Autonomic Nervous System
DRUGS MOA INDICATIONS S/E
Blurred vision, painful eye, night
Parasympathomimetics
Pilocarpine Muscarinic agonist Glaucoma
blindness
Reversal of neuromuscular blockade
Neostigmine Diarrhoea, increased salivation &
Myasthenia gravis
sweating, abdominal cramps,
Pyridostigmine Reversible AchE inhibitor Chronic myasthenia gravis
bradycardia
Edrophonium Diagnosis of myasthenia gravis
Tacrine, donepezil, Tacrine: hepatotoxicity, Others: GI
Alzheimer's disease
rivastigmine, galantamine distress
sickness
Motion
Prevention of motion sickness, postop
Scopolamine xerostomia, sedation, delirium
nausea & vomiting, reduces vertigo
Hyoscine Butylbromide
Reduces smooth muscle and secretory dry mouth, tachycardia, confusion,
GIT
Dicyclomine
activity of gut, IBS antispasmodic urinary ret., intraocular pressure oral
Mebeverine
Decrease salivary & bronchial
Respiratory Secretory
Glycopyrrolate secretions, Relax bronchial smooth COPD maintenance
Parasympathetic Nervous System
muscle
Ipratropium bromide
Tiotropium Relaxes bronchial smooth muscle,
Xerostomia
asthma COPD
Glycopyrrolate
Parasympatholytics
Causes mydriasis & cycloplegia, Retinal
Cholinergic Ophthalmolog
Atropine
exam
Antimuscarinics increased intraocular pressure in
Tropicamide
y
(anticholinergic) Produce Mydriasis and cycloplegia closed angle glaucoma
Cyclopentolate prior to refraction, Eye exam
poisoning
Blocks muscarinic excess at exocrine
glands, heart, smooth muscle, Antidote
in organophosphate poisoning
dilated pupils, warm, dry skin,
Atropine Counteracts vagal effects during tachycardia, tremor, ataxia, delirium,
anaesthesia, Counteracts muscarinic and coma
activity of neuromuscular blockers
CNS
(NMB), Premed, Reversal NMB,
Anaesthesia
Trihexyphenidyl dizziness or blurred vision, dry
Improves tremor, Parkinson's
Biperiden mouth,upset stomach, vomiting,
Oxybutynin
agonist Acting incontinence
Autonomic Nervous System
Darifenacin
Urinary
Reduces detrusor muscle tone, spasms, dry mouth (xerostomia),
Solifenacin
Enuresis (overactive bladder) palpitations, constipation, confusion
Tolterodine
Propiverine
Anaphylaxis, In local anaesthetic incr. N,V headache, Prolonged use:
adrenergic Direct
Epinephrine/ adrenaline α1 α2 agonist β1 β2 agonist
doa peripheral vasoconstriction
Immediate metabolic
precursor of NE. α and β Treat shock, Severe heart failure, Acute
Dopamine Nausea, HT, arrythmias
agonist D1 and D2 agonist hypotension
(dopaminergic)
Dobutamine β1agonist Acute heart failure (MI) Atrial fibrillation
Direct Acting
Sympathomimetics
Salbutamol Short acting β2agonist Restlessness, tremor, tachycardia or
Asthma
arrythmia
Salmeterol Long acting β2agonist
Phenylephrine α1agonist Nasal congestion, hypotension HT, headache
Release stored NE from
Mixed Acting
Ephedrine nerve endings α and β Tacrine: hepatotoxicity, Others: GI
Treat hypotension
agonist distress
Etilefrine
Pseudoephedrine α and β agonist
Nasal congestion CNS stim, HT
Phenylpropanolamine
Sympathetic Nervous System
Central
Acting
Alphamethyl dopa Central α 2 agonist Hypertension in pregnancy Sedation, hyperprolactinaemia
Pheochromocytoma (Pre op), Raynaud Postural hypotension, nasal
α-adrenoreceptor blocking agents
Phenoxybenzamine Non-selective
disease stuffiness, N&V, decr ejaculation
Pheochromocytoma, HPT crisis, (MAO I Postural hypotension, arrhythmias,
Phentolamine α1 + α2
tyramine food, clonidine withdrawal) angina pain
Postural hypotension, drowsiness,
Prazosin, terazosin, Hypertension, BPH (benign prostatic
Selective α1 headache, nasal congestion,
Sympatholytics
doxazosin Hypertrophy)
Retrograde ejaculation
Postural hypotension, drowsiness,
Tamsulosin, alfuzosin Selective α1A BPH (benign prostatic Hypertrophy) headache, nasal congestion, Floppy
iris syndrome
Hypertension, migraine,
β-adrenoceptor Blockers
Propranolol hyperthyroidism, Angina pectoris,
β1 , β2
Myocardial infarction
Bronchospasm, Bradycardia, Heart
Timolol Glaucoma, Hypertension block/failure, Fatigue, Impotence in
Atenolol, Bisoprolol , Hypertension, Angina, Myocardial males, Hypoglycaemia, Cold
Esmolol, Metoprolol β1 infarction(a) extremities, Vivid dreams
Nebivolol Hypertension
Hypertension, non-acute congestive
Carvedilol, Labetalol β1 , β2, α 1
Heart failure
DRUGS MOA INDICATIONS S/E
Blurred vision, painful eye, night
Parasympathomimetics
Pilocarpine Muscarinic agonist Glaucoma
blindness
Reversal of neuromuscular blockade
Neostigmine Diarrhoea, increased salivation &
Myasthenia gravis
sweating, abdominal cramps,
Pyridostigmine Reversible AchE inhibitor Chronic myasthenia gravis
bradycardia
Edrophonium Diagnosis of myasthenia gravis
Tacrine, donepezil, Tacrine: hepatotoxicity, Others: GI
Alzheimer's disease
rivastigmine, galantamine distress
sickness
Motion
Prevention of motion sickness, postop
Scopolamine xerostomia, sedation, delirium
nausea & vomiting, reduces vertigo
Hyoscine Butylbromide
Reduces smooth muscle and secretory dry mouth, tachycardia, confusion,
GIT
Dicyclomine
activity of gut, IBS antispasmodic urinary ret., intraocular pressure oral
Mebeverine
Decrease salivary & bronchial
Respiratory Secretory
Glycopyrrolate secretions, Relax bronchial smooth COPD maintenance
Parasympathetic Nervous System
muscle
Ipratropium bromide
Tiotropium Relaxes bronchial smooth muscle,
Xerostomia
asthma COPD
Glycopyrrolate
Parasympatholytics
Causes mydriasis & cycloplegia, Retinal
Cholinergic Ophthalmolog
Atropine
exam
Antimuscarinics increased intraocular pressure in
Tropicamide
y
(anticholinergic) Produce Mydriasis and cycloplegia closed angle glaucoma
Cyclopentolate prior to refraction, Eye exam
poisoning
Blocks muscarinic excess at exocrine
glands, heart, smooth muscle, Antidote
in organophosphate poisoning
dilated pupils, warm, dry skin,
Atropine Counteracts vagal effects during tachycardia, tremor, ataxia, delirium,
anaesthesia, Counteracts muscarinic and coma
activity of neuromuscular blockers
CNS
(NMB), Premed, Reversal NMB,
Anaesthesia
Trihexyphenidyl dizziness or blurred vision, dry
Improves tremor, Parkinson's
Biperiden mouth,upset stomach, vomiting,
Oxybutynin
agonist Acting incontinence
Autonomic Nervous System
Darifenacin
Urinary
Reduces detrusor muscle tone, spasms, dry mouth (xerostomia),
Solifenacin
Enuresis (overactive bladder) palpitations, constipation, confusion
Tolterodine
Propiverine
Anaphylaxis, In local anaesthetic incr. N,V headache, Prolonged use:
adrenergic Direct
Epinephrine/ adrenaline α1 α2 agonist β1 β2 agonist
doa peripheral vasoconstriction
Immediate metabolic
precursor of NE. α and β Treat shock, Severe heart failure, Acute
Dopamine Nausea, HT, arrythmias
agonist D1 and D2 agonist hypotension
(dopaminergic)
Dobutamine β1agonist Acute heart failure (MI) Atrial fibrillation
Direct Acting
Sympathomimetics
Salbutamol Short acting β2agonist Restlessness, tremor, tachycardia or
Asthma
arrythmia
Salmeterol Long acting β2agonist
Phenylephrine α1agonist Nasal congestion, hypotension HT, headache
Release stored NE from
Mixed Acting
Ephedrine nerve endings α and β Tacrine: hepatotoxicity, Others: GI
Treat hypotension
agonist distress
Etilefrine
Pseudoephedrine α and β agonist
Nasal congestion CNS stim, HT
Phenylpropanolamine
Sympathetic Nervous System
Central
Acting
Alphamethyl dopa Central α 2 agonist Hypertension in pregnancy Sedation, hyperprolactinaemia
Pheochromocytoma (Pre op), Raynaud Postural hypotension, nasal
α-adrenoreceptor blocking agents
Phenoxybenzamine Non-selective
disease stuffiness, N&V, decr ejaculation
Pheochromocytoma, HPT crisis, (MAO I Postural hypotension, arrhythmias,
Phentolamine α1 + α2
tyramine food, clonidine withdrawal) angina pain
Postural hypotension, drowsiness,
Prazosin, terazosin, Hypertension, BPH (benign prostatic
Selective α1 headache, nasal congestion,
Sympatholytics
doxazosin Hypertrophy)
Retrograde ejaculation
Postural hypotension, drowsiness,
Tamsulosin, alfuzosin Selective α1A BPH (benign prostatic Hypertrophy) headache, nasal congestion, Floppy
iris syndrome
Hypertension, migraine,
β-adrenoceptor Blockers
Propranolol hyperthyroidism, Angina pectoris,
β1 , β2
Myocardial infarction
Bronchospasm, Bradycardia, Heart
Timolol Glaucoma, Hypertension block/failure, Fatigue, Impotence in
Atenolol, Bisoprolol , Hypertension, Angina, Myocardial males, Hypoglycaemia, Cold
Esmolol, Metoprolol β1 infarction(a) extremities, Vivid dreams
Nebivolol Hypertension
Hypertension, non-acute congestive
Carvedilol, Labetalol β1 , β2, α 1
Heart failure
