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Chapter 12 & 13 Prototype Drugs - Coggle Diagram

- - - - hypersensitivity
      - mechanical obstruction of the GI or GU tract
      - Caution ->
        
        history of asthma
        
        ulcer disease
        
        cardiovascular disease
        
        epilepsy
        
        hyperthyroidism
        
        sensitivity to cholinergic agents or effects
    - - Quinidine
      - Procainamide
      - cholinesterase inhibitors
      - ganglionic blocking agents
      - depolarizing neuromuscular blocking agents
      - anticholinergics
    - - Heart block
      - syncope
      - cardiac arrest
      - bradycardia
      - hypotension
    - - Stimulate cholinergic receptors
        
        contraction of the bladder
        
        decreased bladder capacity
        
        increased frequency of ureteral peristaltic waves
        
        increased tone and peristalsis in the GI tract
        
        increased pressure in the lower esophageal sphincter
        
        increased gastric secretions
    - - Atropine sulfate
    - - Headache, malaise
      - lactimation, miosis
      - bronchospasm
      - abdominal discomfort, diarrhea, nausea, salivation, vomiting
      - urgency
      - flushing, sweating, hypothermia
    - - Stimulate bladder emptying
- - - - anything that accentuates the PNSlytic response, ie. procainamide, TCA
    - - antimuscarinic
        
        increase HR
        
        bronchodilates
        
        decreases gastric motility
        
        mydriasis
    - - antidote for anticholinesterase poisoning
    - - dry mouth
      - constipation
      - urinary retention
      - increase HR
      - CNS excitement leading to delirium
    - - monitor BP
      - monitor pulse
      - monitor respirations 1 hour before and after
    - - physostigmine (Antilirium)
    - - glaucoma patients
      - obstruction patients
      - BPH
      - MG
- - - - MaOi use can result in hypertensive crisis
    - - tissue injury (extravasation)
      - damage to soft contact lenses
    - - intranasal use/decongestant
      - dilates pupils
      - reverse hypotenstion
    - - narrow angle glaucoma patients
      - heart disease patients
    - - hypertension
      - increased HR leading to severe reflex bradycardia
      - rebound congestion
      - narrow angle glaucoma due to secondary mydriatic effect
      - burning of nasal mucosa
    - - constricts small blood vessels
      - effects related to fight or flight response
      - dilates pupils
    - - Death if used IV
- - - - competes with NE at alpha receptor to block binding
    - - orthostatic hypotension
      - reflex tachycardia
      - nasal congestion
    - - decreases BP, no effect on HR
    - - short half life, must be given 2-3x/day
      - start with a low dose to avoid hypotension
    - - fluid expanders (saline)
      - vasopressors (dopamine, dobutamine)
    - - caution in elderly patients
      - caution in those with known allergies to drug
    - - additional anti-hypertensives
      - diuretics