DRUG NAME

PHYSOSTIGMINE

NEOSTIGMINE

ECHOTHIOPHATE

NERVOUS SYSTEM
AFFECTED
Parasympathetic

SPECIFIC TARGET
MOLECULES
Reversible AChE
inhibitors

Parasympathetic

Reversible AChE
inhibitors

Parasympathetic

Irreversible
acetylcholine esterase
inhibitors

Generate stable
phosphorylated form
of AChE

Glaucoma last
option since
irreversible

Parasympathetic

Reverse irreversible
AChE inhibitors

Transfers phosphate
from serine group to
pralidoxime

Organophosphate
poisoning

Sympathetic

1 agonist

Contraction of smooth
muscle, selectively
activates 1
adrenoceptors

Nasal decongestant

Elevated BP
(hypertension), reflex
bradycardia

Sympathetic

1 agonist

Increases heart rate

Helps reestablish
normal heart rate
following heart attack

Cardiac arrhythmias

Sympathetic

2 agonist

Relaxation of smooth
muscle, dilation of
blood vessels,
inhibition of
histamine release

Asthma, premature
labor

Tachycardia, cardiac
arrhythmias

PRALIDOXIME

PHENYLEPHRINE

DOBUTAMINE

ALBUTEROL

MECHANISM

USED TO TREAT

Forms a more stable

carbamate ester with
AChE, which is more
slowly hydrolyzed
than ACh
Forms a more stable
carbamate ester with
AChE, which is more
slowly hydrolyzed
than ACh

Glaucoma

Urinary retention,
myasthenia gravis

MAJOR SIDE
EFFECTS
Hypotension,
bradycardia,
bronchoconstriction,
excessive salvation,
diarrhea
Hypotension,
bradycardia,
bronchoconstriction,
excessive salvation,
diarrhea

DRUG NAME
AMPHETAMINES

NERVOUS SYSTEM
AFFECTED
Sympathetic

SPECIFIC TARGET
MOLECULES
Indirect acting

Sympathetic

Tyrosine hydroxylase
inhibitors

Somatic

Reversible AChE
inhibitor

Elevates ACh levels at

motor endplate (NMJ)

Myasthenia gravis: an
autoimmune disease
that attacks ACh
receptors

Somatic

Blocks release of
presynaptic ACh
vesicles

Prevents exocytosis of
ACh into synapse

Somatic

Non-depolarizing
competitive agonists
of Ach

Binds to Ach receptor

in motor end plate
and blocks
binding/action of Ach

Blepharospasm
(eyelid), strabismus
(crossed eyes),
urinary incontinence,
migraine headache
Surgical (muscle
relaxant), intubation

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

Sympathetic

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)

-METHYLTYROSINE

EDROPHONIUM

BOTOX

ATRACURIUM

SUCCINYLCHOLINE
CHLORIDE

METAPROLOL

MECHANISM

USED TO TREAT

Block UPTAKE1 in
reuptake of NE,
enhancing adrenergic
activity, expels NT
from presynaptic
vesicles
Prevents NE from
being made: LTyrosine to L-DOPA

Narcolepsy

MAJOR SIDE
EFFECTS
Heightened
adrenergic activity

Pheocromocytoma
adrenal tumor causing
over production of NE

Hypotension due to
induction of His
release

DRUG NAME
PRAZOSIN

NERVOUS SYSTEM
AFFECTED
Sympathetic

SPECIFIC TARGET
MOLECULES
1 antagonist

Parasympathetic

Muscarinic
antagonists

Sympathetic

2 agonists

Sympathetic

Adrenergic receptors
agonist

Produces generalized
sympathetic
responses

Cardiac arrest, asthma

attack, and
anaphylactic shock

Parasympathetic

Muscarinic agonists

Ocular smooth muscle

contraction

Glaucoma

Parasympathetic

Muscarinic agonists

Smooth muscle
contraction

Post operative ileus,

urinary retention

SCOPALOMINE,
ATROPINE

CLONIDINE

ISOPROTERENOL,
EPINEPHRINE

PILOCARPINE

BETHANECHOL

MECHANISM

USED TO TREAT

Inhibits
vasoconstriction

Hypertension and
urinary blockage
associated with
benign prostatic
hyperplasia

Relaxes smooth
muscle in GI and
urinary tract, dilates
pupil, relaxes ciliary
muscles, inhibits
gastric secretions

MAJOR SIDE
EFFECTS
Less potent than
nonselective
antagonists

Opthalmic
Tachycardia, urinary
examination of
retention,
refractive errors,
constipation, blurred
uveitis, chronic
vision, dry mouth,
diarrhea, COPD, peptic
respiratory
ulcer, urinary
depression
incontinence
Partial agonist at postHypotension,
Orthostatic
menopausal hot
hypotension, possible
synaptic 2 receptors,
flashes, glaucoma,
rebound hypertension
and full agonist at
prevents migraines
inhibitory auto-R
(negative feedback)