vmat

cocaine

reuptake inhibitor indirect sympathomimetic

maoi inhibitors

decreased degradation of ne