Cholinergic Agonists and Antagonists Flashcards
Nicotine
- activation of neuronal nicotinic receptors
- Rx= withdrawal symptoms of smoking cessation
succinylcholine
- depolarizing block of muscle nicotinic receptors
- E by butyrl cholinesterase
- Rx= neuromuscular block for electroconvulsive shock therapy or emergency intubation
acetylcholine
- 150 ms half life
- nicotinic and muscarinic agonist
- E by AChE
- Rx = none
metacholine
- muscarinic agonist
- Rx= diagnosis of subclinical asthma or to test for the severity of asthma
carbachol
- muscarinic and nicotinic receptor agonist
- Rx= miotic agent in ocular surgery, to reduc pressure following ocular sugery
bethanechol
- muscarinic agonist
- Rx= urinary retention, bladder atony
pilocarpine
- 1 hr half life
- muscarinic agonist
- Rx= dry mouth from head and neck radiation, narrow angle glaucoma
- crosses BBB
neostigmine
- AChE inhibitor
- Rx = myasthenia gravis, reverse neuromuscular block
- doesn’t cross BBB
edrophonium
- 10 min half life
- AChE inhibitor
- Rx= Diagnosis of myasthenia gravis, reversal of neuromuscular block
Physostigmine
- reversible AChE inhibitor
- Rx = delirium from anticholinergic drugs, glaucoma
- crosses BBB
donepezil
- reversible AChE inhibitor
- Rx = Alzheimers Dx
- crosses BBB
Pralidoxime
-also called 2-PAM
75 min half life
-Peripheral AChE reactivator
-Rx= respiratory muscle weakness in organophosphate poisoning
Echothiophate
- very long half life
- irreversible AChE inhibitor
- Rx = open angle glaucoma
Atropine
- muscarinic antagonist
- Rx = excess secretions during surgery, the incr freq and urg associated with cystitis, hypertonic gut, organophosphate poisining, bradycardia
scopolamine
- muscarinic agonist
- Rx = motion sickness, anti-salilagogue in surgery
glycopyrrolate
- muscarinic receptor antagonist
- Rx= protects against excessive muscarinic activation during reversal of neuromuscular blockade, anti-salilagogue
Symptoms of organophosphate toxicity
DUMBBELS Diarrhea Urination Miosis Bradycardia Bronchorrea Emesis Lacrimation Sweating Salivation
Atropine poisoning
Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone
