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Pharmacology
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Memorize the alpha & beta receptors in under 60s! #shorts #pharmacology #physiology #medstudent #med

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Memorize the alpha & beta receptors in under 60s! #shorts #pharmacology #physiology #medstudent #med
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Sympathetic Nervous System โ†’ ๐Ÿงช Norepinephrine (NE) (Alfa and Beta)

sympathomimetics = Adrenergic agonist

Parasympathetic Nervous System โ†’ ๐Ÿงช Acetylcholine (ACh) (Muscarinic and Nicotinic)

โšก Adrenergic Drugs โ€” Quick Notes

โ€ฃ
Epinephrine - A1, B1, B2 - For cardiac arrest and anaphylaxis -> Increase HR and bronchodilation, Caution in Narrow-angle glaucoma.

โšก EPINEPHRINE (Adrenaline)

Class: Sympathomimetic Adrenergic Agonist

Action: Nonselective โ†’ stimulates ฮฑโ‚, ฮฒโ‚, ฮฒโ‚‚

  • ฮฑโ‚: โ†‘ Blood pressure
  • ฮฒโ‚: โ†‘ Heart rate & contractility
  • ฮฒโ‚‚: Bronchodilation

Uses:

  • ๐Ÿงฌ Anaphylaxis / anaphylactic shock
  • ๐ŸŒฌ๏ธ Bronchospasms
  • โค๏ธ Cardiogenic shock / cardiac arrest

Contraindications / Caution:

  • Cardiac dysrhythmias, Hypertension
  • Hyperthyroidism, Diabetes mellitus
  • Narrow-angle glaucoma, Pregnancy
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Drug Interactions:

  • โŒ Beta blockers (โ†“ epinephrine effect)
  • โŒ MAOIs & Tricyclic antidepressants (โ†‘ effect โ†’ risk of crisis)
  • โŒ Digoxin (โ†‘ risk of dysrhythmias)

Side Effects / Adverse Reactions:

  • Cardiac dysrhythmias, Pulmonary edema
  • Necrosis at IV site
  • Reflex tachycardia, Tremors, Agitation
  • Headache, Weakness, Dizziness, Insomnia
  • Nausea / Vomiting

Would you like me to add Albuterol (Proventil) next in the same short style?

โ€ฃ
Norephinephrine - A1, B1 - Shock = low bp -> Increase BP
โ€ฃ
Albuterol - B2 - for asthma/COPD -> bronchodilation Check Side Effects, Spillover.

๐ŸŒฌ๏ธ ALBUTEROL (Proventil)

Class: Beta-2 Adrenergic Agonist (Selective)

Mechanism of Action:

  • Stimulates ฮฒโ‚‚ receptors in bronchial smooth muscle โ†’

    • Muscle relaxation โ†’ Bronchodilation โ†’ Airways open

Uses:

  • ๐Ÿšจ Acute asthma attack (rescue inhaler)
  • ๐Ÿƒโ€โ™‚๏ธ Exercise-induced bronchospasm prevention
  • ๐ŸŒซ๏ธ COPD, bronchitis, emphysema (reversible airway disease)
  • ๐ŸŒฟ Bronchospasm from allergens, infections, stress, or irritants

Caution:

  • Severe cardiac disease, Hypertension
  • Renal dysfunction
  • Hyperthyroidism, Diabetes mellitus
  • Pregnancy

Side Effects / Adverse Reactions โ†’ Sympatic symptoms

โ€œAlbuterol is selective for ฮฒโ‚‚, but with spillover (especially at high dose or systemic absorption), it can act on ฮฒโ‚ and cause mild cardiac effects.โ€

  • Tremors, Nervousness, Restlessness, Insomnia
  • Dizziness, Blurred vision, Headache
  • Reflex tachycardia, Cardiac dysrhythmias
  • Hallucinations, Hyperglycemia

Drug Interactions:

  • โฌ†๏ธ Effect with MAOIs & Tricyclic antidepressants
  • โฌ‡๏ธ Effect with Beta blockers

Nursing Considerations:

  • Teach to use before exercise if prescribed for prevention
  • Monitor heart rate and BP (tachycardia, palpitations possible)
  • Use spacer device if coordination is difficult
  • COPD pt may use inhaler to much. Be carful with that. Risk of paradoxical bronchospasm.
  • โš ๏ธ Overuse โ†’ Paradoxical bronchospasm (worsens breathing)
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Would you like me to make a quick side-by-side table: Epinephrine vs Albuterol (to easily compare for exams)?

โ€ฃ
Dobutamine - B1 - for heart failure -> increase HR

Special thanks to @Tamagoo

๐Ÿง  Tip:

โ€œEpi = anaphylaxis, cardiac arrestโ€

โ€œNorepi = Sockโ€

โ€œAlbuterol = Asthmaโ€

โ€œDobutamine = heart failureโ€

โ€ฃ
๐Ÿง  Heart Emergencies:
  • Heart Attack: Blood flow blocked โ†’ heart muscle dies. Chest pain. โ†’ Aspirin, Nitroglycerin
โ€ฃ
โค๏ธ Heart Attack (Myocardial Infarction โ€“ MI)
  • Cause: Blocked blood flow to part of the heart (clot in coronary artery)
  • Effect: Part of heart muscle dies from lack of oxygen
  • Symptoms: Chest pain, sweating, shortness of breath
  • Heart still beats, but weakly
  • Treatment: Restore blood flow (Aspirin, Nitroglycerin, Cath lab)
  • Heart Failure: Heart weak โ†’ canโ€™t pump enough blood. Dobutamine โ†’ โ†‘ Heart contraction
โ€ฃ
๐Ÿ’” Heart Failure (HF)
  • Cause: Heart canโ€™t pump enough blood to meet bodyโ€™s needs
  • Effect: Blood backs up โ†’ swelling (edema), shortness of breath
  • Chronic (long-term) condition
  • Treatment: Improve pumping โ€” Dobutamine, Diuretics, ACE inhibitors
  • Cardiac Arrest: Heart stops beating completely. Epinephrine โ†’ โ†‘ HR
โ€ฃ
โšก Cardiac Arrest
  • Cause: Electrical failure โ†’ heart suddenly stops beating
  • Effect: No pulse, no breathing, loss of consciousness
  • Emergency: Needs CPR + Epinephrine + Defibrillation
  • Without treatment: Death in minutes
  • Shock: Blood pressure drops โ†’ organs lack oxygen. Norepinephrine โ†’ โ†‘ BP
    • โ€ฃ
    ๐Ÿฉธ Shock
    • Cause: Not enough blood flow to organs (due to low BP or volume loss)
    • Effect: Organs donโ€™t get oxygen โ†’ failure
    • Types:
      • Cardiogenic: heart canโ€™t pump (after heart attack)
      • Hypovolemic: blood loss
      • Septic: infection
    • Treatment: Fluids, Norepinephrine (โ†‘ BP)

โšก Adrenergic Agonists โ€” Side Effects

  • โ†‘ BP (Hypertension)
  • โ†‘ HR (Tachycardia, Palpitations)
  • Restlessness, Nervousness, Tremors
  • Dysrhythmias (irregular heartbeat)
  • Dizziness, Headache
  • Nausea / Vomiting
  • Urinary retention
  • Shortness of breath (Dyspnea)
  • Pulmonary edema (fluid in lungs)

๐Ÿง  Quick Tip:

โ€œToo much fight = heart races, lungs fill, body shakes.โ€

Would you like me to make a one-line mnemonic to memorize all these?

โšก Hypertension/ Alpha-2 Agonists

Drug
Key Points
Mechanism
Use
Clonidine
Selective ฮฑโ‚‚ agonist
Stimulates CNS ฮฑโ‚‚ receptors โ†’ โ†“ sympathetic outflow โ†’ lowers BP
Hypertension; sometimes ADHD or withdrawal symptoms
Methyldopa
Acts within CNS
Converted to a false neurotransmitter โ†’ stimulates ฮฑโ‚‚ receptors โ†’ vasodilation โ†’ โ†“ BP
Hypertension, especially during pregnancy

๐Ÿฉบ Adrenergic Blockers Summary

Type / Class
Mechanism
Examples
Primary Use
Alpha Blockers -zosin
Block ฮฑ-adrenergic receptors โ†’ vasodilation
Prazosin, Doxazosin
Hypertension; BPH (relaxes prostate & bladder neck)
Beta Blockers -Olol
Block ฮฒ-adrenergic receptors โ†’ โ†“ HR & โ†“ contractility
Metoprolol, Atenolol, Propranolol
Hypertension, Angina, Heart failure, Arrhythmias
Mixed Alpha/Beta Blockers
Block both ฮฑ & ฮฒ receptors
Carvedilol, Labetalol
Heart failure, Hypertension, post-MI
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๐Ÿ’Š Beta-Adrenergic Blockers Summary

Type
Receptor Action
Examples
Main Effects / Use
Contraindications / Side Effects
Nonselective
Blocks ฮฒโ‚ (heart) & ฮฒโ‚‚ (lungs)
Propranolol Sotalol Nadolol Timolol
โ†“ BP and โ†“ pulse Used for Angina, Dysrhythmias, Hypertension, Heart failure
โŒ COPD / Asthma (causes bronchoconstriction)
Selective (ฮฒโ‚ only)
Blocks ฮฒโ‚ receptors (heart)
Atenolol
โ†“ HR & โ†“ BP Used for Hypertension, Angina, MI
Side Effects: Bradycardia, Hypotension, Orthostatic hypotension, Dizziness, N/V/D, Hypoglycemia, โ†“ Libido, Impotence

๐Ÿง  Quick Tip:

๐Ÿซ€ Beta-1 = Heart โ†’ Block = Slow

๐ŸŒฌ๏ธ Beta-2 = Lungs โ†’ Block = Tight (avoid in COPD!)

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๐Ÿ’Š Cholinergic Agonists and Anticholinergics

๐Ÿง  Cholinergic Receptors

  • Muscarinic receptors: Affect smooth muscles (Heart, GI, GU, Glands)
    • Types: Direct and Indirect
  • Nicotinic receptors: Affect skeletal muscles
    • Type: Indirect only

Function: Stimulate the Peripheral Nervous System (PNS)

โš™๏ธ Cholinergic Effects by System

System
Effect
Cardiovascular
โ†“ Heart rate and BP, vasodilation, slows AV node conduction
GI (Gastrointestinal)
โ†‘ Tone and motility, โ†‘ peristalsis, relax sphincter muscles
GU (Genitourinary)
โ†‘ Ureter tone, contract bladder, relax sphincter muscles โ†’ stimulate urination
Eye
Constrict pupils (miosis), โ†‘ accommodation
Lungs
Bronchial constriction, โ†‘ secretions
Glands
โ†‘ Salivation, perspiration, and tears
Striated muscle
โ†‘ Neuromuscular transmission, maintain muscle strength and tone

Metoclopramide โ†’ Used to increase gastric emptying

Pilocarpine /Carbachol โ†’ Used to constrict pupils

Bethanechol chloride โ†’ Used to increase urination( increase bladder muscle tone)

๐Ÿ’Š Bethanechol

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Class: Parasympathomimetic (Cholinergic Agonist)

Main Use: Increases urination

โš ๏ธ Side Effects / Adverse Reactions

System
Effects
Cardiovascular
โ†“ Blood pressure (hypotension), โ†“ Heart rate (bradycardia)
Skin
โ†‘ Sweating
GU (Urinary)
Frequent urination
GI (Digestive)
โ†‘ Salivation, โ†‘ Gastric acid, Nausea, Vomiting, Diarrhea, Abdominal cramps
Eyes
Blurred vision, Pupil constriction (miosis)
Respiratory
Bronchoconstriction (can worsen asthma or COPD)

๐Ÿšซ Contraindications

  • Urinary obstruction
  • Bradycardia, Hypotension
  • COPD, Asthma
  • Peptic ulcer
  • Parkinsonism
  • Hyperthyroidism

๐Ÿ’€ SLUDGE-M + Killer Bโ€™s

Cholinergic (parasympathetic) overstimulation or toxicity

Mnemonic
Meaning / Effect
S
Salivation ๐Ÿ’ง
L
Lacrimation (tearing) ๐Ÿ˜ญ
U
Urination ๐Ÿšฝ
D
Defecation ๐Ÿ’ฉ
G
GI upset (cramps, diarrhea)
E
Emesis (vomiting) ๐Ÿคฎ
M
Miosis (pupil constriction) ๐Ÿ‘๏ธ

Wet symptomsโ€ ๐Ÿ’ฆ U will have liquid everywhere. Cholinergic syndrom => maybe the pt work with pesticides or was a suisidal atempt. Cholinergic Toxicity โ†’ Atropine is the anthidote.

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โš ๏ธ Killer Bโ€™s (Life-Threatening Symptoms)

Bโ€™s
Meaning / Danger
Bronchorrhea
Excess mucus in airways
Bronchospasm
Airway tightening โ†’ difficulty breathing
Bradycardia
Very slow heart rate โค๏ธ

๐Ÿง  Quick memory tip:

โ€œSLUDGE-M = wet symptomsโ€ ๐Ÿ’ฆ

โ€œKiller Bโ€™s = death by airway and heart failure.โ€ ๐Ÿซโค๏ธ

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๐Ÿ’Š Nursing Interventions for Cholinergic Agonists (e.g., Bethanechol)

  • Monitor:
    • Blood pressure and heart rate
    • Breath sounds
    • Bowel sounds
  • Teach:
    • Patient to rise slowly (prevent orthostatic hypotension)
  • Record:
    • Fluid intake and output
  • Give:
    • On an empty stomach โ†’ 1 hour before meals or 2 hours after meals
  • Monitor for Overdose:
    • Signs/Symptoms: Excess salivation, sweating, flushing, abdominal cramps
    • Antidote: Atropine
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โš–๏ธ Cholinergic vs. Anticholinergic Toxidrome

Feature
Cholinergic Toxidrome<br>(Too much ACh)
Anticholinergic Toxidrome<br>(Too little ACh)
Mnemonic
SLUDGE-M + Killer Bโ€™s
โ€œHot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter, Full as a flaskโ€
Salivation / Tears
โ†‘ Salivation, โ†‘ Lacrimation
Dry mouth, dry eyes
Urination / GI
โ†‘ Urination, โ†‘ Diarrhea, โ†‘ GI motility
Urinary retention, โ†“ GI motility / constipation
Pupils
Constricted (miosis)
Dilated (mydriasis), blurred vision
Skin
Sweating โ†‘
Dry, flushed skin
Heart Rate
Bradycardia
Tachycardia
Mental Status
Confusion, seizures (severe)
Agitation, confusion, delirium, hallucinations
Respiratory
Bronchoconstriction, โ†‘ secretions
Dry respiratory tract, risk of hyperthermia
Other
Hypotension possible
Hyperthermia

๐Ÿง  Quick Tip:

โ€œToo much ACh = Wet & Slow ๐Ÿ’ฆโ€

โ€œToo little ACh = Dry & Crazy ๐Ÿ”ฅโ€

๐Ÿ’Š Anticholinergics โ€” Effects by System

System
Effect of Anticholinergics
Clinical Relevance / Example
Heart
Large doses โ†‘ HR (tachycardia); small doses may โ†“ HR
Used to treat bradycardia
Lungs
Bronchodilation, โ†“ secretions
Useful in asthma or COPD
GI
Relax smooth muscles, โ†“ motility & peristalsis
May cause constipation; used to reduce GI spasms
GU
Relax detrusor muscle
Can cause urinary retention
Eyes
Dilate pupils (mydriasis), โ†“ accommodation
Causes blurred vision; used in eye exams
Glands
โ†“ Salivation, โ†“ perspiration
Dry mouth (xerostomia), decreased sweating (anhidrosis)
CNS
โ†“ Tremors and rigidity
Useful in Parkinsonโ€™s disease for symptom control

๐Ÿง  Quick Tip:

โ€œAnticholinergic = Dry, Dilated, and Fast.โ€

Bud Cat MNEMONIC

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๐Ÿ’Š Atropine

Class: Parasympatholytic (Anticholinergic)

Atropine => Dry mouth.

Action:

  • โ†‘ Pulse (heart rate)
  • โ†“ GI motility and peristalsis
  • โ†“ Salivary secretions

Uses:

  • Treat bradycardia
  • Given preoperatively to reduce secretions

โš ๏ธ Side Effects / Adverse Reactions

  • Tachycardia, Palpitations, Nasal congestion
  • Excitement, Confusion
  • Photophobia, Blurred vision
  • Dry mouth, Dry skin, Flushing
  • Urinary retention, Impotence

๐Ÿšซ Contraindications

  • Narrow-angle glaucoma
  • GI disorders
  • BPH (Benign Prostatic Hyperplasia)
  • Myasthenia gravis
  • Myocardial infarction (MI)

๐Ÿ’Š Anticholinergic Drugs Summary

Category / Use
Common Drugs
Primary Action
Common Side Effects
Nursing Considerations
General Anticholinergics
Atropine
Blocks muscarinic ACh โ†’ โ†‘ HR, โ†“ secretions, relaxes smooth muscle
Tachycardia, palpitations, dry mouth/skin, blurred vision, urinary retention, constipation, photophobia, confusion
Monitor vitals, urine output, bowel sounds; provide mouth care & eye drops; advise sunglasses; avoid hot environments; fall precautions
Anti-Parkinsonism Anticholinergics
Benztropine (Cogentin), Biperiden (Akineton), Trihexyphenidyl (Artane)
Blocks ACh in CNS โ†’ reduces tremors, involuntary movements, muscle rigidity
Dry mouth/nose/throat, blurred vision, drowsiness, confusion, urinary retention, dizziness, constipation, nausea
Monitor CNS status, urinary output, vitals; encourage fluids & fiber; teach fall precautions; provide mouth/eye care; advise slow position changes
Motion Sickness Anticholinergics
Scopolamine (Transderm Scลp), Meclizine (Antivert), Dimenhydrinate (Dramamine), Cyclizine (Marzine)
Blocks ACh in vestibular system โ†’ reduces nausea, vomiting, vertigo
Dry mouth, visual disturbances, constipation, urinary retention, flushing, muscle weakness, tachycardia, hypotension
Check for contraindications (glaucoma, urinary retention, GI obstruction); monitor vitals; teach patch use (Scopolamine); avoid alcohol/CNS depressants; fall precautions; hydrate & provide mouth care

๐Ÿง  Quick Tip:

โ€œAnticholinergics = Dry, Dilated, Dizzy.โ€

โš–๏ธ Cholinergic vs. Anticholinergic Effects by Body System

Body System
Cholinergic (Parasympathomimetic) Effects
Anticholinergic (Parasympatholytic) Effects
Heart
โ†“ Heart rate (bradycardia), slows AV conduction
โ†‘ Heart rate (tachycardia); small doses may โ†“ HR
Lungs
Bronchoconstriction, โ†‘ secretions
Bronchodilation, โ†“ secretions
GI Tract
โ†‘ Smooth muscle tone, โ†‘ motility & peristalsis
Relax smooth muscles, โ†“ motility & peristalsis โ†’ constipation
GU / Bladder
โ†‘ Bladder contraction, relax sphincters โ†’ urination
Relax detrusor muscle โ†’ urinary retention
Eyes
Pupil constriction (miosis), โ†‘ accommodation
Pupil dilation (mydriasis), โ†“ accommodation โ†’ blurred vision
Glands / Skin
โ†‘ Salivation, perspiration, tears
โ†“ Salivation, โ†“ perspiration โ†’ dry mouth, anhidrosis
CNS / Muscles
โ†‘ Neuromuscular transmission, maintain muscle tone
โ†“ Tremors & rigidity (used in Parkinsonโ€™s)

๐Ÿง  Quick Tip:

Cholinergic = Wet & Slow ๐Ÿ’ง

Anticholinergic = Dry & Fast ๐Ÿ”ฅ