Cholinergic Drugs Flashcards
What are cholinergic drugs?
Drugs that stimulate the parasympathetic system
What are the two types of cholinergic receptors?
Nicotinic receptors
Muscarinic receptors
What’s the difference between nicotinic and muscarinic?
Nicotinic are located in the ganglia of sympathetic and parasympathetic systems
Muscarinic is located postsynaptically in the effector organs of the parasympathetic system
What are the effector organs of the parasympathetic system?
Smooth muscle
Cardiac muscle
Glands
What is the MOA of direct acting cholinergic agonists?
They bind to cholinergic receptors and activate them
What is the MOA of Indirect-acting cholinergic agonists?
Inhibit the enzyme acetylcholinesterase, which break down ACh
What are the 2 categories of Cholinesterase inhibitors?
Reversible: Short period of time
Irreversible: Bind for a long time and form a permanent covalent bond.
What are the drug effects of cholinergic drugs?
Increased gastric secretions, GI motility, urinary frequency
Constriction of pupils and reduced intraocular pressure
Increased salivation and sweating
Decreased HR and vasodilation
Bronchial constriction and narrowed airways
What can happen when high doses of cholinergics are administered?
They stimulate nicotinic receptors
At recommended doses, they should stimulate muscarinic receptors
What is the indication of pilocarpine?
Glaucoma and intraocular pressure
What is betachenol? (MOA, ID, forms)
Increases tone and motility of bladder and GI tract, relaxes sphincters in bladder and GI tract
ID: Postsurgical atony of bladder and GI tract
Forms: PO, SQ
What is succinylcholine?
Neuromuscular blocker in general anesthesia
What is an example of an indirect-acting cholinergic drug thats used for diagnosis and treatment of myasthenia gravis and what is it also used for?
Physostigmine
Reversal of neuromuscular blocking drugs
Reversal of anticholinergic poisoning
It causes skeletal muscle contractions
What is an example of an indirect-acting cholinergic drug thats used for treatment of mild to moderate Alzheimers?
Donezepil
What are the CIs of cholinergic drugs?
GI or GU tract obstruction
Bradycardia
Defects in cardiac impulse conduction
Hyperthyroidism
Epilepsy
Hypotension
COPD
Parkinson’s
What are the adverse effects of cholinergic drugs?
A result of overstimulation of parasympathetic system
Convulsions, ataxia, Abdominal cramps, Bronchospasms, lacrimation, sweating, salivation, miosis
What is SLUDGE?
Salivation
Lacrimation
Urinary retention
Diarrhea
GI cramps
Emesis
What are the early signs of a cholinergic crisis?
Cramps, salivation, flushing of skin, N/V, Transient syncope, transient heart block, Dyspnea, and orthostatic hypo
What is the drug of choice for early treatment of a cholinergic crisis?
Atrophine sulphate
What is the drug of choice for severe treatment of a cholinergic crisis?
Epinephrine
What are the possible interactions of cholinergics?
Anticholinergics, antihistamines, sympathomimetics
What are the direct uses of Bethanechol?
Treatment of acute postop and postpartum nonobstructive urinary retention
Management of urinary retention associated with neurogenic atony of the bladder
What are the two indirect-acting cholinergic drugs used to diagnose myasthenia gravis?
Pyridostigmine
Edriphonium
What is Ginkgo? (ID, AE, IE)
ID: Prevention of memory loss, vertigo, tinnitus
AE: GI upset, headache, bleeding
IE: Aspirin, NSAIDs, Anticoagulants, anticonvulsants
