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