Parasympathetic (Chlolinergic)

M&N

1. Ach
2. Carbachol
long duration
Urinary retension
Glaucoma

[ Cholinesterase Competitive inhibitor]

1. Edrophonium
BBB
Diagnosis testing for muscle weakness

2. Vesmical
- Vesicle protein

2. Neostigmine
, 3. Pyridostigmine
BBB
Muscle weakness, Myasthenia gravis
ALL secretions

3. Botulinium toxin
- Vehicle associated
membrane protein

4. Physostigmine
BBB
Glaucoma
5. Donepezil, (galantamine,
rivastigmine)
BBB
Alzheimers disease
liver toxicity

[Organophosphate, non-competitive
inhibitors ]
6. Parathion
BBB
Insecticides
Long term poisoning
M

1. Bethanechol
long duration
Urinary retension
2. Pilocarpin
BBB
Glaucoma

1. Atropine
organophosphate /
cholinergic poisoning
Pupil dilator
Diarrhea
ALL secretions
HR
2. Scopolamine
BBB
Motion sickness
3. Ipratropium
BBB
Dilate bronchial
inhalation for COPD

M3

NN

4. Oxybutynin,
tolterodine
- M3 blocker
Relieve bladder spasm

1. Nicotine
2.Varenicline
Smoking cessation
treatment CNS

1. Hemicholinium
- Choline Transporter
(CHT)

Tubocararine
block both sympathetic
and parasympathetic

Sympathetic (Adrenergic)

1. N
BP , HR
2. NE
- 1>> 2
- HR , BP

1. Ephedrine
NE
Oral nasal decongestant

2. Reserpine
Vesicle protein

2. Amphetamine
ADHD

3. Bretylium
Vehicle associated
membrane protein

3. Cocaine, tricyclic
antidepressant
- Monoamine reuptake (
NE-Transporter NET)
Local anesthesia

1. hentolamine , Tolazoline
- Reversible
hypertension

1. Phenylephrine, methoxamine
Decongestant

2. Phenoxybenzamine
- Irreversible
Pheo-chromo-cytoma
1. Prazosin, Terazosin,
hypertension
2. Doxazosin (Long term
treatment)
hypertension
3. Tamulosin
- selective for prostate SM
Benign prostate hypertrophy

1. Clonidine
Hypertension
2. Dexmedetomidine
Anesthetic effect
Isoproterenol
- CO [HR], systole BP,
diastole BP

Dobutamine
shock
heart failure

1. Salbutamol, 2. Terbutaline
asthma
acute bronchospasm)
prevent premature laboring by
relax uterine muscle

1. -methyltyrosine
-Synthetic enzyme

1. Propranolol
Hypertension
Local anesthetic
2. Timolol
Glaucoma by aqueous
humor production
1. Metoprolol
2. Atenolol
Low dose prefer blocking
cardiac 1, high dose danger
to block 2
asthmatic attack by
bronchoconstiction

NANC (Non-adrenergic non-cholinergic)

1st generation

All H

- Dephenhydramine
Multiple dosing
Anti-allergic
Anti-Emetic
Somnifacients
anti-adrenergic : fatigue, sedative
anti-cholinergic : secretion
Overdose: excitement
DDI: not with MAO inhibitors,
cholinesterase inhibitors
2nd generation

H1

- Fexofenadine
Rapid onset
Longer duration of action, reduce doing
frequency
Less anti-adrenergic / cholinergic ANS
side effects
3rd generation
All 5-HT

migraine attack

1. MAO inhibitors
2. Storage inhibitors
(Amphetamine)
3. Reuptake inhibitors
(Fluoxetine, (-pram, -ine))
social anxiety, depression
obsessive- compulsive
disorder

5-HT1A
5-HT1B
5-HT1C

anti-depression
anti-headache

5-HT1D

Triptans
CV related pain - Angina pain, MI,
stroke
anti-depression

5-HT2
5-HT3
P1

P2

Adenosine
- extremely Short acting
- K+ inward rectifier
- Ca2+ current inhibitor
Anti-arrhythmic
hypotension
chest pain

Dipyridamole
- Adenosine reuptake
inhibitor
- phosphodiesterase
( cAMP AMP, hence
indirectly ADP
platelet crosslinkage)
MI
atherosclerosis
ischemic

anti-hypertensive
anti-emetic
chemotherapy supplement
Caffeine

1. Clopidogrel
2. Ticlopidine
Non-competitive inhibitor
MI
atherosclerosis
ischemic