Cholinergic Drugs Flashcards
1
Q
Mech of action (Direct)
A
- Mimic action of acetylcholine
- Binds to cholinoceptors
- Muscarinic Agonists
2
Q
General uses
A
- Opthalmic exmination
- glaucoma treatment
- xerostomia (dry mouth)
- supraventricular tachycardia
- antimuscarinic poisoning
3
Q
Contraindications
A
- Asthma
- Ulcers
- GI obstruction
- urinary obstruction
- Parkinson’s
- AV block
- bradycardia
- Surgery
- Seizures
4
Q
Adverse effects
A
- Systemic:
- Sweating
- Salavation
- Flushing
- Decreased BP
- Nausea
- Abdominal Pain
- Diarrehea
- Brochospasm
- Localized: (EYE)
- Visual Diff on far vision in dim light
- Reddening, stinging, & burning of conjuctiva
- Postopreative iritis
- Cataracts (long term)
- Retinal detachment (long term)
5
Q
Acetylcholine (Choline Ester)
A
- NT-not therapeutically effective, has nicotinic & muscarinic actions
- Iactivated by cholinesterases
- Effects:
- Decreased HR & CO
- Decreased BP
- Stims intestinal secretions of motility
- Uses:
- Intraocular during cataract surgery for RAPIS miosis
6
Q
Bethanechaol (Choline Ester)
A
- No nicotinic activity
- Duration of action 2hrs
- NOT easily inactivated by acetylcholinesterase
- Effects:
- Increased motility & tone in GI
- Stimulates detrusor muscles of bladder
- Used:
- Postpartum or postoperative nonobstructive urinary retention
7
Q
Carbachol (choline ester)
A
- Duration of action 1hr
- NOT easily inactivated by acetylcholinesterase
- Effects:
- CV/GI stimulation & followed by depression
- NOT useful SYSTEMICALLY
- Nicotinic action (epi released from adrenal medulla)
- Pupillary constriction & decreased intraocular pressure
- Uses:
- Locally in eye to treat glacucoma (interocular hypertension)
8
Q
Pilocarpine (naturally occuring alkaloid)
A
- Hydrolysed by acetycholinesterase
- Duration of action 2hours
- Effects:
- Less potent than acetylcholine
- Penetrates CNS-PROFUSE sweating & salivation
- Uses:(topically in opthalmology)
- Rapid miosis & contraction of ciliary muscle
- Immediate drop in intraocular pressure (glaucoma)
- Treat pts w/xerostomia (dry mouth)=promotes salivation
9
Q
Succinylcholine (Choline Ester)
A
- High affinity for nicotine cholinoreceptors
- Resistant to acetylcholinesterase
- Nicotonic receptors agonist
- Effects:
- Paralysis during surgery via depolarizing blockage
- Given prior to surgery intubation
- Pharmokinetics:
- Highly polar
- IV
10
Q
Nicotinic Agonists
A
- Nicotine:
- No therapeutic indications=UNLESS given as path for smokers to stop
- Stimulates ALL ganglia & Neuromuscular junctions
- VERY TOXIC
- Chronic exposure:
- Tolerance
- Cardio abnormalities
- Ulcers
11
Q
Varenicline
A
- MOA: Partial nicotonic receptor agonist
- Clinical uses: Stop smoking
- Adverse Rxns:
- Hypertension
- sweating
- sensory disturbance
- diarrhea
- polyuria
- menstrual disturbance
