Ch 19 1 Pharm

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Author:
jld15
ID:
303924
Filename:
Ch 19 1 Pharm
Updated:
2015-06-10 17:45:46
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19 Pharm
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Ch 19 1 Pharm
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  1. Cholinergic Drugs
    Affects synapses using acetylcholine as a neurotransmitter
  2. Two categories of cholinergic drugs
    • Cholinergic stimulants
    • ----Increase activity at the Ach synapse
    • Anticholinergic drugs
    • ----Decrease activity at Ach synapse
  3. Cholinergic Receptors
    • Muscarinic
    • Nicotinic
  4. Muscarinic receptors
    • Located on peripheral tissue supplied by parasympathetic postganglionic neuron
    • GI
    • Urinary bladder
    • Heart
    • Eye
    • Ach synapses in CNS
  5. Nicotinic receptors
    • Located in the autonomic ganglia (NN)
    • skeletal neuromuscular junction (NM)
  6. 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
  7. Cholinergic Stimulants
    • Increase activity at acetylcholine synapses
    • Direct acting
    • Indirect acting
  8. Direct-acting cholinergic stimulants
    • Muscarinic stimulants primarily affect peripheral tissues
    • Specific, More beneficial
    • Nicotinic (in autonomic ganglia and skeletal neuromuscular junction)
  9. Direct acting cholinergic stimulants Primary clinical use:
    • GI and urinary atony
    • ----Increase contractions (especially after surgery)
    • Glaucoma
  10. 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
  11. Indirect acting cholinergic stimulants primary clinical use:
    • Myasthenia gravis
    • Glaucoma
    • Dementia
    • Reversal of neuromuscular blocking agents
  12. 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
  13. Glaucoma cholinergic drugs
    • Cholinergic stimulation via parasymp increases outflow of aqueous humor preventing excessive accumulation
    • Direct or indirect stimulants
  14. 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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