DRUGS SYMPATHOMIMMETIC DRUGS PARASYMAPTHOMIMMETIC ANTI CHOLINERGIC
DRUGS DRUGS
THERAPEUTIC Hypotension EYE 1- Ophthalmic uses:
USES Nasal congestion GLAUCOMA Atropine
Stuffy head feelings CNS Mydriatic
(common cold) ALZHEIMER DISEASE Opthalmologic
Paroxysmal AUTOIMMUNE examinations
supraventricular Myasthenia Gravis 2- Rx of bradycardia:
tachycardia (dec HR) GASTROINTESTINAL Atropine
Spasticity of muscles & URINARY BLADDER Myocardial infarction
Cardiac decompensation ATONY Atrioventricular nodal
(heart disease or cardiac REVERSAL OF block
surgery) NEUROMUSCULAR 3- Motion sickness-
Prevent bronchospasm BLOCKAGE Scopolamine
Prevent premature REVERSAL OF Block cholinergic
labour,,, b2 agonists Anticholinergic transmission from brain
Shock induced toxicity and brain stem
General anaesthesia GLAUCOMA: 4- Parkinsonism-
Orthostatic hypotension Raised intraocular pressure Benztropine, beperiden
Carbachol, Pilocarpine, Block the central
Echothiophate muscarinic cholinergic
Used topically synapses
Increases the outflow of 5- Bronchial asthma and
aqueous humor COPD- Ipratropium.
Less systemic adverse effects Tiotropium
ALZHEIMER DISEASE relax bronchial smooth
Progressive muscles
neurodegenerative disorder 6– Acute colicky pains
of old age Reduce GI muscle tone
Neurodegeneration of and spasm
cholinergic neurons- (antispasmodics)
memory, cognition and other 7. Peptic ulcer
cortical functions Not cure only treat
Tacrine, Rivastigmine, symptoms
Galantamine, Donepezil 8- Urinary urgency-
Tend to lose effectiveness as Oxybutynin, Tolterodine
disease progresses Neurogenic bladder
MYASTHENIA GRAVIS syndrome
Disease of skeletal Reduce bladder
neuromuscular junction- hypertonicity
weakness, fatigability,
paralysis of respiratory 9. Rx of
muscles. Organophosphorus
Autoantibody to nicotinic compound poisoning-
cholinergic receptor is Atropine
produced prevention in the
Neostigmine, Pyridostigmine poisoning of war gases.
GASTROINTESTINAL & 10- Pre-anaesthetic
URINARY BLADDER ATONY medication
After surgery or trauma To decrease secretions
Atony or lack of tone
Constipation and urinary
retention
Bethanechol, Neostigmine
Increases the smooth muscle
contraction
REVERSAL OF
NEUROMUSCULAR
BLOCKAGE
Skeletal muscle relaxants like
tubocurarine, gallamine,
pancuronium used during
general anesthesia block
neuromuscular transmission.
Reversal by indirectly acting
cholinergic stimulants
REVERSAL OF
ANTICHOLINERGIC INDUCED
TOXICITY
Effects of anticholinergic
drugs like atropine on CNS
are reversed by indirectly
cholinomimetic agents.
Physostigmine
ADVERSE Cardiac arrhythmias: due Bronchoconstriction Dry mouth
EFFECTS to increased heart rate. GI Distress Blurring of vision
Anginal pain: increased Nausea Photophobia
work load & oxygen Vomiting Tachycardia
demand Diarrhea Constipation
Cerebral hemorrhage: Abdominal cramping Urinary retention
Due to marked rise in Increased secretion
blood pressure. (lacrimation,
Pulmonary edema may salivation, sweating)
be produced. Bradycardia
CNS A/E: Only at high
doses, does not cross
BBB at therapeutic doses.
Disturbing Reactions like
fear, apprehension,
anxiety, Restlessness,
Headache, Tremors.
DRUG ALPHA BLOCKERS BETA BLOCKERS
THERAPEUTI Phaeochromocytoma CARDIOVASCULAR USES:
C USES Hypertensive emergencies hypertension
Chronic hypertension angina pectoris: in prevention of
Urinary obstruction due to Benign attacks
Prostatic Hypertrophy (BPH) tachycardia of various origins
Peripheral Vascular Spastic Disease including those of
(Raynaud’s phenomenon). hyperthyroidism
Autonomic crisis congestive heart failure
1- Pheochromocytoma myocardial infarction,
Phenoxybenzamine preoperative & for the unstable angina
chronic treatment of inoperable or metastatic Cardiac arrhythmias
pheochromocytoma, given with β blockers. Obstructive cardiac myopathies
Metyrosine an inhibitor of tyrosine hydroxylase, Portal hypertension
useful in inoperable or metastatic OTHER CONDITIONS:
pheochromocytoma. treatment of migraine, tremor,
2-Hypertensive Emergencies symptoms of anxiety
Labetalol is used in Hypertensive Emergencies alcohol addiction in which there
3-Chronic Hypertension appears a beta overstimulation.
α 1-selective antagonists in mild to moderate HTN treatment of glaucoma by
but not recommended as monotherapy because ophthalmic solutions, but they can
other drugs are more effective. diffuse into the general circulation
4-Peripheral Vascular Disease and give adverse effects
Raynaud's phenomenon Prazosin or
phenoxybenzamine are used but calcium channel
blockers may be preferable for most patients.
5-Benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH) is common in
elderly men.
Prazosin, doxazosin, and terazosin are all
effective.
Tamsulosin is α 1A-receptor antagonists effective
in BPH and has relatively minor effects on blood
pressure at a low dose.
ADVERSE Reflex tachycardia Aggravation of congestive heart failure.
EFFECTS Postural hypotension and syncopy Congestive heart failure is both an
Dizziness, indication and a contraindication to the
headache use of beta-blockers.
Diarrhea In any case, starting a beta-blocking
Nasal Congestion treatment cannot be done without a
Dilates vessels of nasal mucosa rigorous analysis of the state of the
patient and necessitates a close
monitoring.
CVS
Aggravation of bradyarrythmia;
bradycardia, atrioventricular
blocks are contraindications to
their prescription
Cardiodepression
Bradycardia
Cold extremities
Worsening of peripheral vascular
disease
RESPIRATORY SYSTEM
Aggravation of asthmatic disease,
especially with nonselective beta-
blockers - but also sometimes
with beta-1selective blockers.
Bronchospasm
METABOLIC DISORDERS
Increase in triglycerides
-increase in cholesterol and the VLDL (very
low-density lipoproteins)
hypoglycemia in diabetics
-raised risk of developing a type II diabetes
after antihypertensive treatment during
several years by beta-blockers.
