Receptors
Receptor Agonist Antagonist
a1=Decongestants eg BPH eg Tamsulosin
alpha phenylephrine/oxymetazoline high BP
a2=glaucoma eg topical brimonidine HTN eg Doxazosin
beta 1 inotropes eg Doputamine non selective (b1 and b2) eg
propranolol, pindolol
B1 selective eg atenolol,
bisoprolol (B1)-cardioselective
beta 2 bronchodilators eg salbutamol non selective (B1 and B2) eg
propranolol, labetalol (Ses
Salbutamol is a selective short-acting beta-2 BBs=cold peripheries, fatigue,
agonist. brocnhospasm, sleep
Tremor/tachycardia are both recognised side- disturabnce)
effects but do not usually require dose reduction
(although these symptoms may be an indication
of medication overuse).
Watch for hypokalaemia also at high doses,
especially if the patient is taking theophyllines
concomitantly.
Salbutamol may worsen hypertension but this is
rare in patients taking normal dosages
In pregnancy the nebulised route is preferred to
avoid myometrial effects of salbutamol.
may cause sleep disturbance in children
reduces secretions in
intubation eg scopolamine,
glycopyrrolate. glycopuronium
(200-400mcg in adults iv/im 30-
60 mins before induction)-
decrease secretions that may
cause resp obstruction in
smaller airways
urge incontinence eg
oxybutynin
,Nicotinic Nicotine non depolarising muscle
relaxants (eg Atrcurium)
Varenicline (smoking cessaiton)
depolarising musdcle relaxant eg
suxameethonium
cholinesterase PRN atropine/porpantheline =antimuscarinics can (ie anticholinesterase)-
be used to prevent overdose on potential Ach in synapse for
anticholinesterses (cholinergic crisis) longer-= Pyridostigmine.
Neostigmine,. Acts wihtin 1 hr,
lasts 3-4 hrs
Edrophonium=Tensilon Dx test
for MG and reverses effects of
non depolarixing blcokers
, botulinium toxin blocks Ach release causing
flaccid paralysis and resp
failure. Weaken SKM to relieve
focal spasticity and ass
disability. Used in strabismus,
blepharospasm, spasmodic
torticollis, dystonias, cerebral
palsy, MS, severe
hyperhidrosis
Oxytocin inducing labour eg syntocinon Tocolysis (suppress premature
labour, suppress contractions-
only temporary) eg Atosiban
Serotonin Triptans (acute migraine eg Zolmitriptan- in anti emetics
women of reproductive age, give propofol)=5HT1 (ondansetron=5HT3)
pizotifen=5HT2, prophylaxis of
migraines
cyprohepatidine=5HT2, control
diarrhoea in carcinoid
syndorme
PDE5 treat erectile dysfunction
(sildenafil=blue tablet, causes
blue discoloration of vision)
Mx pulmonary HTN- SMC
relaxation in blood vessels
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