Publisher Summary This chapter discusses drugs affecting autonomic functions or the extrapyramidal system. A report describes an autonomic dysreflexic syndrome following the use of an isometheptene combination to treat migraine. Repeated use of an oxymetazoline nasal spray has been associated with changes in fetal heart rate demonstrated as a non-reactive, non-stress test and late decelerations in a patient at 41 weeks of gestation. Six hours after the last dose these changes gradually disappeared. Bitolterol is one of the more recent β2- adrenergic agonists. It is a prodrug which, when inhaled, is activated within the lung by esterase hydrolysis to the active compound, colterol. The effects and side effects of Tulobuterol, a fl2- adrenergic stimulant drug, have been reviewed. Side effects reported in the studies are similar in type, incidence, and severity to those reported for other drugs within this group, the most common being tremor and palpitations. Other side effects include headache, dizziness, vertigo, heartburn, jitteriness, and nervousness. Ibopamine is a another orally active dopamine derivative that has been studied in patients with congestive heart failure.