Adrenergic Drugs
The primary vasoactive drug used in ACLS protocol. Acts on both alpha and beta receptors innervated by the SNS.
Contraindications
Known drug allergy or PVD
Neurotransmitter and Receptors
Acetylcholine, Nicotinic and Muscarinic
Interactions
amantadine, antihistamines, phenothiazines, tricyclic antidepressants, dioxin
Antidote for atropine
physostigmine
Stimulates alpha adrenergic receptors, and beta1 receptors, with not beta2 stimulation. Treats hypotension and shock. Continuous infusion.
phentolamine or Regitine
Cholinergic Crisis Signs, Antidote, SLUDGE
Early: abdominal cramps, flushing, N/V, transient syncope, orthostatic hypotension
Late: Circulatory collapse, shock, cardiac arrest
Atropine
salivation, lacrimation, urination, defecation, GI cramps, emesis
naturally occurring, used for bradycardia, ventricular asystole, antidote for anticholinesterase inhibitor toxicity, reduce pre Op salivation and GI secretions
very similar to this drug as well but with less pazazzz
Atropine
glycopyrrolate or Rubinol
cholinergic drugs
Almost exclusively alpha adrenergic receptors, used for short treatment for bp and shock. SVT, nasal decongestant, topical ophthalmic drug
phenylephrine or Neo-Synephrine
alpha blocker used to treat BPH in males and kidney stones in females, contraindicated with ED meds like sildenafil
Tamsulosin or Flomax
direct acting, acute post Op urinary retention, or management of urinary retention w/neurogenic atony of bladder
bethanechol or Urecholine
antispasmodic used for functional disturbances of GI motility like IBS
dicyclomine or Bentyl
alpha and beta receptors and their function
alpha=in the vessels vasoconstriction
beta1=located in heart increase CO
beta2=located in smooth muscle of bronchioles, arterioles, and visceral organs causing bronchodilation
beta1 selective vasoactive, positive inptropy, IV given continuous infusion.
dobutamine or Dobutrex
Indications
HTN, BPH, Pheochromocytoma, Raynaud's, acrocyanosis, frostbites, extravasation
cholinesterase inhibitor, used to treat moderate Alzheimer's, similar to (galantamine and rivastigmine)
doneprzil or Aricept
antimuscarinic drug used for overactive bladder, antispasmodic for neurogenic bladder
oxybutynin or Ditropan
inotropic chronotropic and dromotropic
contraction, heart rate, conduction through AV
potent alpha1 and beta1, low does dilate blood vessels, high doses improve cardiac output, highest doses cause vasoconstriction, have special receptors that can only respond to this
dopamine or Intropin
Assessment precautions
Hx of COPD, hypotension, cardiac dysrhythmia, bradycardia, HF, may cause dry mouth (eat sugarless gum and drink water)
used to diagnosis myasthenia gravis and differentiate it from cholinergic crisis and the dugs used to treat MG
edrophonium or Tensilon
pyridostigmine or Mestinon and neostigmine
prevents motion sickness, can increase sedation when used with alcohol or CNS depressants
Scopolamine
Difference between PNS and SNS
SNS = mydriasis, reduce salivation, increased SV and HR, vasoconstriction, reduced GI, glycogenesis, inhibit bladder contraction
PNS = miosis, increase saliva, decreased HR, bronchoconstriction, GI increase, bladder constriction