donepezil (Aricept)
PO cholinesterase inhibitor that causes the reversible inhibition of acetylcholinesterase to increase availability of acetylcholine at cholinergic synapses, causes less sudden changes in condition
indication: mild to severe AD
AE: N/V, diarrhea, dyspepsia
rivastigmine (Exelon)
PO or transdermal cholinesterase inhibitor that causes the irreversible inhibition of AChE to increase availability of acetylcholine at cholinergic synapses
Indication: mild to moderate AD
AE: N/V, diarrhea, abdominal pain, anorexia, bradycardia, falls
Co
memantine (Namenda)
PO NMDA receptor antagonist that modulates the effects of glutamate (excitatory transmitter) at NMDA receptors, which are believed to play a critical role in learning and memory
Indication: moderate to severe AD, combine with donepezil
AE: dizziness, head
norepinephrine (Levophed)
adrenergic agonist, catecholamine, activates a1, a2, and b1
Indications: hypotensive states, cardiac arrest
AE: tachydysrhythmias, angina, hypertension, local necrosis
epinephrine (Adrenalin)
adrenergic agonist, catecholamine, activates a1, a2, b1, and b2, treatment of choice for anaphylactic shock, alpha1 vasoconstriction: used to delay absorption of local anesthetics, control superficial bleeding, and elevate BP, beta1: overcome heart block,
isoproterenol (Isuprel)
adrenergic agonist, catecholamine, acts at beta1 and beta2 receptors
Indications: AV heart block, cardiac arrest, shock (increase CO)
AE: tachydysrhythmias, angina, hyperglycemia in diabetics
dopamine
adrenergic agonist, catecholamine, acts on dopamine receptors on kidney and b1 at low doses, acts on a1 at high doses
Indications: shock, heart failure
AE: tachycardia, dysrhythmias, angina
dobutamine
adrenergic agonist, catecholamine, acts on b1 only
Indication: heart failure
AE: tachycardia
ephedrine
adrenergic agonist, noncatecholamine, acts on a1, a2, b1, and b2
Indications: limited, asthma, shock, anesthesia-induced hypotension
AE: hypertension, dysrhythmias, angina, hyperglycemia, insomnia
phenylephrine (Neo-synephrine)
adrenergic agonist, noncatecholamine, acts on a1 only
Indications: reduce nasal congestion, elevate BP, mydriasis, delay anesthetic absorption
AE: bradycardia
albuterol (Ventolin)
adrenergic agonist, noncatecholamine, acts at b2 receptors only
Indications: asthma
AE: tremor, tachycardia at high doses
prazosin (Minipress)
adrenergic antagonist, competitive antagonist that produces a selective blockade of alpha1 adrenergic receptors, this dilates arterioles and veins and relaxes smooth muscle in the bladder neck and prostatic capsule
Indication: hypertension
AE: orthostatic
tamsulosin (Flomax)
adrenergic antagonist, alpha1 blocker, selective toward receptors on smooth muscle of bladder neck and prostatic capsule
Indication: BPH
AE: headache, dizziness, abnormal ejaculation, rhinitis
phentolamine (Regitine)
adrenergic antagonist, competitively blocks alpha2 receptors as well as alpha1
Indications: pheochromocytoma, prevention of necrosis from extravasation, and reversal of soft tissue anesthesia
AE: orthostatic hypotension, reflex tachycardia (more severe th
propanolol (Inderal)
adrenergic antagonist, nonselective beta blocker, by blocking b1 it can reduce heart rate, decrease the force of ventricular contraction, and suppress impulse conduction through the AV node as well as suppress secretion of renin
by blocking b2 it can caus
metoprolol (Lopressor)
adrenergic antagonist, selectively blocks beta1 receptors
Indications: hypertension, angina, HF, MI
AE: bradycardia, reduced CO, AV heart block, rebound cardiac excitation
clonidine (Catapres)
indirect-acting antiadrenergic agent, centrally acting alpha2 agonist, acts on the brainstem to reduce sympathetic flow to blood vessels and the heart
Indications: hypertension, severe pain (Duraclon), ADHD (Kapvay)
AE: drowsiness, xerostomia, rare reboun
reserpine
naturally occurring compound prepared from the root of Rauwolfia serpentina, indigenous to India, it causes depletion of NE from postganglionic sympathetic neurons which decreases activation of almost all adrenergic receptors
Indications: hypertension, ps
pilocarpine
muscarinic agonist, reduces IOP, antidote is atropine
Indications: glaucoma, dry mouth
AE: sweating
bethanechol
muscarinic agonist, direct-acting, binds reversibly to muscarinic cholinergic receptors to cause activation, acts selectively at these receptors, relaxes the trigone and sphincter muscles and increases voiding pressure by contracting the detrusor muscle,
atropine (AtroPen)
muscarinic antagonist, found naturally in the deadly nightshade plant, competitively blocks muscarinic receptors, antidote is physostigmine
Indications: preanesthetic medication, disorders of the eyes, bradycardia, intestinal hypertonicity and hypermotili
ipratropium (Atrovent)
anticholinergic drug that is inhaled to decrease secretions and SOB, antidote is physostigmine
Indications: asthma, COPD, rhinitis
oxybutynin (Ditropan XL)
anticholinergic agent that acts primarily at M3 receptors on the bladder detrusor, antidote is physostigmine
Indication: OAB
AE: dry mouth, constipation, tachycardia, urinary hesitancy and retention, mydriasis, blurred vision, dry eyes, hallucinations, co
scopolamine
anticholinergic drug like atropine, but produces sedation and suppresses emesis and motion sickness, antidote is physostigmine
Indications: motion sickness, cycloplegia and mydriasis for eye exams, preanesthetic sedation
AE: sedation
neostigmine (Bloxiverz)
reversible cholinesterase inhibitor, manages MG, binds to cholinesterase to make acetylcholine more available, antidote is atropine
Indications: MG, reversal of competitive neuromuscular blockade
AE: excessive muscarinic stimulation, neuromuscular blockad
echothiophate (phospholine iodide)
irreversible cholinesterase inhibitor administered topically, binds to AChE to prevent it from hydrolyzing ACh, antidote is atropine and pralidoxime
Indications: glaucoma, insecticide
AE: excessive muscarinic stimulation, neuromuscular blockade, CNS effec
vecuronium (Norcuron)
nondepolarizing neuromuscular blocker, generic names have -curonium or -curium suffix, competitively binds to nicotinicM receptors on motor end plate to block activation by acetylcholine, causes muscle relaxation, does not reduce consciousness or pain
Ind
succinylcholine (Anectine)
depolarizing neuromuscular blocker that competitively binds to nicotinicM receptors to block activation by acetylcholine, remains bound to receptor to produce a state of constant depolarization to cause paralysis
Indications: muscle relaxation during endo
lidocaine (Xylocaine)
amide type local anesthetic that blocks sodium channels
AE: CNS depression and excitation, CV suppression, allergic reaction
nitrous oxide
inhaled anesthetic, "laughing gas," works through binding with NMDA receptor, potent analgesic, low anesthetic potency
AE: minimal, postoperative N/V, respiratory and cardiac depression, malignant hyperthermia, aspiration of gastric contents
propofol (Diprivan)
intravenous anesthetic, works through activation of receptors for GABA, narrow therapeutic range
Indication: induction and maintenance of general anesthesia as part of a balanced anesthesia technique, sedation
AE: respiratory depression, hypotension, risk
ketamine (Ketalar)
intravenous anesthetic that produces dissociative anesthesia through activation of GABA receptors, sedation, immobility, analgesia, and amnesia
Indications: minor surgical and diagnostic procedures, changing burn dressings
AE: hallucinations, delirium, re