Important points about ANS phamacology

Atenolol is not lipid soluble therefore it has longer half life than Metaprolol which is lipid soluble.
Carvedilol blocks both alpha and beta receptors and is the most common beta blocker used in chronic congestive heart failure because it has Antioxidant and Antimitogenic properties in addition.
Esmolol has the shortest and Nadolol has the longest half life among all beta blockers.
Beta Blockers must not be used in compensated (i.e) acute heart failure.
Beta blockers that are excreted in kidneys (lipid insoluble): Nadalol, Satolol, Atenolol, Acebutalol, Bisprolol, Betaxolol, Celioprolol- Should be avoided in renal failure.
Endogenous Norepinephrine is metabolized by COMT and MAO. Exogenous Norepinephrin is metabolized by reuptake.
Hemicholimium- Blocks the reuptake of Choline
Vesamicol- prevents entry of choline into storage vesicles.
Glucagon is DOC in beta blockers overdose. Other drugs that are used- Norepinephrine and Calcium chloride.
Cardioselective Beta Blocker used in Glaucoma treatment- Betaxolol.
Beta Blockers having local anaesthetic activity- Propranolol, Metaprolol, Labetolol, Acebutolol, Pindolol- These drugs must not be used for treatment of glaucoma (more risk of corneal ulcer formation)
Longest acting ocular beta blokcer- Betaxolol.
Latanoprost- It is a PGF2alpha derivative used in Glaucoma.
Intramuscular injection of Atropine causes an initial Bradycardia- due to inhibition of M1 receptors (which normally decrease Ach release).
Hyoscine (scopolamine) is a CNS depressor in low doses. Atropine is a CNS elevator in low dose and depressor in high dose.
Glycopyrrolate is an anticholinergic drug that is used in pre anaesthetic medications and also during surgeries- to decrease secretions and avoid reflex bronchospasm.
Tropicamide- fastest mydriatic (antimuscuranic with shortest half lie).
Rate limiting enzyme in the synthesis of Catecholamines- Tyrosine hydroxylase.
Vasomotor reversal of Dale is seen in case of Epinephrine because it has both alpha and beta2 agonist activity.
Vasoconstrictors must not be used in secondary shock
Adrenergic neuron blocking drugs have no action on exogenous (injected) adrenaline. They only block the release of adrenaline from nerve endings.
Ergot alkaloids are the alpha blockers that can cause vasoconstriction.
Aplha1 inhibitors cause faster and greater symptomatic relief but do not affect the disease progression. 5 alpha reductase inhibitors (Finasteride) slows disease progression.
Most dangerous effect of belladona in very young children- Hyperthermia (not dehydration)
Cocaine inhibits the re-uptake of Dopamine and Noradrenaline in CNS.
The effect of parasympathetic system (and atropine) is of longest duration in Eye.
Adrenaline in anaphylaxis- If used IM, dose is 1:1000; If used IV, dose is 1:10,000

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