Cholinergic Agonists - direct acting

Question 1

M- and N- cholinomimetics

Answer 1

Acetylcholine Chloride

Cabachol

Question 2

M- cholinomimetics

Answer 2

Pilocarpine
Muscarine
Bethanechol

Question 3

Acetylcholin [ACETYLCHOLINE CHLORIDE]

Answer 3

4• amine

Lack therapeutic importance due to its multiple action and rapid inactivation by cholinesterases

Used to produce miosis in ophthalmic surgery

Effects:

1) decrease heart rate and cardiac output
2) decrease blood pressure
3) miosis, ⬆️ salivation, intestinal motility, bronchorrhea, urination

Question 4

Pilocarpinum [PILOCARPINE]

Answer 4

Glaucoma

3• amine

uncharged - lipophilic

CNS penetration

Stable to hydrolysis of AchE

• reduces IOP in open-angle and narrow-angle glaucoma

Question 5

Muscarin

Answer 5

Natural product found in the mushroom species:

Inocybe

Clitocybe

Muscarinic spectrum of action

Question 6

Carbacholin [Jestryl, CARBACHOL]

Answer 6

4• amine

Produce miosis during ocular surgery

Used topically to reduce IOP in open-angle or narrow angle glaucoma, particularly in patients who have become tolerant to pilocarpine

Question 7

Bethanechol

Answer 7

Used in the treatment of urinary retention