Cholinergic Drugs Flashcards
Bethanechol, Carbachol
Muscarinic agonist
Effects GI and GU (BLADDER)
Tx to prevent urinary retention postop/postpartum
Adverse effect: overstimulation of mACh receptors
Pilocarpine
Muscarinic agonist
Used topically to treat glaucoma, mitotic agent to increase outflow of aqueous humor
Tx for xerostomia, selective for salivary glands – Sjorgren’s Syndrome
Cevimeline
Muscarinic agonist
Tx for Sjorgren’s Syndrome – lacrimation and salivation
Antimuscarinic drugs
atropine, scopolamine, ipratropium, tolterodine, oxybutynin
Physostigmine given for overdose
Tolterodine
Anti-muscarinic
Used to treat urge incontinence
Oxybutynin
Anti-muscarinic
Used to treat urge incontinence
Atropine
Muscarinic ACh receptor blocker
Given for overdose of ChE inhibitors (physostigmine)
Treatment for organophosphate cholinergic toxisyndrome
Physostigmine
ChE inhibitor
Binds to esteratic site
Used to treat myasthenia gravis, Alzheimer’s, dementia, and glaucoma
Given for overdose of muscarinic agonists
Penetrates CNS
Edrophonium
Cholinesterase inhibitor, short-acting (‘Ed’ is short name)
Used to test for myasthenia gravis
Binds to choline “anionic” site
Aka Tensilon
Neostigmine, Pyridostigmine
ChE inhibitor
Binds to esteratic site
Quad structures that cannot penetrate the CNS
Used to treat myasthenia gravis
Given postop to reverse NMJ blocking agents
Diazepam
Anti-convulsant used to treat organophosphate cholinergic toxisyndrome
Varenicline
Nicotinic partial agonist
Outcompetes full agonist
Ganglionic stimulating agent
Tubocurarine
Neuromuscular junction blocking agent
Used in surgery to promote SKM relaxation
Long duration
Non-depolarizing (competitive)
Succinylcholine
Neuromuscular junction blocking agent
Depolarizing (non-competitive)
Binds to nACh receptor with higher affinity
May produce life threatening hyperkalemia or malignant hyperthermia (give dantroline as antidote)
Pancuronium
Neuromuscular junction blocking agent
Intermediate duration
Non-depolarizing (competitive)
