Cholinergic Flashcards
Acetylcholine (ACh)
Amine type: Quaternary
Receptor: Muscarinic
Uses: Rapid miosis, cataract surgery
Direct effects:
- vasodilation (M3)
- dec. cardiac rate (M2)
- dec. rate of conduction SA & AV (M2)
- dec. contractile force (M2)
Low dose:
- vasodilation (M3)
- reflex tachycardia
- Inc. HR
- dec. MAP & PVR
High dose:
- vasodilation (M3)
- bradycardia (M2)
- dec. HR, MAP & PVR
Bethanechol
Amine type: Quaternary Receptor: muscarinic agonist Use: - urinary bladder atony - post-op & postpartum urinary retention
Carbachol
Amine type: quaternary Receptor: muscarinic agonist Uses: - Miosis - Reduces intraocular pressure after cataract surgery
Methacholine
Amine: quaternary
Receptor: muscarinic agonist
Use:
- diagnosis of bronchial airway hyperreactivity
Pilocarpine
Amine: tertiary Receptor: partial muscarinic agonist Use: - Acute angle-closure glaucoma (second line) - Dry mouth, radiotherapy - Dry mouth, Sjorgen's syndrome
Nicotine
Amine: tertiary
Receptor: selective agonist
Use:
- smoking cessation therapy
Low dose:
- ganglionic stimulation by depolarization
CV system: (sympathomimetic)
- inc. HR & BP
GI & Urinary tracts: (parasympathomimetic)
- nausea
- vomiting
- diarrhea
- voiding of urine
Secretions:
- stimulate salivary & bronchial
High doses:
- ganglionic blockade & neuromuscular blockade
Edrophonium
Amine: quaternary Receptor: reversible Use: - diagnosis of Myasthenia Gravis - reverse neuromuscular block
Physostigmine
Amine: tertiary
Receptor: NMJ
Use:
- overdoses of anticholinergic drugs
Neostigmine
Amine: quaternary Receptor: NMJ Use: - postop urinary retention - neuromuscular blockade reversal after surgery - Myasthenia gravis
Pyridostigmine
Amine: quaternary
Receptor: NMJ
Use:
- Myasthenia gravis
Echothiophate
Amine:
Receptor:
Use:
- glaucoma, rarely
Malathion
Amine:
Receptor:
Use:
- insecticide
Sarin
Amine:
Receptor:
Use:
- synthetic toxic agent
Alzheimer Disease, mainstay therapy
AChE Inhibitors:
- Donepezil
- Rivastigmine
- Galantamine
- Pralidoxime (split phosphorus-enzyme bond)
Atropine
Amine: tertiary Receptor: M2/M3 antagonists Use: - antispasmodic (GI & bladder) - antidote for cholinergic agonists - dec. respiratory secretions prior to surgery