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The flashcards below were created by user
jld15
on FreezingBlue Flashcards.
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Cholinergic Drugs
Affects synapses using acetylcholine as a neurotransmitter
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Two categories of cholinergic drugs
- Cholinergic stimulants
- ----Increase activity at the Ach synapse
- Anticholinergic drugs
- ----Decrease activity at Ach synapse
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Muscarinic receptors
- Located on peripheral tissue supplied by parasympathetic postganglionic neuron
- GI
- Urinary bladder
- Heart
- Eye
- Ach synapses in CNS
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Nicotinic receptors
- Located in the autonomic ganglia (NN)
- skeletal neuromuscular junction (NM)
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The issue of specificity of cholinergic receptors
- Some drugs bind to specific receptors, others indiscriminately to all cholinergic receptors
- Specific are better bc less side effects
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Cholinergic Stimulants
- Increase activity at acetylcholine synapses
- Direct acting
- Indirect acting
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Direct-acting cholinergic stimulants
- Muscarinic stimulants primarily affect peripheral tissues
- Specific, More beneficial
- Nicotinic (in autonomic ganglia and skeletal neuromuscular junction)
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Direct acting cholinergic stimulants Primary clinical use:
- GI and urinary atony
- ----Increase contractions (especially after surgery)
- Glaucoma
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Indirect-acting cholinergic stimulants
- Allows more acetylcholine to remain at the synapse
- ----Prevents destruction of Ach in synaptic cleft
- ----Cholinesterase inhibitors
- ----Anticholinesterase agents
- Lack of specificity
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Indirect acting cholinergic stimulants primary clinical use:
- Myasthenia gravis
- Glaucoma
- Dementia
- Reversal of neuromuscular blocking agents
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Alzheimer disease cholinergic drugs
- Prevent Cholinergic neurons degradation
- ----Critical for memory, cognition
- Indirect cholinergic stimulants decrease symptoms
- ----Inhibit break down of Ach, prolonging effects of release
- Drugs
- ----donepezil (Aricept)
- Gastrointestinal and urinary bladder atony cholinergic drugs
- Cholinergic agonists stimulate smooth muscle contraction
- Direct acting vs Indirect acting
- ---- indirect acting used Most frequently
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Glaucoma cholinergic drugs
- Cholinergic stimulation via parasymp increases outflow of aqueous humor preventing excessive accumulation
- Direct or indirect stimulants
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Myasthenia gravis cholinergic drugs
Allow endogenous Ach release from presynaptic terminal to remain in junction for longer prior of time allowing for adequate excitation of SM
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