DRUG NAME NERVOUS SYSTEMAFFECTED

SPECIFIC TARGETMOLECULES

MECHANISM USED TO TREAT MAJOR SIDEEFFECTS

PHYSOSTIGMINEParasympathetic Reversible AChE

inhibitors Forms a more stable carbamate ester with AChE, which is more

slowly hydrolyzed than ACh

Glaucoma Hypotension, bradycardia,

bronchoconstriction, excessive salvation,

diarrhea

NEOSTIGMINEParasympathetic Reversible AChE

inhibitorsForms a more stable carbamate ester with AChE, which is more

slowly hydrolyzed than ACh

Urinary retention, myasthenia gravis

Hypotension, bradycardia,

bronchoconstriction, excessive salvation,

diarrhea

ECHOTHIOPHATEParasympathetic Irreversible

acetylcholine esterase inhibitors

Generate stable phosphorylated form

of AChE

Glaucoma – last option since irreversible

PRALIDOXIMEParasympathetic “Reverse” irreversible

AChE inhibitorsTransfers phosphate from serine group to

pralidoxime

Organophosphate poisoning

PHENYLEPHRINESympathetic 1 agonist Contraction of smooth

muscle, selectively activates 1

adrenoceptors

Nasal decongestant Elevated BP (hypertension), reflex

bradycardia

DOBUTAMINESympathetic 1 agonist Increases heart rate Helps reestablish

normal heart rate following heart attack

Cardiac arrhythmias

ALBUTEROLSympathetic 2 agonist Relaxation of smooth

muscle, dilation of blood vessels, inhibition of

histamine release

Asthma, premature labor

Tachycardia, cardiac arrhythmias

DRUG NAME NERVOUS SYSTEMAFFECTED

SPECIFIC TARGETMOLECULES

MECHANISM USED TO TREAT MAJOR SIDEEFFECTS

AMPHETAMINESSympathetic Indirect acting Block UPTAKE1 in

reuptake of NE, enhancing adrenergic

activity, expels NT from presynaptic

vesicles

Narcolepsy Heightened adrenergic activity

-METHYLTYROSINESympathetic Tyrosine hydroxylase

inhibitorsPrevents NE from

being made: L-Tyrosine to L-DOPA

Pheocromocytoma – adrenal tumor causing over production of NE

EDROPHONIUMSomatic Reversible AChE

inhibitorElevates ACh levels at motor endplate (NMJ)

Myasthenia gravis: an autoimmune disease

that attacks ACh receptors

BOTOXSomatic Blocks release of

presynaptic ACh vesicles

Prevents exocytosis of ACh into synapse

Blepharospasm (eyelid), strabismus

(crossed eyes), urinary incontinence,

migraine headache

ATRACURIUMSomatic Non-depolarizing

competitive agonists of Ach

Binds to Ach receptor in motor end plate

and blocks binding/action of Ach

Surgical (muscle relaxant), intubation

Hypotension due to induction of His

release

SUCCINYLCHOLINECHLORIDE

Somatic Depolarizing Binds to Ach receptor and produces a

prolonged action potential (hydrolyzed

by BuChE)

Surgical (muscle relaxant)

Malignant Hyperthermia,

electrolyte imbalance, bradycardia, cardiac

arrhythmias

METAPROLOLSympathetic 1 antagonists

“beta blockers”Has a negative effect

on cardiac output (lower rate and force

of contraction)

Angina (chest pain due to insufficient

blood flow to heart), hypertension, arrhythmias

Bradycardia, heart attack (rare)

DRUG NAME NERVOUS SYSTEMAFFECTED

SPECIFIC TARGETMOLECULES

MECHANISM USED TO TREAT MAJOR SIDEEFFECTS

PRAZOSINSympathetic 1 antagonist Inhibits

vasoconstrictionHypertension and urinary blockage associated with benign prostatic

hyperplasia

Less potent than nonselective

antagonists

SCOPALOMINE,ATROPINE

Parasympathetic Muscarinic antagonists

Relaxes smooth muscle in GI and

urinary tract, dilates pupil, relaxes ciliary

muscles, inhibits gastric secretions

Opthalmic examination of

refractive errors, uveitis, chronic

diarrhea, COPD, peptic ulcer, urinary incontinence

Tachycardia, urinary retention,

constipation, blurred vision, dry mouth,

respiratory depression

CLONIDINESympathetic 2 agonists Partial agonist at post-

synaptic 2 receptors, and full agonist at inhibitory auto-R

(negative feedback)

Hypotension, menopausal “hot

flashes”, glaucoma, prevents migraines

Orthostatic hypotension, possible rebound hypertension

ISOPROTERENOL,EPINEPHRINE

Sympathetic Adrenergic receptors agonist

Produces generalized sympathetic

responses

Cardiac arrest, asthma attack, and

anaphylactic shock

PILOCARPINEParasympathetic Muscarinic agonists Ocular smooth muscle

contractionGlaucoma

BETHANECHOLParasympathetic Muscarinic agonists Smooth muscle

contraction Post operative ileus,

urinary retention