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Overall: Salivation, lacrimation, urination, defecation, GI pain, emesis, miosis (contraction of ciliary muscles causing dilation), bronchospasmBenzotropine: Improves tremor Oxybutynin: Decraese bladder spasamsAtropine: Mydriasis/ cyloplegiaScopolamine: Decreases motion sickness, which is a GI upset!Bethanechol: induce smooth muscle contractions uninaryMethacholine: Used in the bronchoconstriction testPilocarpine: Contract ciliary muscles for glaucomaCarbachol: releases ICP for glaucomaSE: rapid heart rate, constipation, vomiting, nausea, dry mouth, dilated pupils, problems uninatingSE: causes Dry mouthCan’t use for those with asthma, with peptic ulcers, hyperthyroidismB.Examples of cholinergic antagonist: atropine (Areza) and scopolamine (Transderm Scop).B.Understand ganglionic blockade, and whether this is a clinically useful pharmacologic concept.1.Blocks specifically predominant tone-Blocks alpha which brings the BP up, so your BP will go down a lot2.Blocks reflexes (reflex tachy/brady)-If the BP is high, the HR will go down to compensate (reflex brady), if the BP is low, the HR will go up to compensate (reflex tachy) -Ganglionic when the BP goes up and down the HR is going to stay the same because the ganglionic blocker blocks all HRGanglionic blockers are used less frequently now because we have antihypertensive which have fewer side effectsThese were the first effective hypertensive drugsThey are still used in some emergency situations such as aortic dissection or autonomic dysreflexia SE: orthostatic hypotension, tachycardia, dry-mouth, urine retention, digestive problems, failure oferection/ejaculationNicotinic receptors mostly (Nn autonomic junctions, Nm muscle junctions)Adrenergic AgonistsA.Understand the difference between the direct acting adrenergic agonists and an indirect acting adrenergic agonist.Adrenergic Agnoists/ Sympathomimics/ mimic NE or epiDirect acting Agonists:Directly activate Adrenergic receptors
B.Classify the following agonists in terms of the adrenergic receptors they activate and the responses they cause as a result of direct receptor activation:1.EPINEPHrine (EpiPen) $$$A& B receptors (Adrenergics)Increases heart rate and contractionVasoconstriction Bronchospasam2.Norepinephrine A, but both A&B at high doseVasoconstriction-Kidneys do not get blood to them! -Not useful in asthma/ anaphylaxis due to thisIncreased BP, which is accompanied by a reflex bradycardia3.DOPamine B1, but A&B at high dose, along with D1&D2 at peripheral sitesActs on the heartPositive inotrope and chronotropicIncreases blood flow to Kidneys4.Phenylephrine $A1VasoconstrictorIncreases BPDecongestant used to make Methamphetamine 5.