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Adverse effects of alpha 1 blockers - ANSWER -Orthostatic hypotension
Reflex tachycardia
Congestion
Inhibition of ejaculation
Sodium retention
Adverse effects of Alpha 2 blockers - ANSWER -reflex tachycardia
Adverse effects of beta 1 blockers - ANSWER -BRadycardia
Decreased CO
Heart Failure
AV HEart block
Rebound Cardiac excitation
Adverse effects of beta 2 blockers - ANSWER -bronchoconstriction
Hypoglycemia
Prazosin (Minipress) - ANSWER -selective alpha 1 blocker
Used for HTN
** First dose effect - 1% of patients have syncopal episode after first dose
Terazosin (Hytrin),
Doxazosin (Cardura),
Tamsulosin (Flomax),
Alfozosin (Uroxatral) - ANSWER -Selective Alpha 1 blockers
Relaxes bladder nad prostate capsule
,Used for BPH
Labetolol (Trandate)
Carvedilol (Coreg) - ANSWER -Blocks alpha 1, Beta 1, Beta 2
↓BP
Used for HTN, especially post-MI
Propranolol (Inderal)
Sotalol (Betapace)
Timolol (Blocadren)
Carteolol (Cartrol)
Penbutolol (Levatol) - ANSWER -Blocks beta 1, Beta 2
↓HR
Used for HTN.
** use with caution in asthmatics
Nadolol (Corgard - ANSWER -Blocks B1, B2
Longer - t ½ than other BBs
(q day dosing)
Timolol (Blokadren) - ANSWER -Blocks B1, B2
Ophthalmic
also used to ↓ HR
Metoprolol (Lopressor)
Atenolol (Tenormin)
Acebutolol (Sectral)
Esmolol (Brevibloc) - ANSWER -Beta 1 Specific
Used for HTN
,(less bronchospasm)
Indirect alpha blockers - ANSWER -Used for:
HTN
Severe pain
ADD
Clonidine (Catapres) - ANSWER -centrally acting alpha 2 agonist
Used for HTN
Cevimeline (Evoxac) - ANSWER -muscarinic agonist
Used for dry mouth in
Sjogren's
Do not use in asthma
Pilocarpine
(Pilocar, OcusertPilo) - ANSWER -muscarinic agonist
used for Glaucoma;
oral Tx for Sjogren's
Nicotinic-N receptors - ANSWER -located in Ganglia
Promote release of epinephrine from adrenal medula
Nicotinic-M receptors - ANSWER -causes skeletal muscle contraction
muscarinic - ANSWER -located in organs
Sites of muscarinic receptors - ANSWER -Eye - Focus & dilate pupil
Heart - decreased HR
Lung - Bronchial constriction, secretions
Bladder - Voiding of bladder
, GI Tract - Salivation, secretions, motility, defectaion
Sweat Glands
Sex Organs - Erection
Blood Vessels - Vasodilation
Bethanechol (Urecholine) - ANSWER -muscarinic agonist
Used for Urinary retention,
GI atony, ileus
Contraindicated for bladder obstruction, GI obstruction, & hyperthyroidism
Treatment of muscarinic poisoning - ANSWER -Atropine
Mirabegron - ANSWER -OAB drug, works on beta3 receptors
*NOT anticholinergic
Cholinesterase inhibitors - ANSWER -Prevent enzymatic breakdown of
acetylcholine at nerve endings, thus allowing accumulation of the neurotransmitter
Improve strength of contraction in all muscles including respiratory
Neostygmine (Bloxiverz) - ANSWER -Cholinesterase inhibitor
Treatment of myasthenia gravis
Reverse non-depolarizing neuromuscular blockade after surgery
Organophospates - ANSWER -Irreversible cholinesterase inhibitors
Highly toxic
Found in pesticides and nerve agents
Treatment of organophosphate poisoning - ANSWER -Atropine
Pralidoxime
Benzodiazepines (seizure prevention)