DIP Episode 609 - ANS Drugs For Step 2 and 3 (Very HY)

All right, welcome. My name is divine. This is episode 609 of the divine intervention podcasts into this podcast We're gonna be addressing a topic that is pretty high yield for the US Emily step two CK and step three exams And I'm gonna call this podcast in as drugs for step two and step three NS drugs for step two and step three The thing is if you really want to drill crazy crazy deep, you know that I guess that's one thing that kind of freaks people out that hey You know drilling very deep into the a ns from our college is too much for me right because typically for step one You need to know a lot of details, but if you're like Divine what do I need to know for step two and step three with regards to a ns drugs right because again Basic sciences have started making a bigger and bigger showing on the US Emily step two CK and step three exams So hey, what do I need to know about the a ns drugs what a ns drugs do I need to know right so we're gonna capture that here If you know what I teach you here, then you're gonna be pretty much set from an in-s drug perspective for you exams now Real quick before we jump into the in-s drugs I think it's just helpful to discuss the different in-s receptors, right? So number one All right, if you think about it for the most part we have the adrenergic receptors, right? We have the adrenergic receptors, right?

So like alpha one beta one alpha two beta two will talk about those right and then There's the most chronic receptors which we'll talk about as well. All right, so the key things to know here, right? So let's talk about alpha one right so alpha one remember they do certain critical things, right? Number one is that you're gonna find them on your blood vessels, right? They're gonna cause When you stimulate them you're gonna get visual constriction So if you constrict your arteries, right? You're gonna get you know a tear of visual constriction That's going to increase your afterload. It's gonna make it harder for blood to leave the heart They can also cause vino constriction when you do vino constriction that's gonna cause more blood to return back to your heart That will increase your preload, okay? That's the big big big thing to know there and typically when you take these drugs, right? Because they are visual constrictors, right? They're gonna increase your blood pressure if you increase your blood pressure How does your heart rate respond? You're gonna have a reflex ready cardio, right? You're gonna have a reflex pretty cardio And then What else would we see with these Drugs on the USM elite well the big thing is that if you stimulate them they can also cause Popular remind dry asses right because dilation of your pupils because dilation of your pupils, right? So maybe they're not the best idea if a person has like Gloucoma, right?

If a person has like a closed-angle glaucoma for example A dilated eye exam is a terrible idea because by dilating the pupils You're gonna reduce it your tumor drainage and that's gonna raise in tranquillipretters, right? So personally those are the big things I would know about the alpha one receptor the only other thing I would know about the alpha one receptor is That we also find it at the bladder neck, right? You find it at the bladder neck, right? So if you give If you stimulate it if you actually stimulate it and actually closes up the bladder neck So it makes it harder for you to pee it makes it harder for you to your innit That's honestly all I'm gonna say about the alpha one receptors Now alpha two what is the big big big thing to know about alpha two receptors alpha two receptors We find them on pristine uptake sympathetic neurons on pristine uptake sympathetic neurons when you stimulate them That's going to reduce noripinephrine production, right? It's an inhibitory G protein coupled receptor. So when stimulated you're gonna reduce noripinephrine production That's it. All right Let's talk about beta one receptors. Well beta one receptors. What are the key places they found number one? You're gonna find them on the heart gonna find them on the heart when you stimulate them You're gonna increase your heart rate and you're gonna increase your cardiac contractility So your cardiac output is gonna rise, right?

And one thing that's high you to know there is that thyroid hormone increases the number of Beta one receptors that are inserted on the surfaces of your cardiac myocytes If that happens you're gonna become hyper responsive to cardiac colonins That's gonna raise your heart rate. That's gonna raise your contractility and that's part of why people that a Hyperthyroid can develop a rhythmia like a fib All right So another job of beta one receptors remember we find them also at the GG cells the drugs to glomerular cells When you stimulate them when you stimulate them that's gonna cause you to release more Raining that's gonna cause you to release more rain, okay? So keep that at the back of your mind. All right. Let's talk about beta two receptors Beta two receptors the big big big things to know is that there is two things here number one You find them on your blood vessels, right? So they cause viso dilation when stimulated number two you find them on your earway because bronchord dilation when stimulated bronchord dilation when stimulated Excuse me, but another thing they also do is they can also relax your myometrium So back in the day we used to use them for Primatural labor to stop the labor, you know, you can use drugs like a Tributer lane, but these days that's pretty much not done these days before 32 weeks we use endomethocene, right?

Because it inhibits a cox that's gonna shut down for staglandin synthesis So you're gonna have less myometrial contractions But after 32 weeks, obviously you don't want to close the phyto doctor satireosis too early So in those circumstances you're gonna use knife therapy. That's a calcium channel blocker You literally you literally need calcium for your myometrium to contract all right So those are the key receptors beta-3 receptors, you know, they're kind of a minor receptor we find them in the bladder and When you stimulate them that's gonna shut down your detracer muscles, right? That's gonna show down your detracer muscles a big drug that kind of goes in there is a myra background myra background Is a drug that stimulates the beta-3 receptor so that you can shut down your detracer muscles and stop having urge in Continence, I believe the drug is known as my betrach Excuse me my betrach in the in the US right so myra background because think about it if you're fighting or flighting You don't want to be peeing right so you want your detracer muscles to stop working So you want to give a beta-3 like like myra beger like myra beger all right now the most chronic receptors many people like to sweat M1 M2 M3 blah blah blah blah blah blah that level of detail is pretty much not utilized on the US M Ls Right, but what are the key things to know about the most chronic receptors number one when you stimulate them right?

That's gonna slow down the speed of conduction through your AV node right? That's literally gonna slow down the speed of conduction through your AV node That's an important thing to know for your exams number two with most chronic receptors is that we find them You know in the bladder right we literally find them in the bladder right they're part of literally your you know If you stimulate them that's gonna make your detracer muscles work better, okay? Literally if you stimulate them that's going to make your detracer muscles work better That's gonna make your detracer muscles work better right? So you can already begin to see them hmm. They may be useful in certain situations right They may be useful in certain situations. They may be useful in certain certain situations Now another thing you also find With most chronic receptors are another place you find most chronic receptors is in your earway is in your earway Is in your earway?

Actually when you stimulate them when you stimulate them that's actually gonna cause Your earway to close that's gonna cause bronchospasim that's gonna cause bronchospasim that's gonna cause bronchospasim Right that's gonna cause bronchospasim right and then remember if you stimulate your colonergic system You also find it in the you know in your GI tract that's gonna cause you to be pooping very nicely Right that's gonna increase your bowel movements that's gonna increase your bowel movements right so and then in the eye If you stimulate your colonergic receptors, right your pseudo-coloners receptors that's gonna cause Pupillary meiosis Pupillary meiosis gonna cause Pupillary meiosis gonna it's gonna cause Pupillary Construction okay.

It's gonna cause Pupillary Construction right so please just gonna keep that at the back of your mind as your Prepping for your exams right so for most chronic receptors don't forget your earway don't forget your your eyes right so when stimulated in your eyes because Pupillary Construction your earway because Bronco Construction right so you see the constructions kind of match in your heart The slow the speed of conduction through your IV node in your bladder They make your the troster muscles work better right make make sense rest and digest right is like think of yourself reading a newspaper calmly Right the make you poop and things like that right so those are high-yield things to know with your most Critic receptors now We know that also there's there's a kind of a pseudo-colon receptor that's the nicotinic acetylcholine receptor Honestly the only thing I'm gonna say about those nicotinic receptors are the following number one Those nicotinic acetylcholine receptors are the receptors you make auto-antibodies against in a person that has my stenegravis right so those auto-antibodies in my Stenegravis they are anti nicotinic acetylcholine receptor antibodies and then the other thing to know about the nicotinic acetylcholine Receptor is that that's gonna be the target of neuromuscular blocking agents when a person gets something like Rachoronium succino-colon and things like that they are targeting the nicotinic acetylcholine receptor all right So that's it with the receptors again I think just gonna get in that general overview is gonna be very helpful when we start out hitting out some of these drugs All right, so now let's get to the drugs again My goal with this podcast is to peel off fluff and give you the down-and-dirty you need for step two and step three All right, so let's start with the alpha one receptors, right?

So the the big things to know here number one we know the alpha one agonist like phenyl effrin and effedrin phenyl effrin and effedrin Right these things are very powerful alpha one agonist right so they are very good visual constructors What do we use them for we use them for nasal allergies? nasal nasal or allergies and other situations where you may see them used on your exams is if the person has If the person has like high-potention during surgery, right as a result of anesthesia You can give those alpha one agonist to cause visual construction and raise your blood pressure, right? Those are the big things to know about alpha one agonist for you exams now alpha one blockers, right? There's some big ones like a praesosin for example praesosin Presosin is an alpha one blocker the key is on your exams number one is for BPH right because by blocking those receptors You're gonna open up the bladder neck.

You're gonna be better easy for BPH right or if a person has hypertension and BPH That's a very good combination to use and then remember another good thing with alpha one blockers is like praesosin is you can use them for nightmares In people that have PTSD people that have PTSD right people that have PTSD Right and then you can also use alpha one blockers as for preoperative planning in people that have few chromosidumas Right, so remember when people have fields right and you want to treat them You need to block the alpha receptors first before you block the bladder receptors because you don't want that on opposed alpha one stimulation So you can give an alpha blocker for that purpose like praesosin or you can use another classic alpha one blocker like phenoxy Benzamin like phenoxy benzamin, okay? Like phenoxy benzamin so you can use praesosin or you can use phenoxy benzamin You can also use alpha one blockers right for a person that has cocaine intoxication Although typically if you have cocaine intoxication Ivy benzamin that is a piece of pretty helpful for treating that Adrenergic access, right now let's talk about alpha You know Alpha to receptors the big thing to know about alpha to receptors is clonidine clonidine clonidine clonidine clonidine clonidine clonidine Right clonidine is an alpha to agonist So think about if you stimulate you're gonna reduce no repineference production that clonidine is very very helpful to treat hypertension, right?

Although it's not a first-line medication for hypertension because there's this rebound effect Right if you stop it your blood pressure can rebound on the upper right pretty pretty good, right? Now don't forget that clonidine being an alpha To agonist is also used to money job It's also used to is like a Third-line medication right is like a third-line medication for managing ADHD, right? It's a third-line medication for managing ADHD That's something I want to know for you exams and then another alpha to agonist that you need to know is a method Dupa right again reduces no repineference production used to lower blood pressure especially in pregnant women, right?

It's one of those anti-hypertensives that are safe in pregnancy just like hydrozene Labeta law or naipheli-pine all right now in terms of alpha to blockers Well think about it if alpha to agonist reduce no repineference production alpha to blockers will Increase no repineference production because you're inhibiting and inhibitor So if you raise no repineference production, that'll be helpful in a person that is depressed right so drugs like meritazapine meritazapine MIRT AZ api and E Meritazapine is an alpha to blocker and by blocking alpha to receptors It raises no repineference production and that's helpful in depression and one other reason we love meritazapine is that it does No, have sexual side effects right and it can cause sedation it can cause weight gain and things like that So if you have an anorexic that's depressed Ritazapine is not a bad idea you can also do a lanza pin in those people all right and then you know the other thing I'm just gonna say is in terms of How do I put this like Fentula mean is another drug you've probably heard of you know with the alpha receptors Fentula mean is an alpha one and an alpha to blocker Right we use it to lower blood pressure, right?

You can use it to to lower blood pressure You don't like fields you can use it as your preoperative planning right sometimes you can use Fentula mean for adrenergic You know for hypertensive crises you know especially from like an me or you know that tiring crisis and things like that But again Fentula means step two step three something really go after very much all right And then let's get to the beta one receptors right so the beta one receptors the key things to know Don't forget nor a pin effort can go after a beta one receptors in fact let me tell you this Nor a pin effort hits three receptors. It hits alpha one Alpha two and Beta one alpha one alpha two and beta one although we care mostly about the alpha one effect right That's why we use nor a pin effort as the pressure of choice in septic shock in septic shock all right now Let's again continue down this and I guess I'm gonna be like define how about a pin effort? How about a pin effort?

Well a pin effort also hits alpha one and alpha two receptors right It also hits alpha one and alpha two receptors and then it also hits beta two receptors So remember what I said for a nor a pin effort nor a pin effort in those alpha one alpha two and beta one A pin effort in those alpha one and alpha two and beta two That's why we like a pin effort in a lot for an aphilaxis right because he opens up your early being a beta two Agonist being a beta two agonist right being a beta two agonist all right All right, all right, so let's continue right so beta one receptors big thing to know here Don't forget your do be the mean right do be the mean you can use it for cardiogenic shock because it's the least beta one receptors We can also use it as in the context of a pharmacologic stress test right to stimulate the heart If a person cannot exercise for whatever reason then you can stimulate the heart by giving to be the mean Which is a beta one agonist right and then beta one blockers you got to know these for your exams right Basically they all go from A to M A to M A to M right so drugs like a tenelol right Esmolol Acebito law metoprolol right and these drugs we like to use them Uh, you know if a person has heart failure especially metoprolol or be so pro law for example right metoprolol Be so pro law for example low carbide law we like to use those for heart failure remember beta blockers do improve survival in heart failure Right they do improve survival in heart failure they do improve survival in heart failure You're doing proof survival in heart failure and then remember the beta blockers that start from In going forward like pro pro law that's probably the big one to know for you exams um the block both beta one and beta two receptors and Big things to know about pro pro pro law you can use it for migraines on your exams right But pro pro law can also be used for t

hyroid storm Why because it reduces T4 to T3 synthesis in the conversion in the periphery by an enzyme known as a five prime Diogeny spend enzyme known as a five prime Diogeny's a five prime Diogeny's um So I would know these things about beta blockers.

Let me even actually kind of hit a few more beta blockers I think it's kind of helpful here um, so you know in terms of like beta two blockers You know, I know you're like divine you're kind of overlapping beta one and beta two.

So again, it through M The block only beta one And so like n for nc or later they block beta one and beta two right so some other beta blockers You miss your exams right you miss your things like timolo and needle law right we tend to use those for glaucoma Right for open angle glaucoma right because again remember your sympathetic system actually wants you to make iqs humor So if you make more iqs humor right that's gonna increase your intracular pressure So if you wanted to shut down iqs humor production you may want to go ahead and give something that decreases Uh, the sympathetic system you know system in the air like like a like a beta blocker right like a beta blocker like timolo or needle law Right in fact if you wanted to throw in something again, this is kind of low yield But with the alpha receptors this really the alpha two receptors You can give an alpha two agonist reducer in every production in the eye Which will then Cause a popularly meiosis and also reduce the qs humor production right these are drugs like a apracloneidine Ambremonidine apracloneidine and bremonidine those are alpha two agonist that you can use to manage Open angula glaucoma all right, so back to the beta blockers right so don't forget carvidi law Carvidi law and labid law they're kind of special because they are alpha beta blockers Alpha beta blockers right there alpha beta blockers carvidi law will use it primarily for heart failure Labid law is one of the safe anti hypertensives to use in pregnancy And labid law can also be useful hypertensive Emergencies can be useful hypertensive emergency and urgency all right now um, beta blockers don't forget you can also see them used on the usml's for Lowering your risk of having like varicies because they reduce portal pressures they reduce portal pressures Right they do certainly reduce portal pressures So know that for your exams and they

remember beta blockers you can use them for many arrhythmias like a feb You can use them as a form of rate control right although you can also use a non-dihydroperiodine calcium channel blocker Like verapameil or the ulti asm right you can use a feb for hro flotter right you can also use I mean sorry, you can use beta blockers for hro flotter as well I can also use beta blockers for people that have hypertrophic obstructive cardiomyopathy uh Beta blockers are very good for those people beta blockers also good for Migrants as I've mentioned they're very good for migraine perphylaxis right not for acute migraine management Obviously that's gonna be so much triptom around and sit right but also don't forget that beta blockers um besides being used for migraines um you can use them for uh divine come on what's this thing there's this other thing that kind of welled up in my mind um you can use them for It's a kind of tremor essential tremors exactly you can also use them for essential tremors You can also use them for essential tremors all right You can also use them for essential tremors right remember essential tremors and herithetian and autosomodonment and fashion right Know those for your exams and make sure you can contrast an essential tremor with a Parkinsonian tremor right I'll let you kind of move over that in your mind right and then in terms of uh beta A bit of two agonists right don't forget like you are but are all a bit of all Big things used for asthma right used for asthma used for COPD right because it opens up your earway And then also remember we can use a bit of oil as one of the things for managing hyper Right because a bit of oil also stimulates the sodium potassium ATP is pump Which brings three sodiums out of cells and puts two potassiums into cells right so by stimulating that pump You're gonna really lure your serum potassium when you lure seru

m potassium.

That's gonna cause hypochylemia Right something. I want to keep out the back of your mind for exams now in terms of the most chronic receptors Uh most chronic drugs. I will say you should know the most chronic receptor agonists right so things like Bethanico Or carbacol right Bethanico carbacol their most chronic Agonists right the most chronic receptor agonists and when you stimulate them right you can use them for like Ilias in the GI tract right you can use them for Ilias Or you can use them for situations where your the trussor muscles are not pulling their weight Or your the trussor muscles are not doing their job right like if a pressing for example has And your genic bladder right so we have overflowing continents you can give those most chronic agonists to stimulate things right So that those people can can start peeing right so they can start peeing right Another use for most chronic agonists on your exams is something like pylocarpin You can use it for close-down google coma It's gonna cause very rapid Construction of the popio and that's gonna lead to a very rapid ekeosumer drainage.

That's actually gonna reduce your intracurricular pressures Right and then one of the four my guess of most chronic agonists are gonna be your Acidoculin estriase inhibitors where acidoculin estriase inhibitors right so like for example like new stigmin right you You inhibit acidoculin estriase that's gonna raise your acidoculin levels when you raise your levels of acidoculin That's gonna be helpful for things again like Neurogenic bladder where pressing has overflowing continents with the trussor muscles are barely working Right, but new stigmin is also helpful for Ilias is also helpful helpful helpful for Ilias Right and you can also use new stigmin to reverse neuromuscular blocking agents because by inhibiting acidoculin estriase Your levels of acidoculin are gonna bump up and when you acidoculin levels bump up Guess what guess what you're gonna outcompete those neuromuscular blocking agents and reverse that neuromuscular paralysis Right and then don't forget that we use certain acidoculin estriase inhibitors like donepesial Or galanta mean or reverse stigmin to treat Alzheimer's because remember in Alzheimer's We have dysfunction of the basal nucleus of minert dysfunction of the basal nucleus of minert That's a nucleus. That's a nucleus.

That's a nucleus in the brain that makes acidoculin It tends to be dysfunctional in people that have Alzheimer's dementia people that have Alzheimer's dementia Right and then don't forget that you can get rid of my stinia grafts with pyridocetigmin Right because in my stinia grafts you make autoantibodies against the nicotinic acetyloculin receptor So if you want to bump of those autoantibodies you can try to increase acetyloculin at the neuromuscular junction by giving pyridocetigmin Which is an acetyloculin estriase inhibitor which will raise your levels of acetyloculin right and then don't forget that you can use Physos stigmin to fix an atropin overdose right remember atropin is a most chronic receptor and Tagonis most chronic receptor and tagonis right so if a person has atropin overdose you can try to Alcompidose effects of atropin by giving an acetyloculin estriase inhibitor like physo stigmin like physo stigmin So we use pyridocetigmin for my stinia grafts we use physos stigmin for atropin overdose and then if we're looking in terms of um um If we're looking in terms of um Urging continents where you're going to the restroom all the time all the time all the time all the time You know in fact sometimes we call that overactive bladder you can give a most chronic receptor and tagonis most chronic receptor and tagonis like what you can give stuff like You know, oxybutinine right or toterodine or daryphenacin or sulfenacinotrospia right those are most chronic receptor and tagonis that can Kind of shut down the the tissue from osmosols and prevent you from going to the bathroom all the time Prevent you from going to the bathroom all the time now another thing to know about anti-cholineurgics is that they can trigger Delirium ready can trigger delirium right and we tend to find many Drugs that may have other mechanisms of action, but oh, they can also trigger the ly

rium right so like for example Like you know for example like anti-psychotics especially the low potency first-generation anti-psychotics like clopermazine Those drugs they are anti-psychotics, but in addition they have like anti-muscularinic effects right they have anti-muscular nucleus f TCA is your tricyclic antidepressants also have the same issue right your tricyclic antidepressants right they have You know they're tricyclic antidepressants they prevent you know The riesocardicolamines, but they also have these anti-hamm effects right anti-H1 effects right so anti-histamine Conconstitution anti-alphone if they can cause orthostatic hypotension and then anti-muscularinic effects right so they can cause anti-choline Anti-cholineurgic toxic drop remember we're gonna treat that with sodium bicarbonate right and then remember that What else am I thinking of again these things are just kind of coming to mind as I'm talking through the spot cast but another thing you may see with Anti-cholineurgics right think of like these drugs that are code medicines right especially the first generation anti-histamine right like diaphin hydramine or Doxilamine or Diamond hydrinate diamond hydrinate these drugs are anti-histamine but they also block cholinergic receptors Right so you see a person taking cold medicine and then they have this acute change in mental status That person has probably developed some kind of delirium right and then finally with the most chrannic receptors Remember you can use anticolyenergics like diaphin hydramine or Ben strooping to treat to treat a person having um Acute dystonia remember acute dystonia is gonna be within the first few days of use Starting an anti-psychotic right and you have like this uh like stiffness of your neck and you know things like that I could dystonia you can manage that with anti-cholineurgics you can manage that with anti-cho

lineurgics Right and then don't forget nerve gas right souring nerve gas The way it's very dangerous is that nerve gas you know is an organophosphate It literally will inhibit acetylcholine ester is gonna raise your levels of acetylcholine and that can cause death very very Rapidly how do we rescue these people well because it's colonurgic excess you can give them um um Atroping first that's a most chrannic antagonist and then after that you're gonna give them pretty doxing pretty doxing can help you Regenerate it can help us regenerate acetylcholine that is uh acetylcholine ester is that has been messed up acetylcholine ester is that has been messed up by the organophosphate All right, so I think I'm gonna go ahead and stop here again.

There are other uses for these drugs But I'm telling you that what I focused on here is the down and dirty you need to know for you exams Again, this podcast will probably get you like Probably like almost ten questions right on you exams. So just listen to it Make sure you know this and I think you've been good cheap and then As I wrap up if you love the way I teach you're gonna love my classes You know starting next week Tuesday have an nb-metastic in strategies class on Wednesday I have a bio statistics class for four hours on Thursday I have a five-hour social sciences quality improvement hospital medicine and uh ethics class Those classes are all first step one two step three um and then on Friday I have a last-minute review for step two and step three Many people take this class and they find it to be extremely helpful And then the week after that from Monday to Friday I have a 20-hour step two step three review again Many people have taken these classes and found them to be very very helpful. I have literally had Many like and this is like recent exams right exams people took like within the past month Have had people getting the 270s 260s 250s, you know very high scores from taking my classes Again, they're really well put together. I'll tell you that and they're all over zoom If you're interested shoot me an email.

I can give you some more information And then also for one or one two-drain for all the usmly and complex exams And then I help with era's applications I know we're kind of jumping into era season. So like personal statements, recommendation letters, mocking reviews editing your applications editing your personal statements and all those things. Those are all services that I offer Again, I've worked with lots of people that are attendants, residents and specialties literally like all over the country I have tons and tons of experience with this process And then I also have another website called divineinterventionlifelessons.com The vininginterventionlifelessons.com every week I post like two or three podcasts where from a biblical perspective Address a life lesson. There's actually an Apple podcast associated with that called the divine intervention life lessons podcasts podcast So thank you for listening to me today and um again, just check out my youtube channel check out divineinterventionpodcast.com And don't forget that this podcast on apple google and Spotify all right So thank you for listening to me today. I will see you in episode 610 god willing have a wonderful day God bless you and bye for now. Thank you

Vasoconstriction (increasing afterload) and venoconstriction (increasing preload). They are also found at the bladder neck.

Alpha-2 receptors. Stimulation reduces norepinephrine production, making it an effective agent for treating hypertension.

Increased risk of acute angle-closure glaucoma because dilation reduces aqueous humor drainage.

Propranolol. It blocks $\beta_1$ and $\beta_2$ receptors and has anti-migraine properties.

1) Treating Myasthenia Gravis by increasing acetylcholine at the neuromuscular junction. 2) Reversing neuromuscular blocking agents.

Muscarinic receptors (Cholinergic system). This is part of the "rest and digest" response.

Treating Benign Prostatic Hyperplasia (BPH) by relaxing the bladder neck, managing hypertension, and treating PTSD nightmares.

$\alpha_2$ agonists like Brimonidine or Apraclonidine.

Alzheimer's disease, by increasing acetylcholine levels and compensating for basal nucleus dysfunction.

Methyldopa (or Clonidine/Moxonidine).

1) Reversing atropine overdose. 2) Treating Myasthenia Gravis (though Neostigmine is often preferred).

The vagus nerve/parasympathetic system.

Urinary retention (due to detrusor muscle relaxation) and potential for delirium.

Treating Benign Prostatic Hyperplasia (BPH) by relaxing the bladder neck, managing hypertension, and treating PTSD nightmares.

$\alpha_2$ agonists like Brimonidine or Apraclonidine.

Alzheimer's disease, by increasing acetylcholine levels and compensating for basal nucleus dysfunction.

Methyldopa (or Clonidine/Moxonidine).

1) Reversing atropine overdose. 2) Treating Myasthenia Gravis (though Neostigmine is often preferred).

The vagus nerve/parasympathetic system.

Urinary retention (due to detrusor muscle relaxation) and potential for delirium.