Cholinergic Drugs Flashcards by Sarah Gillen

Acetylcholine

Direct acting cholinomimetic

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Bethanechol

Direct acting cholinomimetic

Activates bowel and bladder smooth muscle; resistant to AChE

Treats post-operative ileus, neurogenic ileus, and urinary retention

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Carbachol

Direct acting cholinomimetic

Constricts pupil and relieves intraocular pressure in open-angle glaucoma

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Ambenonium

Cholinesterase inhibitor

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Methacholine

Direct acting cholinomimetic

Stimulates muscarinic receptors in airway when inhaled

Used as a challenge test for diagnosis of asthma

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Donepezil

Cholinesterase inhibitor

Increases ACh

Treats Alzheimer disease

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Echothiophate

Cholinesterase inhibitor

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Cevimeline

Direct acting cholinomimetics

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Edrophonium

Cholinesterase inhibitor

Increases ACh

Extremely short acting, historically used in diagnosis of MG

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Pralidoxime

Cholinesterase regenerator

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Galantamine

Cholinesterase inhibitor

Increases ACh

Treats Alzheimer disease

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Pilocarpine

Direct acting cholinomimetic

Contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE

Potent stimulator of sweat, tears, and saliva, treats glaucoma and xerostomia (Sjogren’s syndrome)

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Neostigmine

Cholinesterase inhibitor

Increases ACh; No CNS penetration (quaternary amine)

Treats postoperative and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade postoperatively

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Physostigmine

Cholinesterase inhibitor

Increases ACh — fixes atropine overdose

Used for anticholinergic toxicity; crosses BBB into CNS (tertiary amine)

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Pyridostigmine

Cholinesterase inhibitor

Increases ACh; increases muscle strength

Treats MG (long acting); does not penetrate CNS (quaternary amine)

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Rivastigmine

Cholinesterase inhibitor

Increases ACh

Treats Alzheimer disease

Tacrine

Cholinesterase inhibitor

Varenicline

Direct acting cholinomimetic

Antimuscarinic drugs used for motion sickness

Scopolamine

Antimuscarinic drugs used for GI disorders

Atropine
Dicyclomine
Glycopyrrolate
Hyoscyamine

Antimuscarinic drugs used in ophthalmology

Atropine
Cyclopentolate
Homatropine
Scopolamine
Tropicamide

Produce mydriasis and cycloplegia

Antimuscarinic drugs used for respiratory disorders (asthma, COPD)

Ipratropium

Tiotropium

Antimuscarinic drugs used for urinary disorders

Darifenacin
Fesoterodine
Oxybutynin
Solifenacin
Tolterodine
Trospium

Antimuscarinic drugs used for cholinergic poisoning

Atropine (+pralidoxime)

Antimuscarinic drugs used for movement disorders

``` Benztropine Biperiden Orphenadrine Procyclidine Trihexyphenidyl ``` Benztropine treats Parkinson-associated acute dystonia

Mecamylamine

Ganglion blocker

Symptoms of cholinesterase inhibitor poisoning

DUMBBELSS ``` Diarrhea Urination Miosis Bronchospasm Bradycardia Excitation of Skel.M.+CNS Lacrimation Sweating Salivation ```

Antidote to cholinesterase inhibitor poisoning

Atropine (competitive inhibitor) + Pralidoxime (regenerates AChE)

Clinical use of glycopyrrolate

Glycopyrrolate used parenterally in post-op to reduce airway secretions; oral glycopyrrolate treats drooling and peptic ulcers

Clinical uses for hyoscyamine, dicyclomine

Antispasmodics for IBS

Clinical use of ipratropium, tiotropium

Treats COPD, asthma

Clinical use of oxybutynin, solifenacin, tolterodine

Reduce bladder spasms and urge urinary incontinence (overactive bladder)

Actions of atropine on the eyes, airway, stomach, gut, and bladder

Eye - increased pupil dilation, cycloplegia Decreased airway secretions Decreased gastric acid secretion Decreased gut motility Decreased urgency in cystitis

Adverse effects of atropine

``` Hot as a hare Dry as a bone Red as a beet Blind as a bat Mad as a hatter ```