DRUG AFFECTING THE AUTONOMIC NERVOUS SYSTEM

ADRENERGIC AGONIST

Drug Drug Action Mechanism of Action Drug effect Clinical Use

DIRECT-ACTING ADRENERGIC DRUG
α1 agonist Potentiator of local anesthetics
1. Methomaxine α1 agonist; Direct acting adrenergic stimulants vasoconstrictor Local hemostatic
2. Metaraminol Treatment of cardiac arrest

α2 agonist Treatment of hypertension ( α2

1. Clonodine α2 agonist Direct acting adrenergic stimulants agonist – Methyldopa)
2. Xylazine ; inhibit release of neurotransmitter
3. Meditomidine (norepinephrine and acetycholine) Use in cases of anaphylactic
reaction; allergies
α and β agonist
1. Epinephrine α and β Direct acting adrenergic stimulants Bronchodilator (Terbutaline)
2. Norepinephrine agonist
3. Phenylephrine

β1 and β2 agonist
Isoproterenol β1 and β2 Direct acting adrenergic stimulants
agonist
β2 agonist;
1. Terbutaline β2 agonist; Direct acting adrenergic stimulants relaxation (smooth muscle, eye
2. Metaproterenol muscle),
3. Ephedrine decreased motility of GIT
increased glucose metabolism
and lipolysis

3. Methomaxine α1 agonist; Direct acting adrenergic stimulants vasoconstrictor

4. Metaraminol

INDIRECT-ACTING ADRENERGIC DRUG

1. Amphetamine Adrenergic Displace Norepinephrine from storage Potentiator of local anesthetics
2. Metamphetamine agonist vesicles or prevent its reuptake Local hemostatic
3. Tyramine Treatment of cardiac arrest
4. Ephedrine
5. Pseudoephedrine Treatment of hypertension ( α2
6. Phenylpropanolamine agonist – Methyldopa)

Use in cases of anaphylactic

reaction; allergies

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 Bronchodilator
ADRENERGIOC BLOCKER

Drug Action MOA Effect Use

a-ADRENERGIC BLOCKLER
1. Phenoxybenzamine (α1)
2. Dibenamine
3. Phentolamine (α1 and
α2)
4. Prazosin (α1)
5. Yohimbine (α2)
α- adrenergic Decrease peripheral resistance Reverse compensatory vasoconstriction in
blocker Increase heart rate by blocking pre-synaptic α2 cardiovascular shock due to excessive
receptors in the heart or by increased activation of epinephrine secretion
baroreceptor reflex
Xylazine and Medetomidine are used to
produced sedation in domestic animals;

Yohimbine reverse their effect

b-ADRENERGIC BLOCKLER
1. Dichloroisoproterenol β- adrenergic Cause cardiac depression, therefore may Treatment for hypertension
2. Propranolol blocker aggravate heart failure Reverse digitalis induced cardiac arrhythmias
3. Timolol May cause bronchoconstriction Treatment of obstructive cardiomyopathy
4. Alprenolol Block the effect of excessive epinephrine in
pheochromacytoma

CHOLINERGIC AGONIST

Drug Drug Action Mechanism of Action Drug effect Clinical Use

Acetylcholine Cholinergic Acetylcholine-like effect without distinction as to Heart- decrease cardiac output Not used; too generalized
agonist anatomic site Vascular Smooth Muscle- effect
vasodilation Biotransform easily
Gut- increased peristalsis
Urinary bladder- urination
Bronchioles- bronchoconstriction
Eyes- papillary constriction
Exocrine glands- increased
contriction
Methacholine Cholinergic No action on nicotinic receptors Increased glandular secretion
agonist Bradycardia
Hypotension
Carbachol Cholinergic Activates both nicotinic and cholinergic receptors Urinary bladder contraction Gut hypomotility
(carbamylcholine) agonist Increased peristatlsis Bladder paralysis
Glaucoma (ophthalmic
solution)
Betanechol Muscarinic Activates muscarinic receptors Neuregenic bladder
agonist paralysis
Post surgical treatment
Esophageal achalasia
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CHOLINERGIC ALKALOIDS

Drug Drug Action Mechanism of Action Drug effect Clinical Use

Muscarine Muscarinic agonist
Pilocarpine Muscarinic agonist Activates muscarinic receptors Pupilarry constriction Glaucoma
Increased inta-occular pressure Synchiae
Gut impaction in large animals
Arecholine Muscarinic and nicotinic effects Purgative effects Purgative

INDIRECT ACTING CHOLINERGIC AGONIST (Cholinesterase Inhibitors)

Drug Action MOA Effect Clinical Use

Organophosphate compounds Irreversible Irreversible AChE inihibition CNS- excitation and Insecticide/acaricides
AChE Excessive stimulation of mania (coma and Anthelmintics
inihibitors muscarinic and cholinergic convulsion) Agricultural pesticides
receptors by uninhibited OP Poisoning- *war gas
endogenouse acetylcholine respiratory failure Antidote for poisoning – Atropine and
(dyspnea and Pralidoxime
paralysis)
Physostigmine (aserine)- Tertiary AChE Binds to esteratic site of Reverse the effect of Relieve glaucoma
amine alkaloid form Calabar Bean inihibitors cholinesterase and leave a fully atropine in the eye
or ordeal bean (Physostigmine active enzyme
venenosum) Mainly on muscarinic receptors
Neostigmine - Synthetic quatemary AChE Inhibits cholinesterase via On gut and urinary For gut hypomoitility, urinary baldder paralysis,
amine analogue of physostigmine inihibitors carbamylation and directly bladder myasthenia gravis
stimulates the cholinergic Can reverse To counter act effects of non-depolarizing
receptor neuromuscular muscle relaxants
bloackade caused by
curare
Edrophonium - Similar to AChE To differentiate between thye muscle
neostigmine but with shorter action inihibitors weaknesss due to myasthyenia gravis and the
muscle weakness caused by overstimulation of
cholinergic receptors (fatigue)
*worses – fatigue
*improves – myasthenia gravis
Carbaryl AChE Cause carbamylation of the Contol external paratsite
inihibitors esteric site of cholinesterase Safer insecticide
and block its action on Ach

ANTICHOLINERGIC DRUGS

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Drug
Atropine- Racemic mixture of D- and
L- hyocyamine, the prototype of
parasymtholytic drugs
Scopolamine- Natural congener of
atropine
Action MOA Effects
Cholinergic Antagonists of Ach at the Tachycardia
antagonist muscarinic receptors Precipitous fall in blood pressure
Very little or no action on (when given IV)
the muscarinic sites GIT, Ureter, Urinary bladder,
billary tract smooth muscle
relaxation
Bronchodilation
Decreased gland secretion
(salivary, bronchial, sweat)
Cyclopegia (ciliary muscle
relaxation)
Increased intra-occular pressure
(not for glaucoma)
CNS stimulation and
hyperthermia followed by
secondary CNS depression
Cholinergic More CNS effects than atropine
antagonist
Use
Pre-anesthetic agent (decrease salivary
and respiratory secretions and prevent
heart block)
Mydriasis for eye examination
Organophosphate poisoning
Antispasmodic therapy
Management of Colic
Counteracting trhe effect of cholinergic
drug overdose
Used in women to produce “twilight
sleep” during childbirth

Homatropine- Shorter duration of Cholinergic

action than atropine and has only 10% antagonist
of atropine potency
Eucatropine- Shorter duration than Cholinergic Mydriasis with little cyclopegia
action of atropine antagonist
Hyoscine Cholinergic Greater CNS depression
antagonist
Anti-emetic effect in dogs
Glycopyrrolate Cholinergic Lack the initial decrease in heart Pre-anesthetic anticholinergic agent
antagonist rate usually observed with 5x more potent than atropine as anti-
atropine sialogogue
Less CNS affects than atropine
Propantheline- Synthetic atropine Cholinergic High ratio of ganglionic GIT anti-spasmodic agent
substitute antagonist blocking to anti
muscarinic activity

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DRUGS AFFECTING THE CENTRAL NERVOUS SYSTEM

TRANQUILIZER-SEDATIVE GROUP

Drug Action MOA Effects Uses

Phenothiazine Group
1. Acepromazine
2. Promazine
3. Chlorpromazine
Butyrophenone Tranquilizers
1. Droperidol
2. Azaperone
Benzodiazepines
1. Diazepam (valium)
2. Lorazepam (Ativan) – very
long acting and with slow
onset
3. Zolazepam – in combination
with tiletamine
Tranquilizer- Block the central excitatory
sedative dopaminergic pathway
Tranquilizer- Produce peripheral a1-
Sedative adrenergics receptor blockade
Binds to dopamine receptor in
CNS and reduce membrane
effect of normally released
dopamine
Tranquilizer a-adrenergic blockade
Tranquilizer- Potentiation of gamma amino
sedative butyric acid (GABA) transmitter
(also
anticonvulsant and
hypnotic)
Hypotension (a-1 adrenegic Tranquilization, no analgesic
blockade) and decrease in affect
sympathetic nerve Pre anesthesia
Sinus bradycardia and 2nd *Acepro- fobehavioral problems
degree heart block *chorpro- less potent, longer
Reflex tachycardia duration; obstetrical operations
Depressed GIt motility
Decresed PCV
Decreased body temp
(vasodilation) and muscular
activity
Depression of
thermoregulatory center of
brain
Reduce motor activity; with Most potent anti-emetic activity
cataleptic effect With fentanyl-
Myocardial contractility is not neuroleptanalgesia
altered
Minimal respiration
Prevent fatal cardiovascular
effects of catecholamine
hypotension Most reliable sedation for pigs
but may cause violent
excitement in horses
Not a general neuronal Control convulsions of any
depressant origin, and restlessness
With awareness, but with Pre-anesthetic (with ketamine
enough relaxation to conduct anesthesia)_
surgery
Cardiovascular minimal effect
Depressed ventilation
Muscle relaxation

SEDATIVE-HYPNOTIC GROUP

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Drug Action MOA Effects Use
Barbiturates
1. Pentobarbital(short-acting) Sedative Potentiate GABA Increased neurotransmitter release at the General anesthesia on
hypnotic Mimicks benzodiazepine but on neuromuscular junction but decrease in the small animals; in large,
a different site sensitivity of the popstsynaptic membrane with chloral hydrate
Decreases the dissociation of Slight depressed reflexes Antidote
rate GABA from the receptor Low- sedation or ecitement
Act on reticular activating moderate- excitement
system High- CNS depression
Inhibit release of excitatory Hyperanalgesic
neurotransmitter Depression of respiratory drive
Cardiovascular depression
2. Thiopental Na/Thiamylal – Sedative Transient apnea Pre-anesthesia
ultra short acting hypnotic Laryngospasm or bronchospasm
3. Phenobarbital Sedative On;y use at sub-
hypnotic anesthetic dose
Also anti- Treat convulsion
convulsant
Chloral Hydrate Sedative Reduce trichloroethanol Hypnotic effect For general anesthgesia
hypnotic Cerebral, cardiovascular, and respiratory
depression
Poor analgesic capabilitry
A2-Adrenergic agonist
1. Xylaxine Sedative Stimulates a2 receptors, Sedation and analgesia Pain relief
2. Meditomidine hypnotic reducing the release of Muscle relaxation As pre-anesthesia for
3. Detomidine transmitter at the nerve Hypnosis surgeries
terminals

ANESTHETICS- INJECTABLES

Drug Effects
Dissociative Agents Maintain heart rate; increased BP and heart rate
Decreased aaterial oxygen tension

Increase cerebral blood flow and intracranial pressure

Dilation of pupil
Action MOA Effect
1. Phenycyclidine Cataleptic, cts on CNS either by stimulation or Catalepsia, Analgesia, Anesthesia
Analgesic, and depression
Anesthetic
2. Tiletramine Cataleptic agent Salivation, lacrimation, mydriasis, and ataxia; No loss of consciousness,
causes seizures and clonic muscular reaction during deep anesthetic
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 stage; Analgesia in the skin; swallowing, pedal and palpebral reflexes
are not abolished
3. Ketamine Inhibit polysynaptic actions of
excitatory nuerotransmitter Ach and
I-glutamate in the spinal cord

BALANCED ANESTHESIA - COMPONENTS

Drug Action Effect

Nitrous oxide, Morphine Mepedirine Fentanyl Xylazine Enflurane Ketamine Sensory Loss of sensitivity to pain
blocking
a. Xylazine - Relaxation- Motor blocking Muscle relaxation diminish motor response to noxious
b. Ethyl chloride - Slight relaxation stimulation
c. Chloral hydrate, Isoflurane Enflurane, Halothane, Barbiturate - Medium
a. phenothizine, ketamine - Ataraxia Mental blocking Loss of awareness
b. Fentanyl-droperidol- Light sleep Amnesia
c. Delirium – deep sleep
a. Atropine- Undesirable reflexes Reflex blocking Minimize autonomic response
b. Barbiturate - Respi and GIt reflex

ANESTHETICS- INHALATION

Drug Effect
Diethyl Ether Initial excitement; delirium during induction, then brain depression; Salivation; coughing and breath holding; Depress impulse transmission

Chloroform Depress sensitivity to CO2; Breathing slowed and shallow; Respiratory and cardiac failure may occur
Halothane Not irritating; No respiratory secretion; Decrease tidal volume; Ventricular fibrillation; Low BP and pulse rate; Relax smooth muscle; May cause
hepatic dysfunction; Sensitize myocardium to effects of epinephne

Enflurane Twitching and seizures; Hypotension

Methoxyflurane Minimal stimulation of respiratory secretions; Depress respiration; Sensitize myocardium to effects of epinephrine

Nitrous Oxide Negative inotropic effect in cardiovascular; Bloat; Diffusion hypoxia; Stimulate sympathoadrenal system

LOCAL ANESTHESIA

Drug MOA Use

Esters: Procaine, Chloroprocaine, Tetracaine Decrease the sodium entrey and block depolarization Local or regional anesthesia
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 Order of blockade: sympathetic flow- pain- thermal and propioceptive Control arrhythmias
Amides: Lidocaine, Mepivacaine Bupivacaine, sensations – motor activity Ophthalmic use
Etidocaine, Prilocaine For delicate mucous membrane
and skin
Facilitation of general
anesthesia
AN ALGESICS

Drug Action MOA Effect Use

Opoid Analgesics
1. Opiates Analgesics Bind` to opoid receptors in the brain Analgesia without loss of Pain relief
2. Opoids( (Papaver somniferum) consciousness Aid in pulmonary
3. Narcotics (sleep) Drowsinees and mental edema
clouding Seadation and
Depressed respiration induction of sleep
Delayed gastric emptying Cough suppression
NSAIDS
1. Aspirin Analgesic Inihibits agglutination by inhibiting Gastric irritation Relief minor pain
Anti-pyretic synthesis of thromboxane Anti-pyrexia Treatment
Anti-inflammatory block cyclooxygenase pathway Anti-inflammation dessiminated
necessary for the formation of Analgesia intravascular clotting
prostaglandin
2. Acetaminophen (Paracetamol) Analgesic block cyclooxygenase pathway Less gastric irritation
Anti-pyretic necessary for the formation of Analgesia
prostaglandin Anti-pyrexia
Can induce hepatic
necrosis
3. Ibuprofen Analgesic block cyclooxygenase pathway Gastric irritation
necessary for the formation of Nephrotoxicity
prostaglandin
4. Flunixine Meglumine Analgesic block cyclooxygenase pathway Alleviate musculoskeletal
necessary for the formation of disorder
prostaglandin GIT spasm
Endotoxic shock
5. Phenylbutazone Analgesic block cyclooxygenase pathway Renal necrosis Lameness
Anti-pyretic necessary for the formation of GIT irritation Osteoarthritis
prostaglandin Non-articular
rheumatism
6. DIpyrone Analgesic block cyclooxygenase pathway Agrunolo/cytosis GIt spasm
Anti-pyretic necessary for the formation of Leucopenia Hypomotility
prostaglandin
Steroidal/Corticosteroid
1. Hydrocortisone and Predisone (Rapid Anti-inflammatory Block the enzyme phospholipase GIT ulcers
onset; short-acting) Anti-allergic Adrenal suppression
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 2. Dexamethasone and triamcinolone Immunosuppression
(Rapid onset, intermediate acting)
3. Betamethasone and Flumethasone
(Slow onset, long acting)
Neuroleptanalgesics (opoid analgesia +
neuroleptic tranquillizer)
1. Fentanyl = Droperidol Neuroleptanalgesic Neuroleptanalgesia Pre-anesthetic
Anesthesia

ANTICONVULSANT (MOTOR DEPRESSION)

Durg Action MOA Effect Use

Phenobarbital Anticonvulsant Depress motor center Anticonvulsion For seizures
Phenytoin Anticonvulsant Depress motor centers but not the sensory Anticonvulsion Seizures
Diazepam Anticonvulsant Anticonvulsion Control status epilepticus
Seizures in dogs and cats
Primidone Anticonvulsant Anticonvulsion
Hepatoxicity, polyphagia, polydispsia
sedation

CNS STIMULANTS

Drug Action MOA Effect Use

Doxaproam CNS Direct action on chemoreceptors of the coratid and aortic regions Reversal of central respiratory
Hydrochloride Stimulant depression
Yohimbine CNS Block B-adrenergic receptor, cholinergic, serotogenic receptors,
Hydrochloride Stimulant GABAnergic receptors
Antagonize CNS depressants
Antagonizing the action of xylazine
Nikethamide Stimulate chemoreceptors of the coratid and aortic regions Stimulate respiration

Carbon Dioxide CNS Mild

Stimulant hypercapnia
Arousal effect

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DRUGS ACTING ON RESPIRATORY SYSTEM

EXPECTORANTS

Drug Action MOA Effect Use

Direct acting Expectorants Act directly on the cells of respiratory lining and Alter respiratory secretion Productive/
1. Eucalyptus increase their secretory activity Increases volume and fluidity of Inspissated cough
2. Camphor secretion for easier expulsion Runny nose
3. Lemon oil
4. Pine oil
5. Potassium Iodide
Indirect acting Expectorants Irritate the nerve endings in the stomach
1. Ammonium thereby, provoking a mild vomiting reflex
carbonate
2. Ammonium chloride
3. Potassium citrate
4. Guaifenesin

DECONGESTANT

Drug Action MOA Effect Use

α-Adrenergic Stimulants Decongestants Constrict blood vessel in the mucus Inhibitors of respiratory Runny nose
1. Phenylephrine membrane of upper respiratory tract and secretion Flu
2. Phenylpropanolamine decrease leakiness Reduce excessive Colds
3. Propylhexedrine respiratory secretions Management of acute
and chronic rhinitis
Antihistamine Decongestants Block the effect of histamine which provokes Inhibitors of respiratory
1. Diphenhydramine increased respiratory secretions secretion
2. Chlorpheniramine
3. Loratadine

Anticholinergic Decongestants Prevent excessive respiratory secretion due to Inhibitors of respiratory

1. Atropine cholinergic stimulation secretion
Produce excessively
stick secretion

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MUCOLYTICS

Drug Action MOA Effect Use

Acetylcysteine/Carbocystine
Bromhexine
Mucolytics Neutralize disulfide bonds in mucus resulting in Liquefy mucus plugs and debris Inspissated cough
its liquefication that accumulate in the Productive cough
respiratory tract
Mucolytics Increase content of immunoglobulin and of Degrade inflammatory debris Inspissated cough
administered oxytetracycline in bronchial Liquefy mucus plugs and debris Productive cough
secretion that accumulate in the Treatment of
respiratory tract tracheobronchitis

ANTITUSSIVE

Drug Action MOA Effect Use

Centrally Acting Antitussive Narcotic Antitussive Depress the cough center in the medulla oblongata Suppress Non-productive
2. Codeine cough cough
3. Dihydrocodeine
4. Morphine
Centrally Acting Antitussive Non-narcotic Depress the cough center but is not addicting
1. Dextromethorphan Antitussive
2. Noscapine
3. Butorphanol
4. Phenothiazine
Locally acting Antitussive Antitussive Act directly on the respiratory mucus membrane to
1. Menthol produce soothing effect
2. Benzonatate
3. Tincture of Benzoin

BRONCHODILATORS

Drug Action MOA Effect Use

Antihistamine Bronchodilators Counteract broncho-constriction caused by histamine Relaxation of bronchial smooth Asthma
1. Diphenhydramine released during allergic reaction muscle
2. Loratadine Increase functional capacity of the
Anticholinergic Counteract acetylcholine-induced bronchoconstriction respiratory tree
1. Atropine
Ephedreine – palpitation of the heart
 Relaxation of bronchial

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Corticosteroids Bronchodilators Catabolic steroid that binds to cytoplasmic receptors and smooth muscle
2. Prednisone inhibit DNA synthesis that affects downstream production  Increase functional capacity
of IL-2 of the respiratory tree
Methylxanthines Bronchodilators Interfere with calcium mobilization  No palpitation of the heart
3. Theophylline
4. Aminophylline
5. Caffeine
Sympathomimetics Bronchodilators Direct stimulation of β2 adrenergic receptor in the
1. Epinephrine bronchial smooth muscle
2. Ephedreine
3. Isoproterenol
Selective Bronchodilators Bronchodilators Stimulate β2 receptor without affecting β1 receptors
1. Albuterol
2. Metaproterenol
3. Terbutaline
4. Clenbuterol

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