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  1. Parasympathetic Activation Clinical Effects
    • -Nonvascular SM contraction
    • -Increase intestinal motility (GI/abdominal cramps)
    • -Increase bladder motility (urinary incontinence)
    • -Increase bronchiolar & alveolar contraction (shortness of breath)
    • -Contraction of ciliary eye muscle (constricted pupil)
    • -Increase exocrine gland secretion (sweat, tears, saliva)
  2. Choline esters
    -Bethanechol (Urecholine)

    -Carbachol (Isopto-Carbachol)
  3. Direct Acting Cholinergic Agonists (sub-classes)
    • -Choline Esters
    • -Alkaloids
  4. Bethanecol (Urecholine)
    • Type: Choline ester; (Cholinergic Agonist)
    • Route: SQ, PO
    • Tx for: prolonged urinary retention

    Note: "usually in response to anesthesia, but not really; if anatomical problem, don't use b/c can rupture bladder"
  5. Carbachol (Isopto-Carbachol)
    • Type: Choline ester; (Cholinergic Agonist)
    • Route: ophthalmic (Top?)
    • Tx for: glaucoma

    Note: DON'T use cholinergic blocker (anticholinergic) for glaucoma
  6. Alkaloids

  7. Nicotine
    • Type: Alkaloid cholinergic agonist
    • Route: patch (top); PO, spray; No chew b/c bad AEs
    • Tx for: quit smoking
  8. Pilocarpine
    • Type: Alkaloid cholinergic agonist
    • Route: opthalmic (top)
    • Tx for: glaucoma
  9. Indirect Cholinomimetics (=agonist)
    Mechanism of action = cholinesterase inhibitors

    Reversible vs. Irreversible types

    Strong parasympathetic action

    NMJ for skeletal muscle (independent from parasympathetic action)

    Clinical uses: Myasthenia gravis, glaucoma
  10. Pyridostigmine (Mestinon)
    Reversible indirect-acting, cholinergic agonist

    Tx: Myasthenia gravis
  11. Physostigmine
    Reversible, Indirect-Acting, Cholinergic agonist

    Tx: Myasthenia gravis
  12. Neostigmine
    Reversible, Indirect-Acting, Cholinergic agonist

    Tx: reverse neuromuscular blockade used in anesthesia
  13. Edrophonium
    Reversible, Indirect-Acting, Cholinergic agonist

    Tx: diagnostic tol for Myasthenia gravis
  14. Organosphosphates (Malathion)
    IRREVERSIBLE, Indirect-Acting, Cholinergic agonist

    pesticide in agriculature; prone to accidental poisoning

    • Note: use Pralidoxime to help counteract effects by regenerating cholinesterase
    • troops get syringe of atropine + pralidoxime for chem warfare
  15. Anticholinergic (cholinoreceptor blockers) Clinical Effects
    • -Decreased contraction of non-vascular SM
    • -Contraction of sphincters
    • -Decrease in exocrine gland secretions
    • -Relaxation of ciliary eye muscle
    • = constipation, dry mouth, dilated pupils/blurry vision, urinary retention
Card Set:
2010-09-01 05:51:34
Drugs Parasympathetic Cholinergic Anticholinergics

Parasympathetic Drugs
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